Coffee Nurse

It's going to vary so much from nurse to nurse. I went through the whole AWHONN NOEP program before I tested, just to dot my Is and cross my Ts, but I've been working in level 3-4 units for 10+ years and honestly could have just winged the exam and been fine. A newer nurse is going to need a lot more study time.

I’m so glad to hear this! I think you’ve made a great decision and will be a better nurse, a better NNP if you choose to go down that route, and- most importantly - a happier person! I started as a new grad in a level IV. If they have a solid residency program and are accustomed to taking new grads and supporting them well, I say go for it! It’s easier to drop down to a level III if you decide the IV is too much, than to go the other way.

Also, it just helps to know the ins and outs of an actual working NICU. I worked with an NNP who had gone back to school after some time in a level II nursery and then got hired into my level III. She was infuriating to work with because she micromanaged everything the RNs did - because she had never worked in a level III as a RN and had no idea how much assessment/intervention we do without even involving a practitioner. If she'd had level III experience, she would have had a much better sense of the intersection between the RN/NNP roles.

I just came across the thread you posted two days before this one: SERIOUSLY. Do yourself an enormous favor: withdraw from/defer this program, spend 1-2 years working in a NICU and learn firsthand what NNPs actually do before you try to become one. Find one you like and grill him/her for the good/bad/ugly about the job. This isn't like choosing a nursing specialty where you can just change if you decide you don't like it. This is putting a lot of time, money, and work into something that you don't seem to know anything about, where there's not really anything else you can do with it if you realize it's not for you. I've worked with plenty of burned-out NNPs at this point and it is so beyond frustrating when your baby is spiraling and the practitioner just doesn't care enough about their job to do anything.

ALL OF THIS. I am super skeeved at the idea of a direct-entry NNP program. At best, a BSN gets maybe a senior capstone in the NICU, and that's just learning on the fly, without a didactic course to ground the hands-on part. Figuring out how to be an actual nurse, without the support of a residency program, working with a population that is barely touched upon in undergrad (because neonates are not just smaller children), while participating a "rigorous" masters program? This sounds like a TERRIBLE idea. Not to mention, NNPs are super pigeonholed. What if you realize you hate the NICU? What if you love NICU but realize you want to be at the bedside, not managing many babies but not doing much hands-on care? Most of us go into the NICU thinking we want to eventually become NNPs, and guess what, most of us actually don't. You can't discover that about yourself unless you have actual NICU experience before starting a MSN program.

DM is fine.

Sure, if you like.

No, I left about a decade ago. The unit is amazing but I was done living in LA.

I will add, a lot of NICU nurses get pretty protective of their patients - we're their main advocates really, since they can't speak up for themselves and their parents generally know a lot less about them than we do - which may be coming off as harsh in your preceptor. I'm not saying it's ideal, but it is a thing. May be worth talking to your educator if you think there's a genuine clash in personality, but bear this fact in mind. And I second the opinion that you need WAYYY more than 10 or even 16 weeks in a level 3 NICU to begin to feel any sort of comfortable or confident. It's a world that very few people ever see and schools almost never give you a peek into it. In a way, it's almost good that you feel "stupid" - it means you understand how little you know coming into it (it's the overconfident new grads that are scary to preceptors) and shows you how much room you have to grow.

Having started as a new grad in a level III/IV that did have some level II kids as well, I'd go for the second option. If the level IV has a residency program then they must have figured out a way to make that work, but I personally can't imagine not having grower/feeders to learn the ropes with before jumping in with the sickest of the sick. As a new grad you need to get a solid grasp of what's normal - especially with babies, who are given short shrift in the typical nursing school program - so you have a foundation for handling things that aren't normal.

You're at the start of your career. You have plenty of time to find "optimal happiness." Appreciate the opportunity you've been given, wring as much knowledge and experience as you can out of it, and either a) you will find you actually love med surg, or b) you can reassess once you have 1+ years on your resume and see where to go from there. Also, use punctuation. Clear communication is critical in healthcare and your post is extremely difficult to read.

I'm trying to think of a plausible backronym to boost credibility, but all I can come up with is W-U-Z-Zero Incidental Extubations.

I've definitely used the Wuzzie technique before too. Alternatively, just make sure your tape is nice and secure, and that the vent circuit won't get caught on anything and start pulling. If you have a feisty kid, make sure they can't get their hands up and grab the tube. Then just take it slow and keep a close eye on your tape/tube as you move the baby. It's one of those things you'll get used to with experience.

No. Some people pick up loads of overtime. Some don't do any. Some are anywhere in between those two extremes. Do what you want to do.

Sounds like you need to assert yourself and your needs a little more. "Sorry, I can't" is plenty of reason not to work extra. Their getting irritated with you just reflects poorly on their own staffing plans, which apparently don't work unless people do extra shifts. Also, you should be calling out sick if you're sick, not "never no matter what." It doesn't sound like they respect you too much, so you need to stand up for yourself.