Special Care Nursery

[HeartNursing3]

I am currently a RN working on an adult med/surg unit. My other experience was only as a PCA and was also adult only (cardiac step down and psych).

I have come to learn that med/surg nursing is definitely not for me, but I am grateful for all I have learned. I

have an interview in a few days for a special care nursery at a typically adult hospital. This hospital also has a NICU. What types of patients should I expect? What is a typical shift like? Any tips for the interview or anything I can do to prepare? I really am hoping to get this job.

Thank you!

[NotReady4PrimeTime, RN]

My first hospital job was in a special care nursery. The babies there are the ones still not ready to go home but not sick enough to require ICU care. They're feeders-and-growers, babies with neonatal abstinence syndrome, babies with cleft lip/palate, babies with congenital defects or syndromes whose parents need education on their care, babies born to mothers with diabetes and a range of other issues. The typical assignment is 3 or 4 babies per nurse, depending on frequency of feeds and other interventions. Premature babies need time to grow and to become neurologically mature enough to maintain their temperatures, heart rate and respiratory rate. (They like to be apneic, often long enough to also become bradycardic and may need stimulation... or more.) Feeding is something that must be learned in many premature babies when they're born before the sucking instinct develops. Gavage feeds are often necessary to fill the breach. Mothers usually require education and assistance in learning to breast feed. Any of these babies are at high risk for necrotising enterocolitis and feeding protocols are used to ensure their guts are as protected as they can be. There's an entire language that applies to this population that you'll learn quickly enough.

Here's a list of a few topics you could review before your interview. Don't try to learn everything but pick out key concepts so that when you answer questions you sound like you at least know what they're talking about.

necrotising enterocolitis (common risk factors, diagnosis and treatment)

neonatal abstinence syndrome (what is scored and how it's treated)

persistent pulmonary hypertension of the neonate (fetal circulation)

patent ductus arteriosus (what it is and how it's treated)

transient tachypnea of the neonate compared to respiratory distress syndrome

hyperbilirubinemia (common causes, treatment)

retinopathy of prematurity

neonatal intraventricular hemorrhage (pathophysiology, grades of severity, outcomes)

care of the infant of a diabetic mother

That's a good enough primer for you. Best of luck with your interview!!