NICU nursing care - positions and competencies?

  1. Hi everybody,

    I got my RN degree specialized in pediatrics back in the Czech Republic. I have some NICU experience gained during clinical rotations at the Nursing College in CZ. Here in USA, I passed NCLEX-RN and now am enrolled in RN-BSN program (and also am looking for a job in NICU).

    Since I am not yet very familiar with all the nursing job positions and competencies in the U.S.A., I would like to ask you to help me with it.

    For what positions in NICU do I qualify now? And after RN-BSN program?

    And what is the difference between NICU nurse practitioner and clinical nurse specialist?

    Thanks for answer. Appreciating it!!!
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  2. 3 Comments

  3. by   Anaclaire
    Congratulations on passing your NCLEX-RN!!! Sounds like you will qualify for being a bedside nurse in a NICU. With more experience you might be able to join your hospital's transport team or become a charge nurse (leader of the unit for a shift). A BSN often makes you eligible for entering management positions and is the first step for being able to apply for more schooling to obtain your Masters Degree in Nursing.

    These days a person usually needs a MSN (Masters) in order to be a Nurse Practitioner or a Clinical Nurse Specialist. Also it's needed to be a nursing school professor, a researcher, a Case Manager, and other higher level nursing jobs which are often called "Advanced Practice Nurse" jobs. Many educators and researchers have their doctorate degrees (PhD).

    In my experience the Neonatal Nurse Practitioners (NNPs) worked with us in the NICU, performing duties and ordering labs, medicines and treatments under the direction of the Neonatologists. They did lots of more invasive procedures than we staff nurses could do, they would ride with us on the transport team when we expected a super critical patient, and they covered the NICU at nights when the Neonatologists were at home. Our NNPs also helped to staff our hospital's after-care program where our dismissed babies would return for routine check-ups and growth/development checks for the next two years. They were very, very knowledgable about caring for critically ill neonates and most loved to share their knowledge with us too. It seemed like our best NNPs had been staff RNs in a NICU for 5 years or so before going on to NNP school, but that's just my humble opinion... I don't feel any of them were paid well enough for the hours they worked or the stressful work they did. Our Level III NICU had 30 beds and 4 NNPs and 1 CNS.

    Our CNS (Clinical Nurse Specialist) was more of a resource person and educator for our unit. She kept up with our skills and educational needs, was responsible for organizing our orientations, kept us knowledgable of new treatments, products, and cutting-edge medical advances in the NICU field. She didn't work a whole lot with us in the unit unless she was showing us how to do things, like changing dressings on percutaneous catheters and things like that. She loved research more than patient contact. Seems like that's the major difference between the two to me.

    I'm sure your school's library will have some good references on the different job descriptions. In the final part of your nursing school there will most likely be a course you take which begins to give you more detail about the different nursing jobs available and what is required to enter those positions. Ask your college librarian to help you find some good information. They love to do that kind of stuff for us!

    I hope this information has been helpful to you in some way.

    By the way, welcome to the USA. We hope you will be happy here and that we can learn as much from you and your experiences as you can from us!

    Warmly,
    Anaclaire
  4. by   Truhlik
    Anaclaire,

    thanks a lot for your advice. I'm getting to understand the basic differences in U.S. nursing positions and that's also thanks to you. I read some definitions and descriptions in books, but I wanted to know more practical view of competencies for different nursing levels.

    It is very kind of you to support me in pursuing my career in the U.S.. It is nice to hear (or read) that I am welcomed as an international nurse, because in my opinion it is not always like that (including all careers). Not all people come to America with the intention to drain money and opportuinities "belonging" to Americans (often they have stable and qualified positions in their countries but want more...), but rather to gain broader experiences and to contribute to a particular field of study (there are also other reasons to move to U.S. that cannot be judged negatively: political, personal (one partner-gaining experiences....-the other-following him/her,....), etc.). Uff. I kind of got somewhere I didn't intend to. But, it makes me feel better that I can express my opinion.

    Certainly, I am decided to advance in NICU nursing at the level of education, experience and specialization. Just to get the opportunity (especially the employment one; the educational I can influence more myself).

    Anaclaire, thank you again.

    Truhlik
  5. by   Anaclaire
    Truhlik,

    You are very welcome! I have worked with several international nurses over the years and still keep in contact with one from Montserrat, and one from Germany. Interestingly they both now live in Virginia. I'm certain you will make many new friends here in the USA and I hope everything goes smoothly for you always.

    You'll find this board is very helpful and supportive of NICU nursing matters, and I hope you'll always feel welcome posting here.

    Warmly,
    Anaclaire

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