Everyone was so helpful with my last topic! My friend and I were talking about Newborn Nursery Nurses and several questions came to mind. First...how do you feel about the training that Newborn Nursery nurses receive? Should they have NICU experience? Does it matter? Does NICU experience make it safer in the nursery? We both have NICU experience and it is very handy in emergency situations that are encountered in regular Newborn Nursery, but we have come across institutions that seem blind to any issues/problems that may come up in a Level 1 Nursery and seem indifferent to the training of new nurses. One (in particular) is giving new orientees that have NO NICU/Nursery training at all, 4 3-day weeks of training and after that, they will be expected to do all care on their own (meaning they would be the ONLY nursery nurse on for the shift). Maybe we are what-if people that know what can happen at any given moment and it makes us feel overly cautious, but they are doing riskier and riskier deliveries in a Level 1 setting. My friend has had 24-week twins born and coding that she had to handle on her own and the pediatrician didn't come in for 1 and 1/2 hours! I see this as a problem. Her only saving grace was that she had NICU experience and was able to handle it. She received praise for her work, but is that considered acceptable? What do Nursery Nurses do that are not NICU experienced and are not in a facility that has access to a level 3 NICU in house or is far away? What is acceptable out there? We are curious.
Nov 30, '12
I think there is a definite difference in thinking and mindset between a newborn/well-baby nurse and a NICU-trained nurse. No, I do not believe that a mother-baby nurse (most places are going to mother-baby/couplet, rather than designated nursery nurses) needs to be NICU trained, just as I don't believe a nurse who takes care of postpartum women needs to be trained in the ICU. Well babies are, well, well. If they're not well, they get transferred to the NICU. A mother-baby nurse should have enough training to recognize what's normal and what's not.
I used to work in a level 1 OB unit that was 90 minutes away from the nearest NICU. When we would have a crash delivery of a premature infant where there wasn't enough time to transport the mother, or if a term infant delivered that was sick and we had to transport, we knew enough to be able to stabilize the infant until the transport team arrived. That meant NRP, starting an IV, administering fluids and antibiotics. Our NNPs could intubate and we would BMV, if necessary, until transport arrived with a vent.
Ironically, our level 1 OB nurses had more experience with NRP and IV starts on newborns that the OB nurses at the Level 3 facility I work at now, because we had to do it all ourselves, where at the Level 3 facility, we can defer it all to the NICU team.