RT a good path towards becoming NICU RN?

[Noob_to_Nursing]

Hi!

Background: I'm in my mid-30s and fulfilling pre-requisites for getting into an RN program in hopes of eventually becoming a NICU nurse someday. I have no healthcare background experience. =(

My goal is to only work with neonates (and I know that entails interacting with parents too).

However, through my research, it looks like there isn't a specific RN program for NICU nursing. I've even read on other posts that some NICU nurses have to learn on the job. I noticed that specialization for NICU nursing is at the Nursing Practitioner level.

So, I know of a Respiratory Therapist program that actually covers neonatal resuscitation. Should I go for the Respiratory Therapist program first and then gain experience in the NICU (as well as other areas) to help me be more competitive for a NICU job as a nurse someday? I just feel like if I eventually want to be a nurse, I should go for that first instead of go the RT route. I'm not saying that RT is a job below RN (my friend is an RT); I just feel that with the long wait times of the RN programs and my desire to work in the NICU, I should go the RT route to make myself more competitive. It just seems that the RT has more exposure to the NICU than other healthcare careers (excluding RN and neonatologist).

I hear it both ways: that there is a great need for NICU nurses and that there isn't. =(

I live in Southern California.

Thanks for your help! I am so absolutely grateful for this forum!

[RTT&Proud]

Firstly, Id like to say I have been an RT for 3 years, and I graduated from a private school. Initially I was looking to get into a community college and then proceed on getting my bachelors from Loma Linda; however the waiting list was horrendous!!! In the Private school, The Pre-Reqs were harder then I imagined, and due to the field being so condensed in LA; the classes were harder! Moreover, I was very fortunate for landing a job with Kaiser Permanente, right after graduation. I have to say, what others said about Rt's regarding the need... It isn't true! We specialize in the Lungs and by specializing we have a broader understand physiologically with whats going on... For Example, Our pulmonologist's swear by RT's, We have Critical Care Pulmonary Physicians in our ICU at all times except for nights. When they are gone.. They tell our ON call Physicians to ask an RT before making any decisions on intubating, and have us do a consult whether they will benefit from other types of therapy. In Addition, we have a core of 5 RT's for the Hospital at all times; regardless of the census/ points. Two RT are assigned in the Nicu and one of them carry a light load with adults. If we require two in the NICU then we call our on call staff for replacement. In other word... WE are Highly Respected in the NICU/ Adult Care! Also, we have 40 RT's in our department and I can say all of them are Highly educated!!! I Love this filed because we are Specialists... RT's work hand in hand with physicians and round with them at all times. Furthermore, all our RT are qualified to operate in the NICU, but we do have core therapists who have first dibs for the NICU. Think about the filed, it's amazing! We are First Responders; therefore critical thinkers!

[phuretrotr]

Isn't this allnurses?

[TiffyRN, BSN, PhD]

Isn't this allnurses?

Well, yes, decent question. The OP would be well served to ask opinions from an equivalent RT board and get their take.

I have a few thoughts:

First thought: Wow! RTs with bachelors or masters? I'm not degrading this at all, merely pointing out my ignorance. I work with RTs all the time and have never heard of this so I obviously need to ask questions from my RT coworkers and get caught up.

Second thought, through my over 20 years of hospital experience it seems to me that the RTs always get the raw end of the deal when downsizing happens. In general RNs keep their jobs and we downsize by attrition; RTs flat out get laid off, positions are cut and patient assignments go up dramatically.

Take home message for the OP; don't delay your dream of being an RN by going through RT school. RT is a wonderful career but unless that is what you want to do you will be quite frustrated especially if you are not assigned to NICU. Very few RTs get to go to the NICU ( at least in respectable units). In our unit, there is a very small pool of RTs that functions there, no RTs float in from other areas, you either are a NICU RT or you are not and will not be welcome behind our locked doors unless by special invitation.

And to my fellow NICU RT; love you guys!! The group I work with right now is wonderful. They completely get the collaborative practice model. We consult each other regularly on patient care and coordinate times. My group this last weekend was really needy from an RT perspective and I had wonderful support, cooperation and problem solving to benefit our infants.

[TraumaSurfer]

First thought: Wow! RTs with bachelors or masters? I'm not degrading this at all, merely pointing out my ignorance. I work with RTs all the time and have never heard of this so I obviously need to ask questions from my RT coworkers and get caught up.

Of course there must be RTs with Bachelors and Masters degrees. Their entry education is an Associates just like RNs. In order to teach at a state or community college, at minimum a Bachelors is required. To be the director of an educational program at a college, it should be a Masters or PhD degreed person.

RTs even has a Bill set up for them to get extended scope of practice if they has a Bachelors or Masters degree. But, with some of the Bachelors programs closing for RTs and the lack of support from the RT community, I think their professional organizations have given up on this.

RTs in California have been hit hard by layoffs. It is no problem for nurses to take over whatever RT tasks in this state. RNs already do most of the SVNs and ABGs. It is almost unheard of to have an RT draw an ABG and definitely not from an A-line. RNs do all of the MDI and asthma teaching in most the hospitals. Physical Therapists and Exercise Physiologists are taking over the rehab side including the research end of things. Paramedics are doing the RT stuff in home care, inter facility transports (including neonatal) and the ERs which also means ventilator management.

Loma Linda Bachelors

Cardiopulmonary Sciences - Welcome to the School of Allied Health Professions Respiratory Care Program

Loma Linda Masters

Cardiopulmonary Sciences - rcmasters?

Northeastern Boston Masters

Curriculum | Master of Science in Respiratory Care Leadership Online | Northeastern University Online

[TraumaSurfer]

Firstly, Id like to say I have been an RT for 3 years, and I graduated from a private school. Initially I was looking to get into a community college and then proceed on getting my bachelors from Loma Linda; however the waiting list was horrendous!!! In the Private school, The Pre-Reqs were harder then I imagined, and due to the field being so condensed in LA; the classes were harder! Moreover, I was very fortunate for landing a job with Kaiser Permanente, right after graduation. I have to say, what others said about Rt's regarding the need... It isn't true! We specialize in the Lungs and by specializing we have a broader understand physiologically with whats going on... For Example, Our pulmonologist's swear by RT's, We have Critical Care Pulmonary Physicians in our ICU at all times except for nights. When they are gone.. They tell our ON call Physicians to ask an RT before making any decisions on intubating, and have us do a consult whether they will benefit from other types of therapy. In Addition, we have a core of 5 RT's for the Hospital at all times; regardless of the census/ points. Two RT are assigned in the Nicu and one of them carry a light load with adults. If we require two in the NICU then we call our on call staff for replacement. In other word... WE are Highly Respected in the NICU/ Adult Care! Also, we have 40 RT's in our department and I can say all of them are Highly educated!!! I Love this filed because we are Specialists... RT's work hand in hand with physicians and round with them at all times. Furthermore, all our RT are qualified to operate in the NICU, but we do have core therapists who have first dibs for the NICU. Think about the filed, it's amazing! We are First Responders; therefore critical thinkers!

I don't know if this was your intent but you have shown the OP why going the RT route if being a NICU RN is what this person wants to be is not the way to go.

The chances of being a dedicated NICU RT is very slim. Calling "dibs"?

For many hospitals, including this one, being "qualified" means having a day or two orientation to know where the equipment is kept.

Working both adults and NICU is well...gross especially if it is the ER since isolation is not done until AFTER testing. The RT then comes back into the NICU with the same clothes and questionable hand washing techniques.

These are examples of why RT is not respected or accepted in the NICU. It would be better for some NICUs which do the split RT is to just have one which does only the equipment. RNs in the NICU are capable of doing everything else. There is no need for an RT to appear from the adult world just to make a vent change or give a neb.

So, to the OP, go for a BSN in nursing. Skip the RT program since RTs will probably be well on their way to being extinct by the time you finish. There will be a few exceptions but reimbursement is no longer there for this profession to remain alive nor is there justification since so many others can do their job.

[zanmilasante]

The level 3 NICU I am at seems always understaffed - so there is definitely a need for more NICU nurses. However, the department is looking for experienced nurses, not new grads. It's probably easier to start out in a lower acuity NICU. Also, if you're goal is just to work wit neonates in the NICU, you can be a RT in the NICU. There are always RTs in our department giving the premies breathing treatments.

[Coffee Nurse, BSN, RN]

The RT then comes back into the NICU with the same clothes and questionable hand washing techniques.

Bit harsh. I doubt the average RT has any worse hand hygiene than the average RN. (Come on, we all know it's the surgeons who are the problem there... )

These are examples of why RT is not respected or accepted in the NICU. It would be better for some NICUs which do the split RT is to just have one which does only the equipment. RNs in the NICU are capable of doing everything else. There is no need for an RT to appear from the adult world just to make a vent change or give a neb.

I just have to disagree with you here. I work in the UK now and miss my RT colleagues on a very regular basis. There's nothing better, when you're attending a crash section or trying to resuscitate a baby on the unit, than knowing that there's someone whose sole job is to obtain and maintain a patent airway (especially with how respiratory-focused NICU is), letting you direct your attention to all the other nursing tasks -- establishing access, giving meds, etc.

[NicuGal, MSN, RN]

Wow big huge disagree! We always have at least one RT in our unit and we rely on them to help residents and even fellows figure out modes and settings! We respect every single one of them. They do rotate thru and take adult floors but they are very conscious of infection control.

[katierobin23]

Definitely disagree with trauma surfer as well! Our unit wouldn't function anywhere near as smoothly without our RRTs! We have a wonderful relationship of mutual respect with them! They attend all high risk deliveries and and invaluable in a code. Our unit is fortunate that we have a respiratory team that is exclusive to the NICU, so it's not impossible to find a job like that. Our therapists can pick up shifts elsewhere in the hospital, but it is not required and never in the same shift that they are with the babies, so even IF they had "questionable hand washing techniques," it wouldn't be a threat to our babies. But they don't. They are professionals.

As to the original question, no, I don't believe it's a good route to becoming a NICU nurse. Being an RT requires it's own set of skills and training. There is an RT in my unit currently in nursing school, but that is because being an RT was his original goal and his career path happened to change. I'm positive that he would say skip the RT path if nursing is what you know you want to do.

[Im_anticipation]

I would suggest taking a neonatal nursing course to help you get into the NICU as an RN

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