How does your NICU unit run?

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I am a NICU nurse and *might* do travel nursing. I was just curious how different NICUs operate across the U.S.

For example, in our level II, the babies eat at 9,12,3, and 6. We do vitals Q4 hrs.

In level III, for the micro premies, we do touch time at 8 and 2, vitals Q2 hrs.

Labs/weights are for night shift.

IV fluid changes/procedures happen on day shift.

Any input is helpful! Thank you

Specializes in NICU. Has 10 years experience.

Well I live in Florida, our NICU is similar. We are a level III NICU. In level 2, our babies eat on an 8 or 9:00 schedule. 8,11,2,5 or 9,12,3,6. We do hands on each of those times.

In level three, we have the same feeding schedule, unless they eat on other than q3 hour feeds, then it's different. We do hands on every 4 hours on our level III babies (8,12,4), unless they are too critical, we get an order for hands on less frequent.

We also do weights and lengths at night. We do labs all day long, just depends if it's needed stat or what, whenever the doc orders it obviously. Our routine daily labs are at 0400. Our fluids are done on day shift. Hope this helps

LucyRn4

17 Posts

Thanks so much for the input! Glad to see similarities in our units!

Specializes in NICU. Has 10 years experience.

Yeah, it definitely is because we have so many travelers, I am sure it is good for them to come in and only get orientation to the unit and be expected to take care of babies on their own after 3 days. I also enjoy reading posts that show the differences. I have only been here for 7 months and I'm always thinking of ways we can do things better.

SteveNNP, MSN, NP

2 Articles; 2,512 Posts

Specializes in Neonatal ICU (Cardiothoracic). Has 9 years experience.

In my unit (Level IV) routine VS and cares/feeds are at 8-11-2-5. Fluids are done by day shift, and routine labs are done at 0400.

Has 10 years experience.

Level III. Babies are on a q4 or q3 schedule per physician order. Vitals are taken with the hands on assessment.

Labs and weight at night.

tinkerbell419

181 Posts

Its quite interesting to see how NICU units are run in the US. Im pretty sure you work similarly to units in the UK. Babies are weighed twice a week or more frequently if there is a concern, maybe with loosing weight or gaining weight fast. Some babies have daily bloods to check for FBC's and U&Es.

We also have checklists to ensure that we are compliant with infection control. We must check emergency spaces, the neopuff, emergency equipment, fridge temperatures, electronic tags etc.

Do any of your units take heelpricks for bloodspot screening? We do this in the UK provided that we have consent.

With fluids it depends on when we get the prescription written up and more to the point when people are free to help you out. So it can be done on day shift or night shift.

The more well babies may feed 2 or 3 hourly and babies nearing to go home are put on to demand meaning that they cant go more than 5 hours to feed. Babies in ITU depending on clinical condition and status may be on hourly feeds or trophic feeds (tiny amounts of milk) to prime the gut but they would be on fluids or parenteral nutrition.

Im guessing that you also use artificial nutrition involving vamin and lipids in the US?

zeus&lincoln

156 Posts

Kiddos eat and are assessed either 8,11,2,4 or 9,12,3,6 unless they are ad lib or in a 3 baby assignment. We do full hands on our first and third touch times unless kid is sick and needs more invasive/frequent monitoring.Sugars done q12 on any kid with fluids infusing. Labs done around 4 am.Weights, routine X-rays and tpn changed on night, clears done on days. Labs, sepsis screens, stat X-rays can be done anytime as needed.

fifita2010

34 Posts

Specializes in NICU. Has 45 years experience.

I've done a lot of travel assignments in the NICU. At my current job it's a mishmash. Babies eat on a 9-12-3 or an 8-11-2. Sometimes you get three or four on the same schedule. The fluids are changed on evenings by 11pm and must be done on time as all the volume infused is cleared exactly at 11pm. I think it's good to know all the different ways NICUs operate. I have seen the hands off approach to micro premise be consistent with monitor VS in between. Nights do weights, baths, car seat testing and labs.

NICURN29

188 Posts

Specializes in NICU. Has 11 years experience.

We have two care times...8-11-2-5 and 9-12-3-6. Our level III babies are assessed and have vitals done q3h. Our level II babies are assessed qshift, so 3x/day. Baths are done whenever parents schedule them or on nights if parents are not taking part. We bathe every four days. TPN/IL are hung after 1900, and labs are done with the 0500/0600 cares for babies on IV nutrition and with the 0800/0900 cares for others.

rnkaytee

219 Posts

I'm curious - why bother putting every baby on an 8-11-14-17 when they obviously aren't going to get fed all at the same time? Are those the times that you just start your round of 3-4 babies? The hospitals I worked all did this. At my NICU we feed each baby at 30 minute increments, so I might have an 8-8:30-9 in my assignment.

LucyRn4

17 Posts

Thank you, everyone for your input. It seems NICUs are run pretty similar, just with a few minor differences. Good to know!