New to NICU, but not nursing...

missnurse01, MSN, RN · Dec 3, 2012

I do not work in this area however have worked in areas 15 years ago where you didn't get much of any orientation. There were no special classes as there are nowadays, and it was trial by fire at the bedside. I think you will be fine. While on orientation always ask ask ask, and observe and ask questions when able to more sick infants. Otherwise, as is true for the medical field, it is often self directed learning-looking things up, reading policies, procedures, studying books for neonatal certifications, etc.

You can do it! good luck

littlepeopleRNICU · Dec 5, 2012

I have to say, I am new in NICU too coming from adults, where I was for 2.5 years. The NICU is completely different! You will already have skills like talking with doctors and families(although these families will be a bit different, most likely), critical thinking, time management, etc., but it is still a whole different ballgame. I'm learning all that in a different way than I had it before. I have been told I'm faster than new grads, but I still feel slow lol...it is a different way of thinking than what I came from. However, you working in SCN before will benefit you, I think!

But just take the orientation and milk it for all it's worth. If you feel like you aren't getting the practice you need, then tell them! The most important thing in the end is for you to feel comfortable and safe...and if that takes longer, then okay. That's worth it! That's what orientation is for. I have had an AWESOME preceptor who is such a good teacher and looks for new skills and things for me to see everyday so I get to experience a lot. I hope you have the same experience.

Congrats on the new job!! I hope you love it. I know I do so far :)

MochaRN424, ASN · Dec 5, 2012

First, Congratulations this is definitely a dream of mine to work in the NICU so I am very happy for you. I don't know how spiritual you are but there is a scripture that states "I CAN do all things through Christ Jesus who strengthens me Phillipians 4:13. When you started as a new grad what experience did you have on that unit before you gained your experience? You have been given this opportunity for a reason. Go in and learn all you can and don't be afraid to ask questions. A good nurse will appreciate you asking those questions instead of making a mistake that could be avoided. Dismiss the negative comments and gravitate to the positive. I am sure you will do well...now have that confidence and peace in youself and be of service to those parents and babies. God bless you! :)

Nurse Maloy · Dec 5, 2012

I, too, would like to end up in the NICU after I have been a nurse for a while. I would def find a mentor, even if it is just another co-worker nurse. Congratulations!!!

PreemieNurse · Dec 6, 2012

I have been a NICU nurse my entire nursing career...since the 70s. It's a wonderful place to work, and many nurses who work there do not leave. We have seen many ICU nurses transfer down to the NICU because they are tired of moving heavy patients around and their backs are getting bad.... I am also reading posts of how hospitals are not offering intensive care courses and merely throwing nurses into the departments and expecting them to learn fast and take a big assignment within the first week or so of going to that unit.

It's very important that hospitals continue education past nursing school. The hospital where I worked had a 6 week ICU course that was mandatory...the nurse (no matter how experienced in med-surg or if new grad) took that course and then was precepted by an experienced nurse for no less than 6 weeks following the course. By the time those 12 weeks were over, that nurse should be able to take on a full assignment on her/his own.

Same for NICU. There needs to be a neonatal course in place (or maybe one offered at another hospital where the new hires into the NICU can attend). My first job in the NICU in a PA hospital offered that 6 week NICU course and then I worked the same schedule as my preceptor for another 6 weeks.

The second hospital where I got a NICU job did not offer the course, but the nearby hospital who had a level 4 NICU did. Our new nurses into the NICU went there 2 days/week for 6 weeks to take their course.

The hospitals need to set up these type of courses in order for their new nurses (to intensive care units) to be successful and confident in their skills. I don't understand how hospitals can just "throw" inexperienced nurses into these intensive care units without any specialized training. That is just dangerous, and sets the nurse (and the hospital) up for potential lawsuits.

walkingrock, ADN · Dec 20, 2012

I really think a NICU orientation of a good number of weeks is important for success in this field, it is too bad that hospitals don't have the resources to do that. I think I had 12 weeks when I started NICU in 1979 (6 classroom, 6 in the unit). Unfortunately, that is getting to be the norm now.

I would suggest you pick the brains of your co-workers and nursing educator for the unit. Remember there is no stupid question, even if someone makes you feel that you are asking one, what is stupid is to act like you know what you are doing, when you don't. Hopefully, your experience as a CNA will help you.

Congratulations on the job, it is a great place to work. We have had several transfers from adult nursing to our unit in the last few years, and they have done well, with much less orientation than I had. NICU is about the little details. :yes:

twinkletoes53 · Dec 22, 2012

I came from a Level III NICU where all new employees were assigned a preceptor, and received 10 weeks of orientation. Depending on each person's experience, the orientation may be shortened. But it is detailed, with the new employee advancing each week as to the level of care they are assigned. And they are with a preceptor the ENTIRE time, and are not counted as a member of staff, unless we are really short-staffed and super-busy.

New employees start with room air feeders/growers, and progress to caring for infants on oxygen, CPAP, stable intubated babies, babies with multiple lines and drips, unstable infants, infants on different types of ventilation (Servo, IMV, SIMV, Oscilators, HFFV, jet ventilators, etc). They are not assigned to care for critical infants on ECMO, dialysis, or head cooling until they have 2 years NICU experience.

I think that NICU nursing is too specialized to have someone start with no formal orientation. I do hope that when you start in your new position in the NICU, the nurse managers know to assign you to less acute, stable infants at first. Ask a lot of questions, and take notes. If the unit does not offer a formal orientation, do they at least have a "buddy" system, where you are counted towards staff numbers, but have a specific RN to go to with questions?

nicurabbott · Dec 22, 2012

Thanks to each and every one of you for the advice and kind words! Yesterday was my second day, I LOVE it already! I am definitely assigned to a preceptor (as I knew j would) and the duration depends on how things go. I will start off with stable feeder/growers. I guess I'm just still so nervous because they don't normally accept someone without NICU experience. They have faith in me though and took me in! But I just feel so "stupid" already because I don't know the equipment and a lot of the issues pertaining to sick neonates...There is a group of modules, however, on NANN.org called NICU nursing essentials that goes through each system. I think I'm going to take that!

nardles13 · Oct 12, 2018

I know this is a pretty old post but did you end up doing those modules from nann? And if so were they helpful?

TIA!