Help new to NICU!

Imafloat, BSN, RN · Jan 10, 2007

I look forward to reading responses, I was coming here to post something similar.

I did my senior practicum in the NICU and this week was the first week of orientation. Things sure are different when you hold a license. I am trying hard to not become overwhelmed. I feel like more will be expected of me since I did my practicum there. I hit the floor with my preceptor on Monday. There is so much more to being a nurse than just taking care of the patients.

I know we can do this, we just need to believe in ourselves!

SteveNNP, MSN, NP · Jan 10, 2007

Hi,

I understand how you are feeling... I started in NICU almost 2 years ago, right out of school, having only worked with adults...never anything younger than 18. I had a great orientation, and took on tasks as I was comfortable. I would watch my preceptor a lot those first few days as I familiarized myself with charting, meds, etc, then started doing those tasks with her help. A lot of what you have learned from adults critical care will cross over: a-lines, vents, chest tubes, iv hyperal etc... you'll just have to modify and add to what you already know. As for turning a 23-weeker.... babies don't have to be turned as often as adults. As long as they are welll nested and their lungs look pretty clear, you can leave them alone for 4-6 hours at a time. With babies that small, it's best to do what you need to, cover their isolette, and leave them the heck alone until you have to reassess them. I learned this trick from one of my coworkers and I love it.. take a typical NICU baby blanket and fold it into thirds crosswise (or 4ths if it's a really small baby), Slide it flat crosswise to the mattress under the baby up to his shoulders and roll both ends of the blanket under until you get a nice roll on either side of the baby forming a "hammock" (roll "toward" you as you roll it up towards the baby) When you go to turn the baby to one side or the other, just keep rolling one side, and the baby will tilt up on one side, without having to physically pick them up. Just make sure you have help available, and all your tubes look OK. Best of luck!!

prmenrs, RN · Jan 11, 2007

I think in this role, you've got an opportunity to get some basic skills down. Basic baby care, skin care, baths; FEEDING--normal babies, then premies, then teaching them how to eat. And you need to know when not to feed a baby, checking girths, watching stools. Color changes, when a premie is overstimulated and needs to calm down, and how to do that. When and what to report to the RN, and how fast.

Interacting, supporting and teaching parents; breastfeeding and how to facilitate that.

I'm hoping you'll be concentrating on the "convalescing premie". You'll have plenty to learn and do w/o dealing w/the ICU environment.

The reason I'm encouraging this is to give you time to aclimate your interior "norms" (by that I mean that thing that you have now--when you look @ a pt, an know something's off). As you are acknowledging, babies are a very different kind of pt., and premies are almost a whole 'nother species. Delightful, but different.

Good luck, and let us know how you're doing.

cmarsh333 · Jan 11, 2007

Thank you. It's all so new but i am really excited to become part of such a specialty. The nurses i work with now always joke with me about the $12/hr i am going to make. My repsponse to them is it's about getting experience i don't have and doing something i am really going to enjoy. I am glad i have the opportunity to gain some hands on experience before becoming the RN. I will keep everyone updated and i am sure i will have plenty more questions. So as far as NCLEX???????? I know i still have 2 semesters left, but everynight i do 10 questions from my NCLEX book to see where i am at. I did a comprehensive exam on the computer i did 100 questions and i got 86 correct. i thought that was okay for now. I would like to find out some info on NCLEX classes.