A day in the life of a level II NICU nurse

Mimi2RN, ASN, RN · Apr 9, 2006

I work in a level II NICU. We are officially a 10 bed nursery, but as we have 350 or so delveries a month, our census is frequently higher than that. We take premies from about 28 weeks, and over a kilo in weight. In our nursery, you would start out with the bigger possible sepsis babies, and growing premies. Gradually you would get to the sicker ones, RDS and mec aspiration babies, we also have babies on vents and CPAP. During orientation, you learn to care for 2-3 of these babies. We do cluster care, and don't disturb babies until it's time to get ready for feedings. Babes need to be assessed, diapers changed and feedings given, basically four rounds during the shift. Many of the premies are still on TPN and OG feeds. They have IV tubing changes in the evenings, and meds, all IV at first, then progressing to po. Parents usually visit in the evenings, although moms who are still inpatients come during the night, too, so think about teaching and emotional support for the parents. Moms need help with breast feeding and kangaroo care. Weighing and bathing, and linen changes are usually done on night shift, too. Premies are also known for their apneic episodes and bradies, so you have to keep an ear open for the alarms, not just on your babies, either.

Last job at he end of the shift is usually doing your numbers...totalling fluid intake and output, and working out calorie counts, always such a fun thing to have to think at the end of a long shift.

You may be assigned a baby who is not yet born as one of your patients, when it is delivered, you would take over care, and do everything from newborn assessment and meds to PIV's or assisting with intubations and line placement. We do work together, so you would not be on your own with a complicated admit. As an admit nurse, I attend high risk deliveries, and c/s. If the baby is OK, I turn it over to couplet care. If not, and it's brought in for observation or admission, I do the care as long as I'm not called away for something else. At that point, I report off to another nurse to continue care. At our hospital, you wouldn't start going to high risk deliveries for about a year.

If you work in a Childrens Hospital, the babies are delivered elsewhere and come in with ETT and lines in place. It's quite different when deliveries (and admits) happen at a moments notice.

God luck in your new career, I hope you get the position that you want!