New NICU nurse seeking advice!

JustBeachyNurse, LPN · Aug 20, 2013

Moved to NICU to elicit more targeted response from our very helpful, experienced NICU nurses. . Look for posts from NICUgal, PRMENRS, Bortaz and others

HomeGrownMichiganRN, ADN · Aug 20, 2013

I can't give you any advice because I am a new grad still looking for my first nursing job but I wanted to say congratulations and good luck!

Bortaz, MSN, RN · Aug 21, 2013

1. Care. Don't go to the NICU because it's supposedly "easier" or because the pts don't weigh 350 pounds. Care about the babies. YOU are the last line of defense for these innocents. Do the right thing, every time. Be safe. Be careful.

2. Neonates are not just small versions of adults. Everything you do in the NICU will be different than any other unit. Read. Research. Learn. Your orientation WILL be insufficient.

3. Learn to ASSESS your baby. Often, your assessment will be the first indication found that something is amiss. Don't skimp on your assessment just to save time.

4. Include the parents in your care. Don't leave them there as simple bystanders. Explain to them what's going on. Get them involved. They're scared. Comfort them.

5. Read. Learn all you can about the neonatal disease process and the various disorders you encounter. Even if it's not your baby...go see what's going on...lend a hand...ask questions.

6. WATCH others who have to touch your baby. Lab, RT, OT, doctors. Make them wash their hands. Make sure they are supposed to be doing what they're doing, and make sure they're doing it correctly. BE AT THE BEDSIDE DURING PROCEDURES. Never trust others with your neonate. They often don't know how to handle a baby.

7. Respond to alarms/crying...EVERY TIME. Don't ignore them. LOOK at your baby, not the monitor. There should never be a monitor alarming that isn't checked by a nurse. Babies cry for a reason...find out why yours is crying.

8. Babies die. It sucks. Can you handle it?

9. Participate in c-section/high risk deliveries if given the chance.

10. Realize that the NICU is an INTENSIVE CARE UNIT. It's not the snuggly/huggly/happy place that a lot of people imagine. It can be ugly, and it can be overwhelming. You will likely have your ethics challenged. You will see things you wish you'd never seen.

I wish you well in your new endeavour. Please feel free to post on this forum if you have any questions/concerns or just want to chat. I love the NICU...going to work there is the best thing I ever did. I'll never do anything else, if I have a choice. It is the most fulfilling, yet most heartbreaking job you'll ever do. Good luck!

prmenrs, RN · Aug 21, 2013

Thank you, Bortaz.

agato · Aug 22, 2013

The merenstein book about neonatology is a good resource to have when you don't know a disease or to understand disease processes. Ask questions, and don't be afraid to question orders especially if you're in a teaching hospital, remember these patients don't have a voice and their parents can't always be there. Definitely be very observant because things with a patient can change in a matter of minutes! Going to deliveries is great for experience and for learning. And most importantly be patient with families and the patient themselves, this is a scary situation for them and a lot of them don't know how to deal with it.

verniec · Aug 22, 2013

Congrats on the position! I have to agree with everything that Boratz said. They ARE NOT tiny adults. They have very specific disease process that you would never see in an adult. Neonatology is one of the few fields that is constantly changing and has made so many leaps and bounds in the past twenty years. Would a 22 weeker have survived in 1990? Definitely not! Take comfort in the fact that you will not know the answer to every question or have the right thing to say to a sad/distressed parent. Use your co-workers, ask questions, get involved on rounds and multidiciplinary meetings. I love talking about NICU, here to chat :)