NICU Nurses! Some advice & recommendations needed!

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    To all the nicu nurses out there! I'm going to be a new hire here soon and wanted to get some pointers before my start date. What I'm acutally looking for here is info that will prepare me for things that will happen in the nicu! Like can i learn beforehand ... procedures ...disease processes .. common nursing diagnosis's .. different machinery used in the nicu .. advice ..recommendations and anything else i could be missing! pros/cons working in this unit!! would love to hear from u guys! even though they are going to orient me, i just don't want to look stupid not knowing anything!!
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    handbook of neonatal intensive care (paperback) by [color=#003399]gerald b. merenstein md faap (author), [color=#003399]sandra lee gardner rn ms cns pnp (author)

    its full of loads of information, but honestly you'll just learn how your unit does things. all units do things so very very differently it'll be a learning process.

    pros i love my babies & what i do. i love how my old unit did things, very structured, it was very into parent/infant bonding etc.

    cons-realize that some kids die its just reality, it isn't always happy, & your going to see & hear about all kinds of bad/interesting things. children have an unimaginable will to live sometimes. i think they deal with more pain & have more will to live than any adult sometimes would ever be able to handle.
    tralalaRN likes this.
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    be patient and kind.

    most everyone in the hospital has a family who is under stress and most everyone knows what it's like to deal with those family members, but having a child or newborn in the hospital is a different ballgame. they're fragile, scared, desperate, angry at the world (maybe even God), and you might be the only person in sight when their emotions are running wild. if you have a child this might be easy for you to understand. i'm not saying all parents will be rude, or that there's any reason for them to be - i'm saying that YOU can make a really difficult time a little easier by being patient and kind. hopefully all nurses are patient (to some degree) and kind to all patients, but it's especially important in NICU in my opinion. to some extent the parents ARE the patients, but since they aren't lying in the hospital bed, they don't always get the same compassion as someone who is. they need all the kindness they can get so remember that especially when you're stressed, hungry, tired, etc. i guarantee you they are too.
    babiesRmylife and tralalaRN like this.
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    Please, please do not EVER tell a parent of a tiny preemie (under 28 weeks) that they will catch up by age 2. Many never will catch up.

    I agree with the poster above, it's not just the baby who is the patient, but the parents too. They are terrified for the present and most certainly for the baby's and their future. Get parents connected to support groups. Only other parents who have been through this can truly understand the magnitude of the emotions involved. Many parents whose babies have long term NICU stays show s/s of PTSD later on. Support them to help minimize the trauma.
    babiesRmylife likes this.
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    agree with all the above! I also want to add that with kids that stay in the unit for a long time, you become like family sometimes to these parents. You ride the roller coaster with these children & their family & sometimes you better understand what these parents are going through better then their families.

    They will talk to you about all kinds of things if you allow yourself to be open to listen & actually talk to them. Never see yourself as better, etc. I couldn't imagine ever having a baby in the NICU. I mean thats the 1 unit NOBODY usually plans on being.

    I know that a lot of the kids I've taken care of over the years have become just like my own sometimes. When your passionate about what you do, the parents can tell, & they feel much better about leaving their precious little life in your hands. I've become good friends with some of the parents & had the pleasure of seeing the kiddos as they grow up. Its amazing!
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    Moved to NICU forum
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    I would recommend getting very good at interpreting blood gasses and lab values. Not only knowing how to interpret them, but going one step further and thinking about the vent settings that will be changed based on blood gasses etc. I feel like I spend alot of time explaining these things to parents. Also know your different forms/types of ventilation (conventional, HFOV, CPAP, Sci-Pap, etc).

    Any type of respiratory diseases as well as GI disorders are going to be common. Get good at recognizing what is normal and it will make it easy to pick up on the abnormal.

    Never, ever be afraid to speak up for your patient. Sometimes you are the one that knows whats best for your patient and you have to be firm and demand what you think your patient needs even if the medical team disagrees with you, you will gain alot of respect among physicians and others when you are able to master this skill.

    Pros: Seeing a sick kid come in and progress and make it to the point where they can go home......Also when one of your patient gives you a little smile after a long shift letting you know they appreciate the care you gave them.

    Cons: Kids not getting to go home, kids passing away. You will see some very disturbing things in the NICU things that will give you nightmares at times. Difficult families can be a bit much at times, but always understand that you have no idea what they are going through. Just be there for them and their baby and support them through one of the most horrifying times in their lives.
    tralalaRN likes this.
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    And I would have to add as far as a con is concerned - the kids that do go home, but are really in tough shape - brain damaged, vent or oxygen dependent. There are worse things than death and surviving with an extremely poor quality of life tops the list.
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    Quote from BarnabusRN
    To all the nicu nurses out there! I'm going to be a new hire here soon and wanted to get some pointers before my start date. What I'm acutally looking for here is info that will prepare me for things that will happen in the nicu! Like can i learn beforehand ... procedures ...disease processes .. common nursing diagnosis's .. different machinery used in the nicu .. advice ..recommendations and anything else i could be missing! pros/cons working in this unit!! would love to hear from u guys! even though they are going to orient me, i just don't want to look stupid not knowing anything!!
    * Study your blood gases and know them inside and out...they are a daily occurance in the NICU.

    * Know Neonatal vital signs and what is normal...this is NOT infant.

    * Read up on the differences between Low-Flow Oxygyen, CPAP, SIPAP, Ventilator support and Jet Ventilators and how they work.

    * Read up on NEC (Necrotizing Enterocolitis) and early signs symptoms in a premature infant.

    * Anything and everything regarding breastfeeding.

    That will let you get your feet wet...
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    I'm not sure if this has been mentioned in any of the other posts, but it would also be helpful to learn the basics of neonatal resuscitation. If you're not already certified, you could pick up an NRP book, as I'm sure your employer will require you to be NRP certified.
    babiesRmylife likes this.


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