First day-fish out of water!

[MistyM]

Hi all

So I've just had my first day as a neonatal nurse! I have originally qualified as an adult nurse an have been working in an adult trauma ICU. My manager said working in an adult ICU would mean I had transferable skills to bring to neonatal. So optimistic on my first day I arrived and was allocated a lovely mentor to work alongside to show me the ropes. Our NNU has an ICU pod an HDU pod and a SCBU pod. My first assignment was in the HDU and I tell you I thought I knew a bit about nursing but stick me into neonates and I know nothing! I feel like I'm right back at square one as a brand new student even tho iv been nursing now for 4 and a half years! It was as tho a foreign language was being spoken! Anyone any tips, websites or any info that may help me. Such as info on gestation, feeding (breast and bottle), typical conplications a neonate might acquire, I feel like a fish out of water and this is what I have been wanting to do for a while now but no amount of pre reading could of prepared me!

Thanks in advance

[monkeybug]

The dosages freaked me out when I started in the NICU. The scale is so much smaller! I was really thrilled that, at that time, the policy was that two nurses had to check each medication before it was administered. You just cannot skip things or overlook them when it comes to neonates. Tummy a bit distended? Watch it in an adult, maybe, but in a neonate you have to immediately consider NEC. I was not a critical care nurse when I came to NICU, but I still had to put aside a lot of my old habits and assumptions. You will learn it, you just have to remember that babies are totally different, and don't rely on your old knowledge.

Some tips? Never, never, never spill Pregestimil on yourself. You'll stink to high heaven for the rest of the day. I loved it when my babies had mommies that breastfed, not just because I'm a firm believer that breast is best, but also because formula is just plain nasty. Nasty going in, and nasty when it comes out, either as spit up or poop. And breastfeeding (and pumping) are hard, so encourage, praise, and support all you can. When a baby is in the NICU and mom is pumping, she doesn't have the payoff of the bonding, so someone has to be there telling her how very important it is. I just read a study the other day that showed that formula, in the digestion process, can release cytotoxins. That would certainly explain NEC. Another thing I remember was an easy way to do urine samples for baby girls. If you were getting a tox screen or something else that didn't require sterility, we would skip the bag (which usually comes un-stuck, spilling the urine all in the diaper anyway) and just put cotton balls in the diaper. When they were soaked with pee, we would pull the plunger out of a 20cc syringe, stuff the cotton balls down in the syringe, replace the punger, and then press it. Voila, pee squirts out of the syringe and you have your sample. Dealing with families is interesting. When you are the nurse, the moms can feel jealous. It's their baby, but you are the one doing the caring. Make extra efforts to point out their importance and encourage their participation.

Good luck to you! I loved the babies, but only spent a year there before I went back to L&D. I found that I lost my objectivity in NICU. I took it home with me and let it stress me out too much.

[prmenrs, RN]

Adults and neonates might as well be 2 different species. If you've spent that much time doing adults (in addition to nsg sch, which focus almost exclusively on grown-ups), you WILL feel like a "fish out of water" for 2-6 months.

If you haven't already, order/borrow a copy of Merenstein and Gardner and some highlighters. You need a neonatal drug reference, too. I suggest Neofax.

Amazon.com: neofax 2012