How long until....

RainDreamer, BSN, RN · Feb 9, 2007

How many weeks have you been on orientation so far?

I started in the NICU last March, had about 14 weeks of orientation, and have been on my own for about 7 months now.

The first few weeks I was on orientation I was SCARED TO DEATH! I don't know why, but I would get so freaked out and overwhelmed, even though I had a preceptor with me. Those first couple of weeks I'd throw up before my shift, it was awful. The weeks got better though, although I was still crying before my shifts, but it wasn't as bad as the first 2 weeks. My preceptor was AWESOME, she was always picking us different assignments, we usually had a new and different assignment each day. I got to see a lot .... we had vents, jets, oscillators, nitric, ECMO, cardiac, post-op, babies with birth defects, etc. It was so overwhelming, but I got to be exposted to a lot of different things. But after having 1 or 2 nights with any of those types of kids isn't nearly enough to feel comfortable, it just exposes you to it, so you have at least some idea of what's going on.

I remember one night we had this really sick new admission, cardiac kid with Truncus Arteriosus. This kid was on like 4 different drips, her CO2 was 100+, they talked about doing ECMO. Originally they had a hard time intubating her because something was blocking the airway, so they ended up coming in and doing a bronchoscopy to see what was going on. Later that night she coded. But then ended up being pretty stable by the end of the shift, gases were a lot better. But wow, that night was insane. I remember when they were coding her I just stood there in shock. The clinical supervisor was recording and she just had me standing over there with her, showing me what she was writing and just talking me through it (it was a slow code, so it wasn't too insane and she was able to talk to me about stuff they were doing). After it was all over my preceptor was like "see, you can handle that all on your own, huh?!" lol I was like you've got to be kidding me, she just gave me a hug and said I did great. Stuff like that was even overwhelming for my preceptor, and she's been a NICU nurse for over 13 years! That whole night was non-stop and insane, even for her. That made me feel better, in knowing that it's supposed to be overwhelming for me and there's no way that I'll be expected to take a kid like that on my own anytime soon.

So that was my orientation, lots of crazy nights, lots of interesting assignments. But I was actually somewhat relieved to be on my own finally. I was able to take my own little "stable" assignment and I knew I could ask for help anytime I needed it.

When I was first on my own they made sure I had a strong pod partner and she would be there any time I needed help, along with the charge nurse, high risk nurse, and anyone else I needed. My 3rd night on my own I had a vent and a feeder grower, not too bad. But then my stable vent turned into an unstable vent ..... he was requiring 100% and still not satting great. So the night just got worse and at about 5 am he extubated when the RT was suctioning him. I had no idea what to do! My pod partner and the RT helped me so much and pretty much took over. I can't imagine being left on my own in a situation like that.

Back in December (I had been on my own for almost 5 months) I got my first big admission. I had done admissions before but they were all pretty "easy", nothing too bad. But this night I got a 24 week twin. UGH! What a nightmare! I don't want to tell you it wasn't bad, because you'll definitely have your bad shifts, and this was one of them for me. All night long I had been expecting this kid ..... finally showed up at 4 am (always a great time for an admission lol). It was insane. EVERYONE jumped in and helped me out. The lady that precepted me jumped in to help me out, along with my pod partner, the high risk nurse and a ton of other people ...... they helped out so much. At the time I wasn't grateful for getting that admission, but I am now ...... an admission like that was one of my fears, I always feared being first admit (still am to an extent) because I feared getting a little 23 or 24 weeker. But it happened and I survived.

I tell you those stories just to show that you'll have fears (your baby that extubates or having a 24 week admission), but once you're finally in that situation and your baby does code or you do get a 24 weeker .... that you're NOT ALONE! I wasn't just thrown a 24 weeker and said "here, all yours!" When my baby extubated I wasn't just left on my own. Generally most people (and I say most in that there will be some that aren't the most helpful, but most of them really are) won't let you drown ..... they don't want to see anything bad happen to these babies, and they remember what it was like when they were new.

During your orientation get to know a lot of the people that you work with. You'll get to know which nurses you can trust to ask for help, you'll see which ones are always asking if they can do anything for you. When you're on orientation if you're preceptor isn't readily available (and they can't be at all times), then seek out one of those other people. Ask them questions, double check things with them, ask for help doing something if you don't feel comfortable doing it yourself. We've got a brand new group of new grads that just started and I love when they ask me for help ..... I remember all too well how I felt at first and I really empathize with them.

You'll be amazed at how much you'll learn over the next few weeks and months and how much more comfortable you'll feel. I still get nervous sometimes when I go in, but it's not nearly as bad as at first.

It will get better, I promise you.

Imafloat, BSN, RN · Feb 9, 2007

How many weeks have you been on orientation so far?

I just finished week 4 of orientation. I get about 10 weeks of orientation. I did my senior practicum (180 hours) at this NICU so they cut down the 14 week orientation time. If I or my preceptor feel I am not ready to be on my own then it is no sweat, I can stay on orientation longer, which is a relief.

My orientation is on days, I go to nights on March 6, then I work with a preceptor for 2 weeks before I am set loose.

Thanks for sharing your story, it is encouraging to know that I might someday be telling a similar one.