What's your experience in a level 2 NICU/ step down ?

Specialties NICU

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Hello all!

i was wondering your experience in a level 2 NICU/ step down NICU unit. I am currently an Adult ICU nurse and am so sick of "critical patients". My original passion was NICU but I didn't think I was cut out for it. However, my passion for newborns keeps growing and I would love to take care of stable or relatively stable babies. I would love a job that's is far less stressful. And I mean stressful in a sense of -is my patient going to die today. I can handle multitasking and fast pace. Let me know your experience and the pros and cons! I've read some people find it boring but honestly in my stage of life I have sooo much anxiety from my work in the ICU that I need boredom(if that makes sense).

thanks!

Specializes in NICU.

I work in a large Level IV NICU that has an attached "step down" or Level II-esque unit also. It's definitely busy in that you have 3-4 babies who need to be changed, fed, assessed, given oral meds, etc... but it doesn't have that high acuity stress that you're talking about. Some babies are on low-flow oxygen cannulas, some are still working on temp regulation inside incubators, and basically all are combination tube and bottle fed, working up on to full PO feeds in order to be discharged home. They can still "spell" (drop HR and O2 sats, needing stimulation to remember to breathe,) and of course you always have to be vigilant for any s/s of infections, especially NEC, but it's definitely low critical stress. That's exactly the reason I don't prefer to work over there, but as always, to each their own! Sounds like you've had your time with the super sick, and I have to say, snuggling a 5 pound baby during a bottle feed is about as good as it gets sometimes...they're the best! :)

Specializes in NICU.
and I have to say, snuggling a 5 pound baby during a bottle feed is about as good as it gets sometimes...they're the best! :)

I prefer the 24 weeker micro preemies, but during a very stressful day, nothing beats snuggling with a grower/feeder. They have the innate ability to suck the stress out of you. All adult hospitals need a snuggle room. Nurses would a lot happier being able to take a snuggle break during their stressful day. That would be an interesting condition in a nurses union contract.

I prefer the 24 weeker micro preemies, but during a very stressful day, nothing beats snuggling with a grower/feeder. They have the innate ability to suck the stress out of you. All adult hospitals need a snuggle room. Nurses would a lot happier being able to take a snuggle break during their stressful day. That would be an interesting condition in a nurses union contract.

Hah, kind of like pet therapy, but with infants. Love it.

I think I'd responded to your previous post. I'd say that even in a Level IV, my job is rarely 'stressful.' It can get pretty busy because I struggle a bit with time management, but we definitely have nurses on my staff who craft for the kids, knit, etc. between cares. If I do have down time, I prefer to spend it snuggling if I have any babies who need it.

Most NICUs tend to have very low mortality rates (except the huge tertiary academic referral centers). For instance, the units I've worked on have had around 50 beds, and we might see one death every couple of months. You as a nurse may go for years without caring for an infant who doesn't make it (although you'll probably have a couple who try during that time). I don't think I've ever gone to work thinking 'I wonder if one of my kids will die today.'

Level II specifically tends to be kids learning to eat, maybe kids who are a bit on the small side (IUGR), late preterms, occasional IVs, occasional supplemental oxygen. Lots of bottle and NG tube feeds, lots of education.

One great thing is that if you start in a Level III/IV, it's easy to move to a Level II; it's almost as easy to do the reverse. Getting you foot in the door without neonatal experience is the hard part.

Specializes in NICU.

I work in a big tertiary academic centre with a level 2 attached down the hall. I'm an adrenaline junkie so I really hate being assigned to level 2 - but it sounds like more what you're looking for. Stable babies, ex prems working on feeds, maybe have an IV, low flow o2...not much going on acuity wise...but bat s*** crazy pace wise. I much prefer being in level 3 - I find I'm much more relaxed and less stressed lol

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