Special Care Nursery vs. NICU

Specialties NICU

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Specializes in ICU/CCU, PICU.

I'm an adult ICU nurse. At my current hospital we have a Level II Special Care Nursey. Is there any different between a Level II Special Care Nursey and a Level II NICU? Or are the terms interchangable?

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Specializes in NICU.

They are the same.

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Specializes in NICU.

The Roman numeral II tells you what you need to know: that this unit cares for acutely ill babies, NOT critically ill babies. Level III is for critically ill. You'll never see a ventilator in Level II, but the other boundaries are a bit more flexible (UAC's, TPN, chest tubes, etc). Level II may include CPAP, probably has lots of (mild) respiratory distress, hypoglycemia, and NG feeds.

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Specializes in NICU.

You WILL sometimes see a ventilator/intubated infant in a level II NICU. However, in most states level II units can NOT keep infants intubated for more than 24hrs. So a level II may be able to take a MEC aspirate infant who is extubated within hours of life, or a late pre-term who needs a little extra help at first. however, if an infant will be intubated for >24hrs, transfer to a level III facility is necessary.

Never say never! AND these designations and rules are also different from state to state.

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Specializes in NICU.

You WILL sometimes see a ventilator/intubated infant in a level II NICU. However, in most states level II units can NOT keep infants intubated for more than 24hrs. So a level II may be able to take a MEC aspirate infant who is extubated within hours of life, or a late pre-term who needs a little extra help at first. however, if an infant will be intubated for >24hrs, transfer to a level III facility is necessary.

Never say never! AND these designations and rules are also different from state to state.

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Specializes in NICU.
You WILL sometimes see a ventilator/intubated infant in a level II NICU. However, in most states level II units can NOT keep infants intubated for more than 24hrs. So a level II may be able to take a MEC aspirate infant who is extubated within hours of life, or a late pre-term who needs a little extra help at first. however, if an infant will be intubated for >24hrs, transfer to a level III facility is necessary.

Never say never! AND these designations and rules are also different from state to state.

Good point about the regional variations.

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A level II SCN is another name for a level II NICU, but there could huge gaps in capabilities between two neighboring units known as level II SCN's or between two neighboring units known as level II NICU's. Because there is no consistency in terminology, no unit can be said to be more "special" or "intensive" than any other just based on the name.

Among the descriptors I've run into: special care nursery, intensive care nursery (ICN), high-dependency nursery (HDN), neonatal intensive care unit (NICU), neonatal special care unit (NSCU), newborn ICU, special care baby unit (SCBU)... the list could go on and on.

If you're familiar with trauma center designations, neonatal unit classifications may strike you as completely nutso. There is no organization that specifically inspects neonatal units and designates levels, so it leads to the inconsistency and disagreements that you've seen in this thread.

The "levels" are also the reverse of what trauma centers use, with level I neonatal care referring to the care of normal newborns. Level II care refers to infants who need some level of extra care or observation. Level III units generally regularly provide care to infants requiring ventilation. Some places even refer to themselves as level IV units, to indicate that they offer highly specialized services that most level III's do not, such as CV surgery, cooling or ECMO.

It's truly bananas.

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Specializes in ICU/CCU, PICU.

Thank you for the clarification. I first started off in a hospital in a different state with a level 1 NICU (including ECMO, HFOV, open-heart). Once I started here I though SCN just meant like a nursery with some failure to thrive babies getting feed. I was just curious because the other day I had to drop off some breast milk (we had a post-partum mom in the ICU) to the SCN and noticed some babies on more invasive therapies than what I assumed there to be (like c-pap, bili lights, etc). I thought to myself, should they be doing that?

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Specializes in Medsurg/ICU, Mental Health, Home Health.
I first started off in a hospital in a different state with a level 1 NICU (including ECMO, HFOV, open-heart).

That wouldn't be Level I. Level I is has the least sick babies in it when compared to other NICUs. It's the opposite of trauma levels, wherein level I is the highest level. Your old hospital probably had a level III NICU.

We have a Level III NICU but call it the Special Care Nursery. The name change was relatively recent and I think it was just to sound, I don't know, more family friendly?

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Specializes in NICU, Infection Control.

Level 1 is basically Mother-Baby Unit or Newborn Nursery.

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Specializes in ICU/CCU, PICU.

Gotcha. We were a Level 1 Trauma, Level III NICU.

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Specializes in Medsurg/ICU, Mental Health, Home Health.
Gotcha. We were a Level 1 Trauma, Level III NICU.

It can be hard for those of us in "adult patient" world to remember! I just know because I did a rotation in a Level III NICU in school.

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