Is it me, or am I being given unrealistic assignments in the NICU?

[tmjwe3]

Hey guys I just have to get this off my chest. Yesterday I had an assignment with 3 babies.

#1: PICC scalp, meningitis, 2 broad spectrum abx Both were twice my shift... she had bath/weight, ng change, linen change, 2 person sterile like change, and she was very poor bottles- max 30 mins which I had to do each time if I went faster she'd vomit, would only take 15% of her volume.

#2: Baby query CF, meconium plug, irrigations Q6H, weaning IV PIV, working up feeds, bottled over 30 mins as well, weight done.

#3: Baby tube bath, weight, change ng, linen, oral eversion, genetics involved. very poor bottles - in 30 mins would only take 15% volumes... tons meds ex premi

all three were fed Q3H... I ended up making a mistake and used the previous orders heparin flipped a page behind... had to write a safety occurrence on myself. I cried... idk if this assignment was realistic or if I'm just garbage. I didn't take any breaks, and the charge nurse just judged me like I was an idiot... bottling all three in an hour is unrealistic... with all the meds/assessment/ baths etc. I didn't eat, didn't sleep because I became so anxious. I feel like such a failure...

[ILoveHorsesRN, ADN]

Wow. That sounds like a heavy assignment! I worked NICU a total of 25 years. At the first NICU, we never had 3 baby assignments because the babies were high level acuity. At the second hospital they gave us 3 baby assignments and ever just having grower/feeders can be way too busy!

[Altalorraine]

It does sound heavy to me. After all Nicu is an *ICU* which should mean a limited patient load for each nurse.

[NICUmiiki, DNP, NP]

It does sound heavy to me. After all Nicu is an *ICU* which should mean a limited patient load for each nurse.

Not all NICU babies really need intensive care. Unless there is a separate "special care" or "Level II" nursery, the NICU will have a mix of patients. I like to simplify it and say that Level III babies are ICU, and Level II babies are like med/surg.

[ThePrincessBride, MSN, RN, NP]

Why are all babies fed on the same schedule? We have two feeding schedules : 8, 11, 2, 5 and 9, 12, 3, 6. Also, feeds do not have to last thirty minutes. In fact, if a baby is a poor feeder, it is best to limit feeds to even shorter intervals as at some point they just start burning calories trying to learn how to coordinate suck/swallow.

Very doable assignment, though your night/day would have flown by!

[ThePrincessBride, MSN, RN, NP]

It does sound heavy to me. After all Nicu is an *ICU* which should mean a limited patient load for each nurse.

Depending on the unit. The vast majority of NICU (Level III and below) consists of feeder-growers and babies on CPAP or NC. Very few are extremely sick and usually they end up being a 1:1 assignment.

[ThePrincessBride, MSN, RN, NP]

Very busy assignment,I would not po feed longer than 20 mins,that's our standard,three slow feeders is too much,not having a decent meal break is unacceptable,you are NOT paid for your lunch hour,you are working for free.Unless you know you will get back your time somehow when it is slow stop working for free.There is a value to your knowledge and experience.

Actually it is pretty standard on my unit to have three feeder-growers who suck at sucking and it is the case in many lower lower NICUs.

[essT]

Actually it is pretty standard on my unit to have three feeder-growers who suck at sucking and it is the case in many lower lower NICUs.

The pod system level II-III NICUs I've been in will do 4-5 crummy feeders together, provided they don't have a ton else going on. Not a fun assignment, and not fair to the babies.

[walkingrock, ADN]

I wouldn't feel that I could give safe and adequate care with this assignment; it's too heavy.

[vintage_RN, BSN, RN]

I wish I worked in the nicus that think this is a heavy assignment lol

[neonn965]

This would probably be an assignment in my NICU, albeit a somewhat heavy one. Three crappy PO feeder assignments are the absolute worst. I wouldn't PO all three every time, it's just not realistic unless charge is stepping in for some of the nippling. Your policy is really to wake for every feed? I would be really bothered by that. And the fact they all eat at the same time. If anything does not go according to plan with this assignment (say you lose your PIV, your PICC dressing suddenly needs changed, etc) charge is going to need to step in but otherwise it's manageable. Now, whether I would enjoy this particular assignment is a different story. I'd be happy to leave at the end, that's for sure. I also wouldn't feel that I could give my all to every kid which is a bummer.