Adult to NICU

[kmn0601]

Hi everyone,

I am considering applying for an internal transfer to my hospital's NICU unit. Right now I work on an adult medical/surgical floor specializing in stroke and neurological complications but we still see a large variety of patients. I feel like now is the time I'm ready to make the move to something that I have had my mind on since I started nursing school. In comparison to other areas, I always found the neonate to be more interesting.

If I were to go to the NICU I have the understanding that I will have to learn everything all over again from the ground up as NICU is it's own world. I am ready to do that. What are the biggest challenges going from adult to neonate?

From what I've seen, many NICU nurses find the job very rewarding and interesting. But, I've also read about the occupational hazards of the NICU, primarily the radiation exposure. Does your NICU take any initiative to lessen your exposure to radiation? Is the exposure minimal or is it something that is as frequently encountered as in the cath lab? I know we are all exposed to radiation but I find that the talk of cancers and thyroid issues seems to be a theme on some NICU threads.

I'd appreciate any advice about going to the NICU.

[adventure_rn, MSN, NP]

I have literally never heard of radiation being an issue in the NICU. (Am I missing something here??) Our NICU babies are very vulnerable to radiation, so we try to minimize x-ray exposure as much as possible. I help hold babies in position for x-rays maybe a couple of times a month (sometimes once every several months), always while wearing a lead apron and lead thyroid collar. Every so often the tips my fingers end up in the film, but it's pretty rare (maybe once a year). I worked for a while as an x-ray tech assistant, and the techs would hold patients in position for films several times a day; they had very few concerns about cumulative radiation as long as they were diligent about wearing their lead. I cannot imagine that the exposure would be anything like a cath lab (or an oncology floor) with daily exposure. You'd probably get more radiation exposure in the ED or ortho.

I find NICU incredibly rewarding/uplifting, and I can't imagine doing anything else. I'd definitely recommend that you continue to browse through the NICU specialty forum; there's a ton of awesome information about benefits/challenges, and transitioning into the field.

[prmenrs, RN]

Don't forget that the dose of radiation to take a "baby" X-Ray is significantly less than an adult X-Ray, so the nurse's exposure is much, much less.

A few years ago, some of our nurses wore those rings to monitor their exposure; even holding babies daily or more, those rings never showed ANY exposure. None.

It probably helped that the pediatric radiologist was adamant that no nurses fingers were to be included in an X-Ray. Tech's coned down to just expose the part of the baby that needed to be examined, and we learned how to keep our fingers out of the picture.

We were also careful to use small shields to cover the babies reproductive systems if @ all possible.

[RA0224]

I work on a med/surg stroke unit too and have just been called for an interview in the NICU at a different hospital. Another nurse from my floor transferred to the NICU at my current hospital and likes it. She was trained and didn't have a problem changing from adults to babies.

[katiekat4]

I started working as a nurse on a neuro med/surg floor, then went to a neurosurgical ICU and now recently moved to the NICU this summer. So far, I absolutely love it. It was definitely a big transition - relearning all the vital sign norms and how to manage them, the different kinds of respiratory support, medication and fluid calculations, feeding preemies and just learning about newborn diagnoses in general were some of the things I had to learn. In neuro where you do frequent neuro checks and spread out your care a little to avoid increasing ICP's, babies developmentally need as little stimulation as possible so you cluster everything together and let them sleep in between.

I haven't been in the NICU long but I know I am definitely happy I made the move.

P.S. I don't think radiation exposure is really an issue, if anything, I'm being exposed to radiation significantly less than I was in neuro between the constant CT scans and CXR's sometimes multiple times a night.

[vintage_RN, BSN, RN]

I successfully transitioned from adults surgical oncology to a large academic level III (highest in Canada) NICU about 8 months ago....I say that just because in the US you have level 4 but we only go to level 3. Anyhow. it was definitely a big learning curve for me but definitely manageable. I felt completely comfortable managing a patient assignment on my own by 3 months...however my NICU staggers training so I am still with relatively stable/intermediate level babies. I am starting my critical care training very soon, and I'm sure that will be a whole new ballgame. Overall it has been a very nice transition and I enjoy it much more than adult nursing. It excites me and challenges me on a whole new level :)

[Julius Seizure]

Can you link to any of the info you have read abut radiation in the NICU? I have never heard of this being a specific NICU concern.

Edit: Did a search, and found this thread. It sounds like the concern is when NICU nurses don't wear lead when assisting with x-rays. In most NICUs, the nurses DO wear lead when in the x-ray field, and I would recommend that you do the same no matter what unit you work in!