Beginning in a level 3 NICU..any tips?

zanmilasante · Feb 23, 2014

Congrats! My goal is to go straight into a level 3 NICU upon graduation too.

staycalm · Jun 22, 2014

Ask questions! Any new employee to our NICU that stays quiet and observes only without question raises a lot of eyebrows. Absorb the answer. Speak up to your preceptor nurse or charge nurse to let them know if you haven't had the opportunity to see a high-risk delivery, watch a picc insertion, draw lab, put in iv's, take a baby to mri, etc. Basically whatever you see happening around you and feel like you would like to be a part of and want experience in before you are out on your own. Often they forget you haven't done xyz yet.

Just as important as bedside experiences is learning how to correctly chart them. It is super boring to watch a nurse chart. It will be a springboard on how you want to chart. When you begin to chart your own work....ask, ask, ask those around you how they would chart a specific situation. Always be objective. Take your opinion out of the chart. Just the facts. (for example-never chart a mom was sad- rather chart mom was tearful upon visiting her baby). Take charting very seriously. It is your record and witness for the day. Make sure to always state how the patient responded (tolerated well for example). Most of us in our unit have a paper to prompt us to remember specific things we forget!

Be a sponge when nurses speak to families. I learned so much listening in to conversations- great examples, explanations (and also how NOT to speak to families).

remember the grief process- anger and denial are part of that. The parents are traumatized/terrified jumbled with joy and excitement . Be as empathetic as possible, and empower them however you can to make them feel like they are parents. Offer choices on things that can seem small-but means a lot, like bedding color, having them help position the baby just so with your help, teaching them to assist with oral care, etc. Bonding can be difficult for a majority of families. Talk about the baby's personality, sleep habits, features- not just a/b's, desats, medications, etc.

Nursing is a lifelong of learning! Best of luck in the NICU!

rnkaytee · Jun 22, 2014

Any new employee to our NICU that stays quiet and observes only without question raises a lot of eyebrows This! I know how much nursing students get about the NICU - which is hardly anything in our local programs. My biggest pet peeve is someone new saying "I know, I know" over and over again when they just started.

champagnesupeRNova · Jun 24, 2014

When it comes to nursing care, definitely ask questions and do not try to pretend that you know everything right off the bat. When it comes to learning about the environment of the unit, how things work, getting report, and getting to know staff...LISTEN more than you talk. You will learn a lot by listening to what others say. When you get report from someone on a baby you have taken care of already, do not say "I know this baby already, just give me a brief update" or anything like that. Get a full report and listen.

tinkerbell419 · Jun 24, 2014

Hi There- Just wanted to say the best of luck. I would learn about neonatal anatomy and common conditions and the management of those conditions, side effects to look out for, and trying to make the links between what you know and what you don't know. As someone else rightly said dont assume that because you had the same baby last week that things are still the same. Trust me things constantly change. Ask why, why and why again? Question everything you do, do you know why your doing this. Don't get into the habit of doing things robotically either. Know your patients or at least try too. Try and get hold of the induction book or whatever they have compiled on the unit. Learn about the ropes, who is who, important bleep numbers, calculating feeds etc.

Just be careful too. Don't assume everyone will have your back. You have to own it and prove your worth. Just keep breathing and putting one foot in front of the other. :)