Choosing comfort over challenge, am I a bad nurse?

[Superbabes]

I have been in the NICU for about 1.5 years now and have been conflicted regarding this. I am starting to see a pattern where I work. Majority of the microprems/prems are stable but requires respiratory support, whether it be low flow, high flow, CPAP, NIPPV, HFO or the jet. Some of them get sick and needs antibiotics, some of them have low sugars and needs IV fluids, most of them are working up to full feeds. There are those rare incidences where babies are admitted very sick or gets very sick so they get intubated with high pressures and gets put on a whole load of drips.

I feel like I am at a point where I can take on more challenging assignments... but there’s a voice inside that’s screaming noooooooooooo. I feel like because I am new and young this is my time to dive into the complex assignments for optimal learning (or so people tell me) but at the same time my body is telling me that I really do not need the stress. I’ve had this conversation with a colleague of mine and she said that she doesn’t really care to be the “hero” and “save” the extremely sick babies, she’s happy to take care of the stable cpap ones. Am I a bad nurse if I chose the easier way out?

I know there’s not a right or wrong answer to this. I guess I am just curious as to what you guys out there think.

[Sour Lemon]

Even stable NICU babies have a lot going on. I'm sure there's plenty to learn, and it sounds like you have plenty of time to learn it. Moving along at your own pace sounds a good strategy, IMO.
I have been in med/surg for ten years and have no desire to "move up", so consider the source. I'm an easily content person.

[TriciaJ, RN]

We don't all need the big adrenaline rush. If you don't think your body needs the added stress, then listen to it. You're probably planning to be a nurse for more than a couple of years so you need to do you and pace yourself accordingly. And the more stable babies are just as deserving of your care. No patient should be someone's stepping stone to greater glory.

[Jory, MSN, APRN, CNM]

Critical care isn't for everyone. Does your NICU have a step down? You can see if you can apply for that if they do. There isn't anything wrong with how you feel, but I do feel you need a little bit more education on what a high pressure system is and why the very young ones are frequently placed on jets. High frequency is not high pressure, but it has to be enough to where the lungs stay inflated. Very small premies do not have a constant flow of oxygen through the blood from a cord anymore and their lungs are not developed enough in many cases for there to be enough exchange if the frequency was lower due to low surface area.

Take an opportunity when it is slow and talk to respiratory therapy or a more senior nurse. I think you'll be more comfortable if you understand more what is going on.

[traumaRUs, MSN, APRN]

Moved to NICU nursing forum

[ruby_jane, BSN, RN]

You've got a good solid year and a bit behind you in arguably one of the toughest nursing environments. Ever.

But good news - the shift to any other PEDS specialty might be easy, given what you know. You're not stuck in one place. You don't have to feel like you "have" to "move up" if you don't want to. Best of luck!

[LilPeanut, MSN, RN, NP]

Hey, do what you like to do. One of the hospitals I worked at, we had NNPs that only worked the step down unit. Most of them were older, getting ready for retirement and they didn't want the stress and aggravation of the acute babies anymore. There's no shame in that. For every nurse that doesn't like those babies, there's another who does, we need all types.

[NICU Guy, BSN, RN]

I routinely have that conversation with myself. I want the high acuity babies for the mental stimulation, but why be constantly busy for 12 hrs when I can take an easy assignment and get paid the same?

[NurseKait_11, BSN, RN]

Stumbled upon this post late, but I am actually glad to see a post like this. I have thought a lot about this because I work in a Level IV NICU and we definitely get our fair share of mico-preemies and unstable patients but I enjoy the feeders and growers, CPAP, relatively stable kids. But sometimes I think, Does this make me a bad NICU nurse because I have a preference or would rather be with a baby who is learning to eat then with a fresh 24-weeker? One of my co-workers love the fresh mico-preemies and absolutely dislikes having the feeders and growers. I don't mind the occasional challenge, but I found that working with the babies that are just learning to eat and helping the parents figure out how to handle their little ones and care for them is what I really enjoy the most. I feel like I can connect and be hands on with those babies, interact with them. But I figure that those babies can have issues too and if we aren't there to care for them, then who will? I definitely think a lower acuity NICU is for me. Maybe a level III since I still get some challenge but not as critical as our NICU.

Thanks for starting this topic!

[Seriously?!, ADN, LPN, RN]

One of the great things about NICU is that you have a variety of acuities and needs. We have some nurses that love NAS infants, some love to do feeder/grower, some love discharge teaching and time spent with parents, some love the critical care. None of those type of nurses are “bad” in any way. And what’s really cool is usually you’re good at what you love. For me, I love my patient to be intubated and on tons of critical drips. I love the details, the titrations, the intricate subtleties of it all. I do not love helping a mom learn to breastfeed, or teaching parents how to give a multivitamin. Of course I still do those things, it’s just not my favorite. I think it’s part of the beauty of nursing, and of NICU, it takes all kinds! Do what you love and love what you do. I think it makes you a great nurse! ❤️