Student Seeking Advice - Is NICU for me?

NicuGal, MSN, RN · Oct 11, 2013

I would go shadow for a day in NICU. If you want to be a psych nurse, NICU isn't really going to help you reach that goal, in my honest opinion.

Only you know how you learn, but you have to be able to learn and carry out tasks pretty quickly, and our meds aren't standardized doses or gtts like adults. You will most likely have a 12 week orientation and you will have lots of different skills to master, many of them not remotely related to the adult world. Like I would go shadow for a full shift, on day shift when it is crazy with procedures, orders etc. See what you think.

SeattleRS24 · Oct 11, 2013

I appreciate the insight, NicuGal. I am not positive about wanting to be a Psych nurse; I just like the idea of being a specialized NP down the road. I guess I'm simply considering less common ways of practicing mental health nursing in the acute care setting.

I have spent two full day shifts in a level II NICU; however, neither day was particularly busy. I did really enjoy it. I witnessed nurses really addressing the psychosocial needs of the families and that seemed really appealing to me. And I also thought the skill and knowedge base of those nurses was incredible - I can only dream of knowing so much.

What you mention about speed of mastery definitely concerns me, but I like to think I would learn if I had to. Food for thought, I suppose. Thank you!

wannabecnl · Oct 16, 2013

I'm not a NICU nurse, but my second child was a preemie, so we were "up close and personal" with the NICU for 2 weeks. Two things concern me in what you wrote: first, that math isn't your strong suit, and second, that you worry about your fears getting in the way.

I work in the PACU, and unless my patient is a tiny old lady who weighs 93 lbs. OR a regular-sized person who takes chronic pain meds at home, they pretty much all get standard dosing of meds. That is not the case with our little pedi patients, and it is REALLY not the case with neonates. Everything is based on weight. Now, you'll have orders for the right amount, but you need to be confident in your math to check the dosing before you give it.

I'm actually more concerned about the second problem, but I think it's fixable in the long run, though perhaps not starting in the NICU. What I observed time and time again during my daughter's tenure in the NICU was that all of the nurses were VERY decisive and quick to act. There is just not time to sit and figure things out. When you are a new grad, you will have to stop and think about almost everything you do, which costs time, which you have less of in the NICU. The fear thing is also a problem that I've suffered, though it is getting better with time and experience. Frank Herbert once said, "Fear is the mind-killer," and it is absolutely true: nothing can make all that nursing knowledge from school fly out of my head faster than a big dose of fear. The unfamiliar is scary, which means you need to make things familiar so they don't scare you. Eventually, enough of the job is familiar that even something new won't throw you, but that takes time. You might do REALLY well on a pedi floor to start, though; lots of interaction with parents, support from other staff, lower acuity than NICU. Pedi to PICU to NICU would take time but would let you get that experience to deal with your confidence! :)

This may sound hypocritical as I have just finished up my first year in the PACU, which I started as a new grad. Just wanted to address those two issues. The fact that you have a real heart for the whole patient and for their non-medical needs is something that can't be taught, so set yourself up to learn the rest and you'll be a fantastic nurse!

royhanosn · Oct 16, 2013

before your ego get the best of you, you have to earn your stripes. You will have to develop a TOUGH skin in this day and age. Never get emotionally involved with a patient problems You dont know their background.

SeattleRS24 · Oct 16, 2013

Thank you very much for the feedback! I appreciate it. After some soul-searching, I came to the conclusion that NICU is most likely not for me. I am more likely going to enter into postpartum/L&D or something general to hone my skills.

Is there any way to delete or close this post?

davewayne · Oct 16, 2013

Hey Seattle RS24, I hope that this post stays up. I'm in semester 1 of my 15 month accelerated BSN program so I am already trying to figure out my path in nursing. I found your thoughts and the thoughtful responses super helpful. Thanks for sharing.

SeattleRS24 · Oct 16, 2013

Glad it was helpful to you! :) Good luck, Davewayne!

favraeRN · Oct 16, 2013

SeattleRS24 your post just describe me. thank you so much for posting. i have been dealing with healthy newborns and new mothers for the last four years as their baby nurse (home setting)and I enjoyed every minute of it. troubleshooting breast feeding problems as well. it is such a happy and clean environment. i hope to work in the Nursery and NICU however the job market in big cities (i'm a foreign graduate) is so bad, or even just to get in the hospitals. ugh. no lack for me so far anyway. i worked as dialysis nurse and in the nursing home it doesn't come close to working with newborns. well good luck to us! thanks again for posting it just made me smile how similar we are in our likes, strengths and weaknesses.

kaela_v · Oct 17, 2013

@SeattleRS24

I graduated from a BSN program in Dec 2012, received my license in Jan 2013, and began working in March 2013. I was hired at a local hospital working in Perinatal Services. I went through 16 weeks of orientation for not only Labor and Delivery, but also Postpartum, NICU, and Peds. At my hospital, "Perinatal Services" is what we call a 'pod.' That means that any nurse working in any one of the 4 units is trained to float to the other units and should be able to take care of low acuity patients there (obviously we are not going to give a Peds nurse a woman in active labor, but perhaps a pregnant woman who is in the hospital for another reason).

I wanted to make a few points i regard to your feed here:

1. In many hospitals L&D, Postpartum, and NICU are not completely separate units and often work together. I am primarily a L&D nurse but very often work postpartum and NICU. Also, I work with Postpartum and NICU nurses to take care of my L&D patient.

2. EVERY patient is a PSYCH PATIENT!! That is a phrase I heard over and over in my program! You will be able to not only provide hollistic care, but specifically some mental health care to every single patient and their family. As nurses, it is our job to care for the entire patient and that includes their mental health. I am always assessing the mental health, financial stability, social support and more of ALL of my patients.

3. The fact that you are concerned with your skill level and your ability to care for your patients shows an accurate assessment of our skills and thats a good thing. Being concerned with your ability to care for patients shows that you are truly concerned with their welfare. If you felt as though you were ready and already possessed the need skills as a new grad, you'd be narcissistic and probably an unsafe nurse, LOL. As a new grad, you will have less than half the knowledge and skills you will need! Unfortunately, thats true for all new grads. You will NEVER be alone while you are working, you will always have the help and the guidance of your more experienced peers. And as nurses, we see something new and learn something new constantly, regardless of the amount of experience we possess.

4. When I was starting nursing school, I have several people (some nurses) tell me that I would not be a good NICU nurse and that they did not think that I would enjoy it. So, I went the L&D route. Now that I am working on my own and have taken care of my own NICU patient, I LOVE the NICU. Do not let others tell you what you will like, what you will or wont be good at, etc. Only you can look into your heart and find your passion

Good Luck, I hope this has helped you!

babyNP., APRN · Oct 17, 2013

The math with neonates is pretty easy once you know how to do it because it's all per kilogram and is basic algebra. The crazy conversions they have you do in nursing school are not applicable (or at least at my home facility and the 5 places I've done agency at)

I was a bit weaker at nursing procedures as well in nursing school as I came to it with absolutely no healthcare background. Most of the students in my class were CNAs. The curve changed when I got a job as a nurse tech, but even when I started in the NICU, I was really hesitant at first.

If you want to do it, I say go for it. You can always ask to do your last practicum in the NICU or L&D where you can get more exposure.

Long story short, even though I was very nervous during nursing school and subsequent NICU (in a Level IV to boot) as a new grad, aged 22, 5 years later I feel so happy that I made the choice to do it. I'm now in a NNP program and my nervousness at new procedures and learning more heavy didactic content are intimidating, but I'm in a better place now because I know that I've felt like this before and I've gone through struggles and I've still made it through.

Best of luck whichever way you go...

SeattleRS24 · Oct 18, 2013

BabyRN and Kaela_V, thank you so so so much for your responses. They give me lot of hope and make me very excited to continuing honing my skills. I know that the skills will come with practice and exposure and time. The stories you shared make me feel a lot better!