Giving Nursing Students a Taste of NICU

[SteveNNP]

Too often, nursing students are abruptly dropped off at the NICU door, handed a scrub sponge, and abandoned by their nursing instructor, who is equally petrified of what lies beyond the glass-paneled door...

We all know that students rarely get a glimpse of what we do in NICU, let alone get to experience the day-to-day life that is our job as a neonatal ICU RN. Often we groan inwardly at the idea of having someone tag along with us on our highly organized and structured routine, interrupting our seamless flow of care with the interjection of questions and gasps at "how small these babies are."

Nursing schools haven't changed much in the way they teach neonatal nursing care. They just, well, don't. I mean, when I was in nursing school 5 years ago (= ages), We briefly covered nursing care of the well newborn along with the onslaught of information that comes with learning enough antepartum, labor/delivery, pediatric and newborn nursing in a mere 15 week semester. I can't even remember what I learned about neonates.

So where does that leave us, the lucky nurse to have been volunteered to show a student around?

I think it leaves us NICU nurses with an obligation to give them a realistic and honest taste of what NICU life is like. This means having them get report with you, check orders, go on deliveries, calculate meds, run fluids, change diapers, feed, assess, look up labs, observe procedures, attend rounds, etc. The most important thing is to let them get their hands "dirty." I can't tell you how many students have followed me, with a wild, petrified look in their eyes, suddenly relax and melt when I've picked up a bread-and-butter 31 weeker on room air and passed him to them while I changed the isolette mattress....The look is priceless..puzzlement, terror, then excitement... They suddenly go from believing "This is something I could NEVER do" to "Wait, I could do this!"

We need more good nurses in NICU. Here's our chance to mentor a few good ones, before they leave the unit thinking, "Wow... I could never do that.... I'm going to med/surg!"

My goal is to have that wet-behind-the-ears nursing student, overwhelmed by life, school, and the choices ahead of them, leave the unit after that one day thinking "THIS is what I want to do....."

[lovemybabes]

I am a Preceptor to many Student Rn's and want to give them a packet with helpful info on the first day. Student RNs, what would have been helpful to you to have information on to refer to? Does anyone else handout packets of info to Student RNs? If so, what info do you give them?

Thanks

[megan1019]

I am an LPN student and we are in our OB/Peds rotation. I had the opportunity of going into the NICU and the nurses were amazing! I know that LPN's can't usually work in the hospital, but I am going on to get my RN after this, so it was beneficial to me. I feel that the NICU nurses are special people that just have the biggest hearts. I got to feed a couple of the babies and rock them to sleep. The day before I had the opportunity to help with a birth, then go into the OR to watch a C-section. This just pushes me to get my RN right after LPN because I want to work in Labor and Delivery.

[Double-Helix, BSN, RN]

I haven't read through the comments, so I'm sorry if this was already said, but:

I'm really glad that your NICU allows students to participate in care, because the hospital where I did my clinical rotations was not like that. Students were there for observation only. We got a one day rotation in the NICU. We could feed and change diapers on the stable "grower/feeder" kids, but were not allowed to perform any nursing interventions.

Now I work in a PICU that has the exact same policy for our nursing students. Observation only. There are opportunities to learn by watching, but in my opinion you perform so many skills in the PICU and it's unfortunate that student's can't participate at the discretion of the nurse. When I have nursing students now I always try to explain everything, but I always feel sorry that they can't actually do anything.

[prmenrs, RN]

@Ashley--you are so right!

We had some students who did an elective and were w/us for much longer periods of time. They were given preceptors and worked 12 hour shifts along side the preceptor. They got to do everything!

But if a student is only there for a day or two, feeding and diapering are about all they get to do. Especially if they have a "deer in the headlights" look and confess they've never held a baby, fed a baby or changed a diaper. If you can get them thru that much while still teaching thermoregulation, hypoglycemia, and maybe hyperbili, you're doing really well.

[hikernurse]

We also do the observation day for nursing students, just to give them a quick overview and hope that the ones who like it will lobby to come back and do their capstones with us. We take them around and show them the different things that are going on in the unit and have them do an assessment alongside us. No charting or giving meds, etc.

Part of the reason we do that is the nursing schools send their students to us at such varying times--it may be at the start of their second semester when they really haven't had any acute clinicals or it may be during their last semester.

I do agree with you, it is nice to have the opportunity to learn new things at the nurse's discretion. Depending on the situation, I'll try to find fitting activities for the student I'm assigned. Some love to sit and hold babies and others want the adrenaline--those students I'll try to find an unstable baby for them to watch and learn from a safe distance.

I haven't read through the comments, so I'm sorry if this was already said, but:

I'm really glad that your NICU allows students to participate in care, because the hospital where I did my clinical rotations was not like that. Students were there for observation only. We got a one day rotation in the NICU. We could feed and change diapers on the stable "grower/feeder" kids, but were not allowed to perform any nursing interventions.

Now I work in a PICU that has the exact same policy for our nursing students. Observation only. There are opportunities to learn by watching, but in my opinion you perform so many skills in the PICU and it's unfortunate that student's can't participate at the discretion of the nurse. When I have nursing students now I always try to explain everything, but I always feel sorry that they can't actually do anything.

[awildsoul]

[h=1]Hi Steve,

I just commented on the Advanced Practice Nursing forum. But I found this thread and thought you might be able to offer some advice. I want to become a nurse practitioner focusing on maternal child health in low-resource areas (either in the US or Africa).

I am considering Neonatal because a few years ago I was working in a rural hospital in Kenya, and I found myself volunteering in the NICU during all of my free-time. I loved it. Looooved it. I would stay late into the night. I think I spent the last four years of my life trying to make sense of what I witnessed in the NICU (watching many babies die) through literature courses and art.

Although I am also considering midwifery (and pediatrics, and primary care), I want to be qualified to work with sick babies AND healthy mothers/babies. I already have a bachelor's of arts, so I am looking at ABSN, Direct-entry MSN and MPH programs. To become a neonatal nurse practitioner, I would need to gain experience to meet the requirement (maybe a year full-time, and then a year part-time while going back to school?). How do I ensure that I become the best I can be? And as quickly as possible (within reason, I am just SO ready--mentally, at least)?

Do you have any programs you recommend? Thank you so, so much.

In light and love,

Julia[/h]

[HyperSaurus, RN, BSN]

I realise this thread is old, but I just wanted to say that it is because of how I was treated as a student and the experiences I was allowed while in NICU that I pursued NICU as an RN.

In my Peds/OB semester, I had a day observation as part of my peds practicum and ob practicum ( work with a feeder/grower). Then, while following a mother through her last month of pregnancy and delivery, I ended up watching the resuscitation, stabilization, and admission of the newborn to NICU. The nurses made it clear that I was free to watch (and hold the surfactant to warm it up) as long as I stayed out of the way. They were calm, professional, and kind to me. In my senior semester, when it came time to select our top picks for our internships, I wrote down NICU (even though it wasn't an option). I was the only one who did that, thus I got it. I spent 90 hours with an experienced RNC. We went on a transport, to two sections, and cared for a variety of babies. I did run afoul of some of the more territorial nurses ("Get away from my baby!"), but overall, it was an amazing and educational experience that I was incredibly lucky to have.

As a new grad, I was hired to an adult med/onc with tele unit. It has been enjoyable (and incredibly stressful), but I didn't forget NICU. Medical just hasn't felt like my home or niche. There were recently several openings in NICU which I applied for. I was able to use my experiences as a student for my interview. I start in 5 weeks!

As a side note, I was pleased to find out that since I did the first student internship there, there are several nurses who will take students now, an opportunity that did not exist before.

[prmenrs, RN]

Best wishes on your new gig!!

[ehankins]

You wrote this so long ago, I doubt you will see this. I just wanted to let you know that I appreciate nurses such as you incredibly. I am a junior nursing student and will never step foot into a NICU as a student. I crave more information about neonatal nursing but all I have been exposed to are well babies/labor&delivery/postpartum. When I ask nurses what it is like, I just get told that it is emotional/hard & some have even told me straight out not to do it. It's so disheartening because the whole reason I went into nursing is to become a neonatal nurse and I know so little about it.

[NICU Guy, BSN, RN]

When I ask nurses what it is like, I just get told that it is emotional/hard & some have even told me straight out not to do it. It's so disheartening because the whole reason I went into nursing is to become a neonatal nurse and I know so little about it.

It can be emotional at times, but every specialty can have those moments. There are plenty of good moments that make it worth it. If NICU is your dream, then go for it. Don't let anyone discourage you. If you want to see what it is like to work in a NICU, call the NICU at Vanderbilt to see if you can do a job shadow or come see me at Kosair Children's Hospital on Louisville.

[ehankins]

Thank you so much! I will definitely look into that!

[Maevish, ASN, RN]

I got to spend a mere 4 days in NICU during my OB rotation, and luckily, I had a nurse to follow that fit your goal exactly. She gave me the best nursing experience that I'd yet encountered in a clinical rotation.

I went into the semester with some interest in possibly going into NICU, but wasn't sure. I knew by then that I wanted to work in pedi at least. After working with this particular nurse, I was sold out to the NICU, and am still working toward accomplishing my goal of being placed there.

On behalf of all the nervous and scared nursing students, thank you for caring.

4 days?? I would think that was a long time anywhere (unless you were precepting)!! That was unheard of in both my nursing programs and I'm so jealous We got 1 or 2 days, I don't remember which, but weren't allowed to do much and were nervous the whole time (when I'm nervous I don't retain information well at ALL) and they were busy.

A lucky duck is what you are So happy you had that experience!

xo