New Grad.. need advice pls

Nurses General Nursing

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Hey everyone. I'm new here and I just came across this forum for the first time this morning!

I'm graduating this May and was recently offered a job in Mother/Baby as well as one in NICU (level II). I was just hoping some of you in these areas could give me some feedback on the pros and cons of each and maybe this could give me somewhat of an idea on what to expect. I told each dept. I would let them know by this week and so I need to make a decision but I'm torn! :uhoh3:

Any insight/advice would be greatly appreciated. Thanks so much in advance!

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Are you interested in critical care at all? If yes, I'd say NICU.

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I am doing my practicum in the NI... I work in both level II and III. I definitely prefer II because it is more hands on and less acute. The reason why I'm considering Mother/Baby is because I do love the teaching aspect of nursing. However, there is definitely a lot of family teaching invovled with NI as well... and I'm afraid I might get bored with MB.

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I think you just answered your own question!!!

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Specializes in NICU.

My opinion would be to take NICU....that's what I would take because I want NICU!! Not that I am trying to by biased or anything, but I think NICU is so much more exciting than mother/baby. I liked mother/baby during my clinical rotation but thought it was kinda boring at times...but just my opinion.

Good luck on what you choose!

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Specializes in Maternal - Child Health.

I have 11 years experience in OB and NICU, including 2 as a nurse manager of a Level II NICU. I am supportive of new grads starting in specialty areas (as I did), but I don't think that starting as a new grad in a Level II NICU is a good idea. Let me explain.

Level III NICUs usually are large units (30+) beds, and usually exist within large teaching or referral hospitals. They are typically staffed with a number of resource people whose jobs are to support the nursing staff. For example: shift coordinators, transport nurses, ECMO nurses, research nurses, and education specialists. For this reason, it is easy for these units to hire new grads and other nurses without OB or peds experience and give them extensive orientations 1 to 1 with consistent preceptors. There are also a wide variety of patients present in these units on any given day, making it possible for preceptors to select patient assignments ideally suited to the learning needs of the new employee. A Level III NICU is the ideal setting for training a new NICU nurse.

Level II NICUs differ in many ways. They are typically located within smaller community or rural hospitals that have smaller nursing staff, and lack many of the resource people typically found in a Level III unit. This makes it very difficult to provide a thorough orientation (classroom and clinical) 1 to 1 with a consistent preceptor. The classroom portion of orientation, which is cricial in the NICU setting since most nursing schools don't cover neonates in depth, is usually non-existent. Also, Level II units often have large fluctuations in patient population and census. One week, the unit may be over-flowing with babies, and empty the next. For example, I changed jobs after about 5 years experience in the NICU, going to a Level II unit. During my 6 week orientation, the unit was closed for several days due to no census, and there was not a single vent baby admitted during that time frame. It was no big deal to me since I was experienced and competent in caring for vent babies, but as a new grad, you would have missed out on a very important aspect of NICU care.

If NICU is your "calling", I would suggest fnding a Level III unit. Work there for 1-2 years, and then transition to a Level II unit, if you like.

After working in NICU for a number of years, I was afraid that I would be "bored" by mother-baby nursing. I couldn't have been more wrong! I loved it, especially the teaching aspect. So don't discount mother-baby nursing. I think it is highly rewarding.

Best of luck, whatever you choose!

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Thanks guys for all of your input!

Jolie.. the hospital that I'm applying at has a huge NICU & so I think there will always be a lot of babies. I see where you're coming from as far as the availability of more in-depth training in Level III. I can imagine much of the NICU teaching would be more geared toward the more acute (level III) situations. I haven't really thought about that before. The reason I applied for II is because I am doing my practicum in the NI and I alternate between II and III and have found that I'm not so much into all the vents and technological stuff that go along w/ III. With level II, it tends to be more "hands on" with the patients, which I like.

Thanks for your feedback, it has definitely given me a lot to think about!

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Specializes in NICU.

Jolie, thanks for clarifying that for me as well! I'm interviewing this week for a rather large level III NICU (38 bed). They always hire new grads...and I now understand why....that they have the resources and census to teach. What you said makes sense. Thanks for helping us all!

NewGrad07, go with your gut. Do what you think will make you happy. That is all that matters! Good Luck and let us know what you decide!!

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