New grad, do not feel challenged at all. Help?

Nurses New Nurse

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Hello all,

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!

Advice?

Specializes in Pediatric Hematology/Oncology.
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?

Didn't want to say it but I'm glad you did. I would get the hint after the 2nd and definitely would think twice after the 1st. What a terrible way to welcome your newest addition into the world time after time after time....after time. If one of hers was a "golden hour" preemie, that is implying (I guess, since it's not really a widely established standard of care) very low birth weight. I'm also very jaded when it comes to NICU. When I had my clinical rotation at the county hospital I was assigned to, it was the first day I cried after clinical. My precepting nurse said something along the lines of, "Usually if a baby ends up here, it's because mom didn't have too much of a clue." And, considering the population that was being served by that facility, this is true. Women going into labor at 22 weeks (7th child or so) because they were high on meth and wondering aloud to the nurses "if CPS would let me keep this one." Women who were absent from their education sessions for their third or fourth preemie because the other two or three kids were disabled and it was a hardship just to get back to the hospital. :no:

Not that this has anything to do with the OPs situation but, when one chooses to start a family, the onus is on them to try make sure that conditions are optimal for the kid who, frankly, did not ask to be born. All I'm saying is that 4 kids in the NICU does not a good NICU nurse make. This unnecessarily highlights their personal situation and calls into question their judgment in their personal lives (which, again, does not have any bearing on their situation at work but...if the OP has made mention of that as a way of supporting their request to have harder assignments, I can see a big eye roll coming down from management).

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Specializes in NICU.
My precepting nurse said something along the lines of, "Usually if a baby ends up here, it's because mom didn't have too much of a clue."

What a horrible thing to say, especially to an impressionable student. And it clearly has impressed you, since - for all that you try to qualify it - you seem to be assuming that OP is similar to this population of hard-luck cases. For all you/we know, OP had one VLBW baby and three who were in the unit for a few hours of observation for TTN - unpredictable and in no way a parent's fault. Not every NICU admission should automatically mean reconsidering whether to have another baby or not.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Didn't want to say it but I'm glad you did. I would get the hint after the 2nd and definitely would think twice after the 1st. What a terrible way to welcome your newest addition into the world time after time after time....after time. If one of hers was a "golden hour" preemie, that is implying (I guess, since it's not really a widely established standard of care) very low birth weight. I'm also very jaded when it comes to NICU. When I had my clinical rotation at the county hospital I was assigned to, it was the first day I cried after clinical. My precepting nurse said something along the lines of, "Usually if a baby ends up here, it's because mom didn't have too much of a clue." And, considering the population that was being served by that facility, this is true. Women going into labor at 22 weeks (7th child or so) because they were high on meth and wondering aloud to the nurses "if CPS would let me keep this one." Women who were absent from their education sessions for their third or fourth preemie because the other two or three kids were disabled and it was a hardship just to get back to the hospital. :no:

Not that this has anything to do with the OPs situation but, when one chooses to start a family, the onus is on them to try make sure that conditions are optimal for the kid who, frankly, did not ask to be born. All I'm saying is that 4 kids in the NICU does not a good NICU nurse make. This unnecessarily highlights their personal situation and calls into question their judgment in their personal lives (which, again, does not have any bearing on their situation at work but...if the OP has made mention of that as a way of supporting their request to have harder assignments, I can see a big eye roll coming down from management).

I won't pretend to know anything about NICU or what causes premature births, why anyone would have four premature infants or the heartbreak and terror that must surely cause. What I will remark upon is that making mention of one's four premature infants as a way of supporting their request for more difficult assignments will indeed generate a big eye roll from management, from the charge nurses and from one's fellow newbies. I cannot imagine that having an infant in the NICU has any more relationship to one's competence as a NICU nurse than having a relative in the CCU has to one's competence as a CCU nurse. And that is a topic I DO know something about, from both sides of that equation.

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Specializes in NICU, PICU, educator.

Here is my take just from her post, and as a former charge nurse and manager in a high acuity NICU:

You seem to be over confident, that may give your charge nurse a reason to not give you sicker

kids. Over cofidence can lead to errors or not asking for help when you start sinking, especially if you want to prove something.

Being a mom of NICU babies is very very different than nursing care of them.

10 years experience, not in NICU or peds doesn't really mean a whole lot to us. Some adult ICU or ER is good, but even those peeps will tell you how different it is.

Cool your jets, ask for more experiences that work up to the sicker kids. Ask if you can take admits, start IVs, calculate meds and drips, little steps to

move up. And don't cop an attitude.

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Specializes in NICU, ICU, PICU, Academia.

One can have four kids in NICU for non-prematurity reasons. Mine were:

1) Prolapsed cord

2) Pulmonary hypertension

3) Macrosomia/ hypoglycemia (10.5#- and no, I did not/ do not have diabetes, gestational or otherwise)

4) Pulmonary hypertension / persistence of fetal circulation

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Nefarious isn't what came to mind. More of a question why someone would continue high risk pregnancies after a likelihood was established.

And I don't think anyone has a right to judge anyone else's reproductive choices. And I think that it's, yes, ******, to do so on a public forum.

And as MeanMaryJean mentioned above, someone could actually have four different NICU babies for four very disparate and unpredictable reasons. I just think it's really crappy for that to even be brought up.

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Specializes in Thoracic Cardiovasc ICU Med-Surg.
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.

Sorry, I'm still chuckling over how a very casual kiddo that I didn't even think about is being dissected on multiple levels. LOL!!!

My bad--I should not have assumed the OP is a young nurse, although, you must forgive me, since the entire tone of her post does not exactly scream 'mature.'

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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?

The OP should NOT be under scrutiny regarding her personal child bearing experiences.

On a side note, not everyone meets sepsis criteria. I deny payment for admission with a sepsis diagnosis.. on a daily basis.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Shoot, people call me "kiddo" (or something like it) all the time and I am far from a kid. I don't get all bent out of shape, and take it in stride. Always have. Never let it bother me. Most mean it affectionately and if they don't, they are not your "kind" of people and you should not care one whit what they think anyway.

Life is too short for me to be butthurt over ill-conceived, albeit, well-meaning remarks. You get this insight with age, I guess.

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If OP doesn't want an eyebrow raised over such a statement, then OP can refrain from making such a statement.

If anyone puts it out there that they, albeit SEEMINGLY, repeatedly took a chance with the well being of yet to be conceived children, someone like me who has a completely polar ethical view is potentially going to post a thought about it. Trying to paint it as credibililty just further opens the door.

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Didn't want to say it but I'm glad you did. I would get the hint after the 2nd and definitely would think twice after the 1st. What a terrible way to welcome your newest addition into the world time after time after time....after time. If one of hers was a "golden hour" preemie, that is implying (I guess, since it's not really a widely established standard of care) very low birth weight. I'm also very jaded when it comes to NICU. When I had my clinical rotation at the county hospital I was assigned to, it was the first day I cried after clinical. My precepting nurse said something along the lines of, "Usually if a baby ends up here, it's because mom didn't have too much of a clue." And, considering the population that was being served by that facility, this is true. Women going into labor at 22 weeks (7th child or so) because they were high on meth and wondering aloud to the nurses "if CPS would let me keep this one." Women who were absent from their education sessions for their third or fourth preemie because the other two or three kids were disabled and it was a hardship just to get back to the hospital. :no:

Not that this has anything to do with the OPs situation but, when one chooses to start a family, the onus is on them to try make sure that conditions are optimal for the kid who, frankly, did not ask to be born. All I'm saying is that 4 kids in the NICU does not a good NICU nurse make. This unnecessarily highlights their personal situation and calls into question their judgment in their personal lives (which, again, does not have any bearing on their situation at work but...if the OP has made mention of that as a way of supporting their request to have harder assignments, I can see a big eye roll coming down from management).

It seemed like you and Libby were implying evil about her. Thanks for finally clearly stating what you meant.

Given your schooling patient population background, it seems you WERE implying bad stuff about OP. But we don't know if she used drugs or had terrible nutrition or no prenatal care, or if she just had a rough way to go - someone mentioned incompetent cervix.

And I can see where women with 2 or 3 disabled kids might have a hard time getting to classes. Why not have educators go to the home of women in that or similar boat to educate? Be innovative and caring, not jaded and disappointed because you have seen some terrible situations (and you have. Being hardened would be understandable but please try to help patients, not criticize or decry their behavior).

Maybe student nurses could go to patients' homes as part of their OB and/or public health rotations to teach these prenatal classes. Try to set something up with a local school of Nursing.

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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.

I'm 43 and look about ten years younger than my age. Not waving my own flag, but it's the absolute truth (and not as great as most people think - it's actually a PITA). Whether or not one finds the term neutral is subjective. I find it annoying when it's directed at me (unless you're either my 61 or 59 year old brother), and I don't use the term in referring to anyone else.

I also don't get the context being anything remotely resembling affection. It was a jab, plain and simple, used with a very specific intent and a crafted delivery.

I am in agreement with those who said if the tables were reversed and the OP had used a term like "old timer" (instead of the "kiddo" used by that particular respondent), the responses would be quite different. And that in no way defends the OP's attitude.

It does seem that with many people it's okay to be condescending to younger folks/exhibit ageism down the chain, but unacceptable in the reverse. Both are wrong.

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