Need advice on going to another unit in another state

Gompers, BSN, RN · Nov 23, 2005

When experience NICU nurses come to our unit, we usually give them as long of an orientation as seems necessary. It's usually about 2 weeks, just having a preceptor there to help transition the nurse since every hospital (and every NICU especially) does things a little differently. Once they get a hang of our routine, they usually ask to be off orientation themselves. In a way, it's like when an agency nurse comes to work - they know what they're doing, just need a little help getting used to the new unit.

As far as the ECMO and heart babies go, they'll teach you that. As far as I know, you still need to be certified to do ECMO, and if you're interested, they'll probably send you for certification after you've gotten the lay of the land. So don't worry, they'll teach you everything you need to know there. As far as heart babies go - we used to do that in our NICU. Each baby had 2 nurses - one for patient care and giving meds, the other for charting and organization. If a nurse wanted to learn how to take care of the post-op hearts, we'd just put them with another nurse as part of that two-nurse team, and they learned on the job that way. It's very complex work, and I saw nurses who'd been there for over 10 years just learning how to do it, almost like a cardiac orientation. There was no shame in it - no one is born knowing what to do! I was only there for a year at that time and was terrified of hearts, so I never did learn how to care for them post-op.

Enjoy your new job!

bbrown1 · Nov 30, 2005

what area of south carolina are you planning on moving to?

KK7724 · Nov 30, 2005

what area of south carolina are you planning on moving to?

Charleston and I'm so excited!!! So, of course that means I'm looking at MUSC for their NICU. I really hope I can get a position with them since they're the only Level III in the city and I think, for about an hour and a half??

I'm moving either in mid-June or early to mid-July. When do you think I should start applying?? I am scared that new grads will be graduating around May and taking the open slots though!! I really want to secure a job asap!

~Kristina, RN, BSN~

Mithrah · Dec 6, 2005

I made a transition from one state to another going from a Level III NICU to another Level III NICU and it was a such a huge shocker for me. There are so many different ways of doing things.

For example:

My old job - used heel warmers before heelsticks, had appropriate diaper sizes for all neonates, used the Neosucker to suction nares and oral secretions, never poked the big toes or fingers on preemies, gave developmental baths, gave blood only when the baby was symptomatic and absolutely needed it. And central lines were put in ASAP when babies were going to be on TPN and lipids for several weeks.

My new place of employment doesn't believe in heel warmers, uses Preemie Pampers on 1700 gram babies (lol), uses pediatric nasal aspirators, developmental baths are unheard of, loves to poke big toes, gives blood like it is candy when the HGB drops below normal, and central lines get placed, but very few nurse are able to place them and it can take weeks for a 27 weeker to get one.

The list goes on and on, but when you have the equipment you need at one NICU and go to one that can't afford even appropriate diapers sizes it can be frustrating and annoying.

Good luck to you and your new job. I hope that you work at a place that embraces change and thinks of the babies. The reason you are there are for the babies, but I guess some NICUs don't understand that.

bbrown1 · Dec 6, 2005

Good luck in Charleston! I am sure you will enjoy it there, I have heard it is beautiful!

bbrown1

KK7724 · Dec 6, 2005

I made a transition from one state to another going from a Level III NICU to another Level III NICU and it was a such a huge shocker for me. There are so many different ways of doing things.
For example:
My old job - used heel warmers before heelsticks, had appropriate diaper sizes for all neonates, used the Neosucker to suction nares and oral secretions, never poked the big toes or fingers on preemies, gave developmental baths, gave blood only when the baby was symptomatic and absolutely needed it. And central lines were put in ASAP when babies were going to be on TPN and lipids for several weeks.
My new place of employment doesn't believe in heel warmers, uses Preemie Pampers on 1700 gram babies (lol), uses pediatric nasal aspirators, developmental baths are unheard of, loves to poke big toes, gives blood like it is candy when the HGB drops below normal, and central lines get placed, but very few nurse are able to place them and it can take weeks for a 27 weeker to get one.
The list goes on and on, but when you have the equipment you need at one NICU and go to one that can't afford even appropriate diapers sizes it can be frustrating and annoying.
Good luck to you and your new job. I hope that you work at a place that embraces change and thinks of the babies. The reason you are there are for the babies, but I guess some NICUs don't understand that.

Wow, the NICU I work in now sounds like the the "old job" you described. We only give blood if symptomatic and PICC lines are golden! Even if the baby is on one of the Increase/Decrease feeding schedules, we don't turn that TPN below a KVO rate because heplocks just do not last and TPN and Lipids will tear that tissue up! We have several PICC line certified nurses in our unit and they do all the dressing changes on them too. I haven't heard of developmental baths, but we do position them developmentally. The Preemie Outreach group, Threads of Love, sends us clothes and bean bags, and my favorite thing of all---(Kozies)...the little thing that look like a kangaroo pouch or cocoon....really mimics the womb and calms a baby in an instant. Now, we do several things that a lot of our travelers say are BAD....for example, we never have a doctor in house after a.m. round are done. They come in for new admits when they can....(If they're sick enough), nurses intubate, we interpret blood gases and make vent settings changes based on parameters the docs leave us for the child to be in, so, tons of autonomy and responsiblity, plus our assignments are very heavy.....so, I guess it will be nice to go to another NICU that lets Respiratory manage the airway, and the docs make more of the decisions....did I mention we also give Survanta at our unit??? Yep.....(I have not, but I know the experienced nurses do!). You really raise a good point though...NICUs are so different....even in same states I think. I think it's going to be really tough for me to get out of the routine I'm used to or the policy and procedures I'm used to...but I'll have to learn. Thanks for replying!

~Kristina~