Do Any Hospitals Hire New Grads For Nicu?

chare · Apr 15, 2022

I would be surprised if facilities with new grad residencies with residency programs would hire you as a new grad, and allow you to opt out of participation in the residency.

It seems odd to me that you were told being a student prohibits you from partciparing in a residency. We have new graduates participating in our residencies that continue their education, both bachelors and masters.

Im curious, who told you this, and what was the rationale?

Best wishes.

Hopefulstudent333 · Apr 15, 2022

29 minutes ago, chare said:

I would be surprised if facilities with new grad residencies with residency programs would hire you as a new grad, and allow you to opt out of participation in the residency.

It seems odd to me that you were told being a student prohibits you from partciparing in a residency. We have new graduates participating in our residencies that continue their education, both bachelors and masters.

Im curious, who told you this, and what was the rationale?

Best wishes.

Hi. Thanks for your response. Unfortunately it was the program director at my school who told us we can’t do a residency program and complete the school program at the same time because the program is very rigorous. We do have to show proof of employment to our school as well so they know we are fulfilling the requirement of working while in the program, so they would be able to check if it’s a residency program. I did talk to the director and explain that I was worried about finding a job as a new grad without going through a residency program and all she said was that there are lots of hospitals that hire new grads into the nicu and I shouldn’t have a problem but so far I haven’t found any hospital that will take me so I’m confused.

Editorial Team / Admin · Apr 15, 2022

6 hours ago, chare said:

I would be surprised if facilities with new grad residencies with residency programs would hire you as a new grad, and allow you to opt out of participation in the residency.

I would expect that there is a zero chance of this happening as many residency programs seek accreditation. Vizient's program pretty much requires that every single new grad participate in the program.

OP, I hate to say it, but the hospitals that don't have a nurse residency program are also likely few and far between. I would ask for a policy stating the requirement not to participate in a residency while in school in writing. If it's not in writing, then I would take it as just someone's unofficial opinion. Yes, it will be difficult to complete all of that at once, but for some it's likely doable.

adventure_rn, MSN, NP · May 16, 2022

It seems very bizarre that you're in a direct entry NNP program? Is it a reputable program?

The 'residency' in and of itself isn't the busiest part of your first year as a new grad--it's being a new grad. There is an insane amount of stuff to learn, especially because NICU is barely touched upon in nursing school. It's mentally exhausting to simply absorb all of that knowledge, and to feel so overwhelmed and on your toes all of the time, not to mention that you may have very little control over your schedule (including working around classes, clinicals, and tests).

Plus, there's not even a guarantee that you'll be able to get a NICU job straight out of school? And if you even hint that school will be more of a priority than your new grad job, hospitals will probably have a lot of reservations about hiring you compared to the dozens of other hopeful new grads who can fully commit.

I'm a little skeptical about direct-entry MSNs in general, but a NNP direct-entry seems like a very bad idea (hence why almost all of them require you to get two full years of experience before you start classes). Even if you find a job that you can work into your schedule, it seems unlikely that you'll be able to absorb the class material as effectively with very limited hands-on experience. It's part of the reason why NICUs recommend that you don't take NRP until you've got 6 months on the job--if you try to take NRP without any hands on experience, you can do the class, but you're not going to really understand or retain it very well. Plus, many NICUs won't really start letting you take the sickest kids solo until you have a couple of years under your belt--you may find that you graduate NNP school and have minimal direct experience assessing and managing critically ill babies.

I hate to be a downer, but I would be very, very cautious about pursuing a program like this if I were in your shoes. This seems like a lot of red flags. At the end of the day, you'd probably do yourself a big favor by taking at least one full year off to just focus on learning about NICU (and doing a residency)...

Coffee Nurse, BSN, RN · May 18, 2022

On 5/16/2022 at 5:38 PM, adventure_rn said:

It seems very bizarre that you're in a direct entry NNP program? Is it a reputable program?

The 'residency' in and of itself isn't the busiest part of your first year as a new grad--it's being a new grad. There is an insane amount of stuff to learn, especially because NICU is barely touched upon in nursing school. It's mentally exhausting to simply absorb all of that knowledge, and to feel so overwhelmed and on your toes all of the time, not to mention that you may have very little control over your schedule (including working around classes, clinicals, and tests).

Plus, there's not even a guarantee that you'll be able to get a NICU job straight out of school? And if you even hint that school will be more of a priority than your new grad job, hospitals will probably have a lot of reservations about hiring you compared to the dozens of other hopeful new grads who can fully commit.

I'm a little skeptical about direct-entry MSNs in general, but a NNP direct-entry seems like a very bad idea (hence why almost all of them require you to get two full years of experience before you start classes). Even if you find a job that you can work into your schedule, it seems unlikely that you'll be able to absorb the class material as effectively with very limited hands-on experience. It's part of the reason why NICUs recommend that you don't take NRP until you've got 6 months on the job--if you try to take NRP without any hands on experience, you can do the class, but you're not going to really understand or retain it very well. Plus, many NICUs won't really start letting you take the sickest kids solo until you have a couple of years under your belt--you may find that you graduate NNP school and have minimal direct experience assessing and managing critically ill babies.

I hate to be a downer, but I would be very, very cautious about pursuing a program like this if I were in your shoes. This seems like a lot of red flags. At the end of the day, you'd probably do yourself a big favor by taking at least one full year off to just focus on learning about NICU (and doing a residency)...

ALL OF THIS. I am super skeeved at the idea of a direct-entry NNP program. At best, a BSN gets maybe a senior capstone in the NICU, and that's just learning on the fly, without a didactic course to ground the hands-on part. Figuring out how to be an actual nurse, without the support of a residency program, working with a population that is barely touched upon in undergrad (because neonates are not just smaller children), while participating a "rigorous" masters program? This sounds like a TERRIBLE idea. Not to mention, NNPs are super pigeonholed. What if you realize you hate the NICU? What if you love NICU but realize you want to be at the bedside, not managing many babies but not doing much hands-on care? Most of us go into the NICU thinking we want to eventually become NNPs, and guess what, most of us actually don't. You can't discover that about yourself unless you have actual NICU experience before starting a MSN program.

Coffee Nurse, BSN, RN · May 18, 2022

I just came across the thread you posted two days before this one:

SERIOUSLY. Do yourself an enormous favor: withdraw from/defer this program, spend 1-2 years working in a NICU and learn firsthand what NNPs actually do before you try to become one. Find one you like and grill him/her for the good/bad/ugly about the job. This isn't like choosing a nursing specialty where you can just change if you decide you don't like it. This is putting a lot of time, money, and work into something that you don't seem to know anything about, where there's not really anything else you can do with it if you realize it's not for you. I've worked with plenty of burned-out NNPs at this point and it is so beyond frustrating when your baby is spiraling and the practitioner just doesn't care enough about their job to do anything.

adventure_rn, MSN, NP · May 18, 2022

4 hours ago, Coffee Nurse said:

Not to mention, NNPs are super pigeonholed. What if you realize you hate the NICU? What if you love NICU but realize you want to be at the bedside, not managing many babies but not doing much hands-on care?

@Coffee Nurse makes a lot of really good points. Part of what makes nursing so amazing is that there are dozens of different specialties with millions of different jobs you can do. The trick is, it's really hard to figure out exactly what you would like until you jump in and actually try it.

I can share a personal example: As a new grad, always felt like I needed to be trained to attend deliveries because it was a super-specialized training that only experienced nurses were allowed do, and all of the nurses who did it seemed so capable. I started to attend deliveries, and quickly realized that I hate it--I hate the unpredictability, I hate running around when four separate babies (or an unexpected set of multiples) all fall out at once and there's nobody available to help you, I hate that if you're working with a terrible provider the process can be miserable. To me, deliveries are like the ER of NICU. I much prefer the controlled, predictable ICU-style setting of the NICU after the kids have left the delivery room. Part of the reason I've opted not to become an NNP is because I dislike deliveries, and that's an inescapable part of being an NNP; however, I didn't even realize that about myself until practicing in the NICU for a couple of years.

As @Coffee Nurse said, you may not fully understand how hyper-specialized NNP is--if you get into it and realize that you don't like it, or if you do it for a decade and later come to realize that you don't like it, there is literally almost nothing else you can do. NICU is effectively the only practice setting for NNPs; granted, there are some smaller Level II community NICUs and some giant academic Level IV ICU-style NICUs, but they are always NICUs. You will likely always be running to deliveries (potentially with unexpectedly shell-shocked, coding, sick-as-snot kids), working 12-24 hour shifts, and sharing nights, weekends and holidays with the other NPs in your group. This is true whether you're 25 or 65.

A lot of the NNP job is amazing, but it is best suited to a very specific type of person, and it's not a career that I would recommend starting without knowing what you're getting into and if it would be a good fit. Honestly, even though most of my background is in NICU, I'm attending school for my Acute Care PNP specifically because of the vast range of practice settings (inpatient, outpatient, procedural, specialty clinics, ICUs, floor); granted, that path also requires at least a full year of inpatient peds to apply and two years by the time you enroll, much like almost all NNP programs.

I'm sorry if it sounds like we're piling on--you're clearly a very capable student since you've gotten into the program, and it's apparent from all of your posts that you are a very conscientious planner (I'm the same way!) but as someone with experience, I wouldn't recommend this path. Getting a couple of years of experience will benefit you whether you ultimately become an NNP or not--if you decide it's not for you, no harm done, and if you decide that it is the correct path for you, you'll be set up for greater success during school and as a new grad NNP.

Coffee Nurse, BSN, RN · May 18, 2022

Also, it just helps to know the ins and outs of an actual working NICU. I worked with an NNP who had gone back to school after some time in a level II nursery and then got hired into my level III. She was infuriating to work with because she micromanaged everything the RNs did - because she had never worked in a level III as a RN and had no idea how much assessment/intervention we do without even involving a practitioner. If she'd had level III experience, she would have had a much better sense of the intersection between the RN/NNP roles.

EricJRN, MSN, RN · May 29, 2022

I'm late to the discussion, but I'm just echoing that that's an odd "no nurse residencies" requirement. A nurse residency program should make it easier to succeed as a new grad, not harder.

**NICU Guy, BSN, RN** · Jun 2, 2022

On 5/29/2022 at 5:19 PM, EricJRN said:

I'm late to the discussion, but I'm just echoing that that's an odd "no nurse residencies" requirement. A nurse residency program should make it easier to succeed as a new grad, not harder.

Many NNP programs require 2 yrs experience. Nurse residency may involve extensive classroom time or preceptor time which should not count towards experience since you are not independently taking hands-on care of patients.

EricJRN, MSN, RN · Jun 2, 2022

1 hour ago, NICU Guy said:

Many NNP programs require 2 yrs experience. Nurse residency may involve extensive classroom time or preceptor time which should not count towards experience since you are not independently taking hands-on care of patients.

Almost all of them do in my experience, and I think it would be reasonable if an NNP program said they didn't count the orientation period as experience. (In the longer Vizient-type residencies, they'll probably be taking independent assignments long before the nurse residency program ends.)

I know that nurse residency requirements can be time-consuming, but no matter how difficult it is to succeed as a nurse resident, I think it would be harder to learn those essential things without the structure of the residency.

When I think about units that might hire a new grad without a nurse residency program, I'm thinking of small, low-acuity units that wouldn't exactly be great preparation for an aspiring NP.