What are the reasons nurses leave the NICU?

  1. I've known since I was about 9 years old that I'm meant to be a NICU nurse.
    I'm starting actual nursing courses in Jan, so I still have a journey ahead of me.

    I like to be prepared and to look at things from every possible angle and I seem to research things to death. I'm wondering what the reasons are for nurses leaving NICU?

    Thanks!
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  2. 14 Comments

  3. by   fergus51
    Sress. It can be incredibly difficult to deal with sick or dying infants, crazy families, mean coworkers, etc. Plus the unit is very fast paced and intense. Some people don't do well under those circumstances.
  4. by   babynurselsa
    The reason I left NICU was Neo's who take a baby int the unit for a asinine reasons. Basically fabricated because census is low.
    I have seen babies admitted for a full sepsis workup because mom spiked 99.9 temp 30 min before delivery and was recieving pit. Big surpise everthing was negative. Of course after being npo for 24 hours we had to keep the kiddo maybe a week to "gradually work up to full feeds." Babies admitted based on weight alone, baby too small that has been in well nursery overnight without any complications. 5# baby able te eat maintain sugars and temp.
    It is about the money sometimes not needed or required interventions.
    Babies stuck 25 or 30 times in a shift for IV's because UAC or UVC or a picc are potential sources of infection. I guess 40 or 50 holes in a baby aren't.
    q1-2 arterial sticks for abg's because of above. Of course then it is the nurse's fault that the baby went into pphn because we didn't keep the baby quiet. A neo who didn't believe in givng pain control to infant's " because infants don't feel pain. Lying to parents who requested such for their babies.
    Not allowing infants under 34 weeks to be held because of the lack of brown fat.
    Neo's who determine viability based on mom's face sheet. HHMMM non-English speaking hispanic mom who is a self pay. Nope that baby is non viable.
    OR attending ANY delivery even though the OB advised you this was previable <20 weeks But he insists on attending and demanding that the RT attemt to intubate an infant obviously <300gm. In the process if attemted intubation the baby's jaw got ripped off. Now wasn't that nice to hand to the family.
    I became so unhappy and burnt out by doing things that I felt were beyond not beneficial to the babies that I loved so dearly or even bordering on detrimental and abusive. I will go back to NICU in time but only after finding a unit that practices in at least somewhat a more pro-baby manner. TO me it is about the babies not the old mighty dollar.
  5. by   onehusbandsevenkids
    Quote from babynurselsa
    The reason I left NICU was Neo's who take a baby int the unit for a asinine reasons. Basically fabricated because census is low.
    I have seen babies admitted for a full sepsis workup because mom spiked 99.9 temp 30 min before delivery and was recieving pit. Big surpise everthing was negative. Of course after being npo for 24 hours we had to keep the kiddo maybe a week to "gradually work up to full feeds." Babies admitted based on weight alone, baby too small that has been in well nursery overnight without any complications. 5# baby able te eat maintain sugars and temp.
    It is about the money sometimes not needed or required interventions.
    Babies stuck 25 or 30 times in a shift for IV's because UAC or UVC or a picc are potential sources of infection. I guess 40 or 50 holes in a baby aren't.
    q1-2 arterial sticks for abg's because of above. Of course then it is the nurse's fault that the baby went into pphn because we didn't keep the baby quiet. A neo who didn't believe in givng pain control to infant's " because infants don't feel pain. Lying to parents who requested such for their babies.
    Not allowing infants under 34 weeks to be held because of the lack of brown fat.
    Neo's who determine viability based on mom's face sheet. HHMMM non-English speaking hispanic mom who is a self pay. Nope that baby is non viable.
    OR attending ANY delivery even though the OB advised you this was previable <20 weeks But he insists on attending and demanding that the RT attemt to intubate an infant obviously <300gm. In the process if attemted intubation the baby's jaw got ripped off. Now wasn't that nice to hand to the family.
    I became so unhappy and burnt out by doing things that I felt were beyond not beneficial to the babies that I loved so dearly or even bordering on detrimental and abusive. I will go back to NICU in time but only after finding a unit that practices in at least somewhat a more pro-baby manner. TO me it is about the babies not the old mighty dollar.

    WOW. Thats alot to think about.
    I gave up wanting to work labor & delivery or being a midwife because I know I wouldn't fit well in a mainstream USA L&D unit due to things being done that are not necessarily needed or to moms or babys benefit and because of all of the politics.
    Guess this kind of stuff goes on everywhere, huh?

    So, what kinds of questions would you ask about a unit in the future to see if its a decent unit?
  6. by   onehusbandsevenkids
    Quote from fergus51
    Sress. It can be incredibly difficult to deal with sick or dying infants, crazy families, mean coworkers, etc. Plus the unit is very fast paced and intense. Some people don't do well under those circumstances.
    Stress, probably #1 huh?
    I seem to thrive under pressure and do my best in stressful situations, but I can definately see how it may get old after a while.
  7. by   fergus51
    OMG. I have never heard of a place like that Babynurselsa! No wonder you left!!! I would have left too. For us, the census is always so high we never want a wasted admit
  8. by   babynurselsa
    Unfortunately fergus this is a several year conglomeration of several Neos, and units. The only unit that I worked on that had neos with an ounce of integrity was a vipers den on the nursing side. I am older and stronger now and could probably deal better with catty staff but the neo's that I respected so much are no longer there. Can't have everything I guess.
    For now I am completely content to work agency. No politics, no popularity contests. I just go to work, be a nurse, and go home.
  9. by   sparkyRN
    Quote from onehusbandsevenkids
    I'm wondering what the reasons are for nurses leaving NICU?

    Thanks!
    Number 1 is high acuity/high census with chronic short staffing that leads to Number 2...STRESS!!!

    I can handle the sickest kids...my favorite patient is the term baby with multiple issues. Don't get me wrong, I don't like that he has issues, I like working as part of a team to help him get better. I like being his advocate and watching for those subtle changes that show he's getting better. What I've discovered that I'm tired of handling is this patient and a couple or 3 others to boot. I can give the meds, do the charting, deal with the families. I just don't feel I can do it very well. I like doing things very well. We all have to work like this on occasion. It's when it's expected all the time that nurses start to bail. As an aside: my unit has lost many good or potentially good nurses for this very issue. Luckily, this is slowly starting to turn around. At the very least, the admin is actively trying to staff and improve our ratios.
  10. by   Mithrah
    I just wanted to share this with you all. There is a new nurse in the NICU unit I work in who has over 10 years experience in L&D/healthy baby. She started the same time I did at this place and the very first day there she was precepted to a baby with PPHN. That is right, she precepted on the sickest baby in the unit and was absolutely terrified and overwhelmed. Understandably she is thinking about quitting and going back to L&D.

    If you get the right training (like I did at my first NICU job) then you will feel comfortable and confident. Make sure you check out the unit and see what kind of training structure they use. One should start with grower feeders, RA (room air) babies, then on to nasal prongs, NCPAP, then to vents, oscillators, and drips. Organization is key to your success. Plus, you should have classes during your orientation. In my opinion, orientation should be at least 3 months.
  11. by   Gompers
    1. (by a landslide) Emotional stress - either the fact that the babies are very sick and it is a very sad place to be sometimes - or that there is so much to know, so much responsibility - or that the families are too stressful to deal with - or that the staff is hard to work with.

    2. Moving to a place where there are no NICUs nearby.

    3. CRNA aspirations - go to adult ICU to get experience before CRNA school.

    4. Not having a good orientation and never gaining confidence.
  12. by   JjoBsn
    If one leaves the NICU and goes to work in an unrelated area of nursing (i.e psych or med/surg) how hard is it to get back into NICU??

    I'm assuming "jumping ship" and trying out other specialties looks bad to managers if one was to ultimately decide to go back to work in a NICU? Is this true, plz help!

    Thanks!
  13. by   NebraskaRN
    I think that if you went to work in another area of nursing and then decided that NICU really is for you they should not fault you for that. I have worked with a lot of nurses with varied backgrounds and some leave NICU and return. Nurses burnout it happens a lot even if nurses don't leave the NICU they may change something because of burnout due to the harsh stressful work we do....that we love But if you leave NICU and come back just try and stress that you love NICU and give a honest answer on why you left and why you want to come back.
  14. by   HappyBunnyNurse
    I think that if you worked NICU for a while then did something else for a while you would still have a hiring advantage over another experienced nurse that had never done NICU. As far as your commitment goes, you night be viewed as having the potential to be more committed. After all would be coming back and not likely to stray again. LOl.

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