Going from Level III to Level IV

[HyperSaurus, RN, BSN]

I've recently gotten a new position in a larger (70 ish beds) level IV NICU after three + years experience in a small (20 ish beds) level III NICU. After a week of orientation, I have to say, I feel like I've got some culture shock going on. New charting system, more complex patients, a huge unit, private rooms (previously from an open bay unit), and while they're getting me some orientation time working with issues I haven't dealt with before (namely, surgical patients), I'm only going to end up with 4 weeks orientation. I'm not sure if there's a point to this, other than to ask if anyone else has made this transition, and if so, what advice do you have.

[Burnvegas]

I think a lot of us have survived the transition to higher acuity.

Lots of learning curves, but if you know your basic vent and inotropes and stuff, everything else will come to you in time.

Don't forget your basics and assessment skills, cause they're the same (the just have a silo now).

Don't get second unit syndrome.

Use your orientation time wisely. And don't feel like you can't ask for help or refuse an assignment just because you're experienced in neonatal.

Because that's all the mistakes i made :). The rest will come, so don't worry too much. I hope you get a lot out of it. Level IV i find is a lot more interesting and you'll gain great skills if you choose to go back to different levels.

[HyperSaurus, RN, BSN]

So, what's second unit syndrome? lol

[NICU Guy, BSN, RN]

So, what's second unit syndrome? lol

I think it is the "At my old unit we did it this way and it was so much easier than the way you do it."

[HyperSaurus, RN, BSN]

Lol, my version seems to be, "Wow, this is so much better than the way I used to do it!"

[mslema]

Sorry I have no advice but I am also wanting to work in a level IV NICU. My issue is that most places won't hire unless you already have the experience. Was the level IV position a training position when you applied?