what kind of pts did you get first year on your own?

Specialties NICU

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Just curious about what kind of patients and how sick your patients were first year you were on your own in the NICU, meaning when you were OFF of orientation. Specifically Level III NICU as opposed to Level 4. Did you get more feeders and growers your first year? Did you ever get babies that were 1:1? Is there any specific kind of condition baby that is typical NOT to get your first year until you have more experience or did you really get a little of everything?

I am in orientation and I'm sure I'll ask that question but I'm just curious at the moment so I'm asking here :) I previously asked something along the lines of whether I'd mostly get feeders and growers off of orientation and they said no, that would be a disservice to you because you wouldn't be getting experience with everything. But being new to NICU, I didn't know if there were still just certain kinds of babies you would be more likely to get or not get your first year. I'll ask soon but I'm curious how it compares or IF it compares to other NICUs! Thanks!

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Specializes in NICU, PICU, PACU.

Our new peeps everything. They are assigned a resource buddy. We do give them sick kids, admits, etc.

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Specializes in NICU.

I got a fresh post-op baby on a vent during the first week after orientation. I got the range of feeder/growers to sable vents, UVC/UAC during the first yr. Now I after nearly 2 yrs I have gotten babies with Dopamine, Dobutamine, Prostin drips.

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Specializes in NICU.

I got a good range on my first year off orientation -- fresh s/p reanastamosis, oscillator, iNO, prostin, pressors, micros, new admissions... In my unit (level III), nurses who are committed to learning and have shown initiative get just about anything thrown at them. People who have not yet proven themselves to be safe and responsible (yes, we have some...) tend to get the straightforward assignments. Your unit likely has a policy or tradition of how the first year off orientation works.

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thanks guys for your replies!! From my understanding, on my unit, you can get pretty much anything thrown at you, but if you haven't done something during orientation, they would assign you a buddy person so you're not out in deep water. That way you still get the experience but you're not left to the wolves to figure something out you've never done before. By the looks of it so far, I think I like the system my NICU has. Though I'm only just starting out, I feel like I'm working for a NICU that encourages nurses to experience as much as they like but they support you along the way. Also, I work for a teaching hospital, and I feel like that makes a huge difference sometimes, or at least it should. Also, after a year or so we're trained to do transport, so I guess that also means you could be getting pretty much anything. So I think I've answered my own question with what I've been told abt my unit so far!!

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Specializes in Med-Surg, NICU.

Unfortunately I have been getting mostly bubbles and feeder growers. I have been off orientation for over five months.

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On the units I've worked, new grads off orientation get everything but the train wrecks. They actually try to give new grads as many vents and drips as possible to help them get comfortable, but they wouldn't give a new grad a baby who is continually coding and unlikely to survive the shift. That's something you work up to, since the primary nurse has to take such a crucial role in running/calling codes, and I could see it being an emotionally devastating experience if a new nurse felt responsible for a baby's death because they were in over their heads.

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Also, at the facilities where I've worked, new grads did not attend deliveries solo. They could 'ride along' and observe/participate with an experienced nurse, but you wouldn't be the person holding the delivery pager your first year off orientation. At one place, only specific 'stork team' transport nurses were trained to attend deliveries, at the other you had to have at least two years of experience. However, some of my friends from other hospitals were trained on deliveries during new grad orientation. It seems like the policy on delivery attendance is quite different from unit to unit.

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Definitely seems like things are different in different hospitals. I'm not a new grad nurse, I'm just new to NICU. So in a way, it's like I'm a new nurse because it's such a specified specialty. I think my hospital basically gives you just about anything, but you work up to it, I'm sure. We can actually write in a book what assignments we'd like to request if there's something we want to see more of I think...or maybe that's just on orientation...I forget ...but I feel like the floor is pretty good about assigning you to something if you want it. If we do get something new that we didn't experience on orientation, we get buddied up the first time so we can acquaint to it. We are trained to charge nurse role, oriented to high risk deliveries, and transport after around a year or so. With that being said, I'm sure the "trainwreck" patients probably take time to get...for example we have this one kid that's been here for a few months and he's got a lot of complications going on...he's 1:1 and mess and is still trying to get sorted out ... I think he's been close to coding too...with the kind of patient he is, I see more experienced nurses getting him. Anyways, I want to be the person who gains as much experience as possible that first year!! As a safe pace, of course.

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I was not a new nurse when I started in NICU but new to NICU. I got an awesome orientation. I think it lasted 6 months and when I went solo, I got everything. But we were a soft level 3. We are a stronger level 3 now so I grew with the unit. I left for a while to work in a level 4 and got the worst orientation ever, so mileage does vary.

We've recently lost a lot of experienced nurses and are taking a lot of new grads and they seem to be much more eager to push them beyond their comfort and safety level. I'm pretty unhappy about that. Heck, even when I asked, they wouldn't let me do charge for years. Now, three months in and they are pushing them. I think there is a happy medium and I don't think we've got that figured out.

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Specializes in NICU.

I know this is an old thread but I thought I'd share what my unit does since it's different. My NICU has 5 "pods" and a level 2 around the corner. The entire unit is basically one big L...with the 5 pods branching off the thoroughfare and level 2 being separate around the corner. When you start out, you only work in level 2 or intermediate care pods. 3 of 5 are critical care pods and 2 are intermediate pods. Level 2 is basically feeders and growers, lots of bottlers, hypo babies, photo babies etc...the intermediate pods are usually ex micro prems or ex really complicated or sick babies on CPAP...so all new staff state out only working in these areas....then after about a year when the educators feel you're "ready," they will give you another month of orientation in the critical care pods. Currently were super backlogged on staff needing to be trained in the critical pods....our nicu has a huge staff and a huge turnover so people who have been in their critical orientation are being pulled to have an assignment because weve been short...so staff that started a year ago are just starting their critical orientation now. Kind of sucks because I really want to get to the more critical and complicated babies..but it will be awhile before ill be trained...theres a million people ahead of me who are also waiting. So back to my CPAPs and feeders :)

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