I have been a nurse for almost nine months now and work in the NICU. This was my absolute dream job, and I worked so hard to land it. While I was on orientation I felt challenged as I was learning SO many new things. I have been off orientation for a while now and have have been stuck with feeder grower patients for over a month. My unit favors nurses with many many years experience and assigns them the sicker kids, daily. They are never given an intermediate assignment.
I am talking more about the nurses who have less than 2 years experience getting mostly the stable ICU cases and some intermediate patients. We are supposed to be mixed around the unit, with at least 30% ICU exposure. I have also (politely) asked my charge nurse to assign me anything ICU because I need the exposure. Usually I am given an excuse, and the next day I am back with the feeder growers. Managment likes me, and there has never been an issue with the care I have provided my patients. I don't understand. I am just about at my wits end with this matter. I did not go to school to be a daycare provider who rarely uses her brain. I understand that an intermediate case can shift quickly, but I need consistant exposure to vents, bcpap, umbilical lines etc to remain competent. Ugh!
That would be a convenient interpretation. However, no one would let it slide if the positions were reversed and the OP used the expression "old timer" when arguing with someone else who was experienced in the field. People would flip out and call it ageism in a second -- which is what this is.
I have to disagree. I'm 36 and my A&P teacher calls me kiddo all the time. There's no disrespect there. It can also be an affectionate term.
Charge RNs often asked feedbacks from other RNs on how the new hires are performing in their job. They might seem not watching you but they do observe the new comers. So for her not to be given the critical patients, the charge nurse has a valid reason...
Someone please fill me on on this. I'm either really tired, or just a clueless, non-NICU nurse :/
The OP cited personal experience with her own 4 children (with 1 on "Golden Hour" Protocol) ending up in the NICU as evidence that she should be allowed to care for more acute patients. Having 4 of your own children land in the NICU post-delivery is ummm....interesting to say the least.
Forgive me, what is "Golden Hour" protocol (zero exp in NICU)
It's the optimization of practices (temperature, oxygenation, glucose control, nutritional support, etc.) to improve outcomes for the super tiny premature infants. I don't think it's quite yet a standard across all NICUs in the US, however. The below article was published in 2014 as a means of supporting it's use.
Specializes in Nurse Leader specializing in Labor & Delivery.
The OP cited personal experience with her own 4 children (with 1 on "Golden Hour" Protocol) ending up in the NICU as evidence that she should be allowed to care for more acute patients. Having 4 of your own children land in the NICU post-delivery is ummm....interesting to say the least.
I don't think it's "ummm...interesting." She could be someone who has an incompetent cervix and delivered all her babies early after PTL. She could be someone who gets pre-eclampsia (which, if you get it once, you're at greater risk of getting it again) and had to be induced with all of her children at 34 weeks.
I don't agree with her assertion that it makes her better at the clinical skills of a NICU nurse, but I think it was pretty ****** to imply that there is something...I don't know...nefarious about the fact that she had 4 kids in the NICU.
I don't think it's "ummm...interesting." She could be someone who has an incompetent cervix and delivered all her babies early after PTL. She could be someone who gets pre-eclampsia (which, if you get it once, you're at greater risk of getting it again) and had to be induced with all of her children at 34 weeks.
I don't agree with her assertion that it makes her better at the clinical skills of a NICU nurse, but I think it was pretty ****** to imply that there is something...I don't know...nefarious about the fact that she had 4 kids in the NICU.
Nefarious isn't what came to mind. More of a question why someone would continue high risk pregnancies after a likelihood was established.
Or has the criteria changed? Like everyone meets sepsis protocol, now there's lower criteria for NICU admission and everybody is doing it these days? Or do babies still have to be pretty sick/under developed?
Specializes in Huntingtons, LTC, Ortho, Acute Care.
Unfortunately, my superiors also like to beat around the bush and not explain why certain nurses are not getting patients they want or feel they need... I do not doubt your skills OP, but maybe you need to re-evaluate your own attitude. I get we are all different people out side of work and maybe on the job you don't appear the way you do on this forum, but... That said I only know you through here so here goes...
i work as a shift lead/ charge nurse on my unit. Factors that go into deciding which nurses get what patients are based on many many factors.... I will explain some of my thought process so hopefully this reaches you and gives you some insight...
experience: as always the more experienced nurses get the more complex patients... Yes I know youll never get the experience if you aren't assigned them, but I'm not here to challenge you...I'm here to keep patients alive...
attitude: you get a big F on attitude for me... When you said you didn't go to school to be a day care worker? I hope you don't say things like that at work... But I digress... If a nurse especially new to the unit or new grad... Exhibits a know it all attitude or feels entitled to harder assignments...they don't get the hard patients, not as a means of punishment but as a means to protect the patients... If you know it all, then how can I trust you will ask for help when your more critical patients take a turn for the worse?
Performance: have you missed something on one of your patients? Nurses that make mistakes even non harmful ones are usually sidelined to the more seasoned nurses. Fine tooth comb your charting, your interactions with the babies, and their families... Maybe you aren't giving parents the warm and fuzzies (which if you don't want to be a day care worker, may translate in your relationships with family members).
So my homework for you.... Ask more questions, smile more, enjoy the "easy assignments" for now. I know it isn't where you want to be... But there is most definitely a reason why you aren't getting advanced despite your feelings of excellent performance. I understand you said the new policy is to spread the acuity of patients out, but at the end of the day their safety needs to come first. You are being passed over for reasons your charge may not feel like discussing, even management can be flimsy on offering true honest feedback because... If your confident... We definitely do not want to destroy confidence... In the right light confidence is awesome! Confrontation... Management does not want to fight with an otherwise good nurse that just needs to wait for her turn in the sun.
Seperate yourself from your feelings and try to be on the outside looking in... Is there something in your personality, performance, or skills that needs more work? If so have a slice of humble pie and just wait for your turn in the sun. You'll get there Rome wasn't built in a day, and all GREAT critical care nurses had their turns on the "bottom"
I don't think it's "ummm...interesting." She could be someone who has an incompetent cervix and delivered all her babies early after PTL. She could be someone who gets pre-eclampsia (which, if you get it once, you're at greater risk of getting it again) and had to be induced with all of her children at 34 weeks.
I don't agree with her assertion that it makes her better at the clinical skills of a NICU nurse, but I think it was pretty ****** to imply that there is something...I don't know...nefarious about the fact that she had 4 kids in the NICU.
No, not nefarious, just minimally remarking that they have terrible bad luck and, yes, that has no bearing on the OPs clinical judgment and is definitely not an indicator of being in possession of advanced skills and abilities.
Managment likes me, and there has never been an issue with the care I have provided my patients. I don't understand. I am just about at my wits end with this matter. I did not go to school to be a daycare provider who rarely uses her brain. I understand that an intermediate case can shift quickly, but I need consistant exposure to vents, bcpap, umbilical lines etc to remain competent. 
I sincerely hope this isn't your attitude in the unit.
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It could just be a string of bad luck but............
ItsThatJenGirl, CNA
1,978 Posts
I have to disagree. I'm 36 and my A&P teacher calls me kiddo all the time. There's no disrespect there. It can also be an affectionate term.