New to the NICU... What Should I Know?

LaNICUnurse · Jul 5, 2006

Always listen to the veterans. Don't act like you know, especially if you don't. Everyday you'll learn something new, even after years in NICU. I have also found that the NICU forum is pretty acurate, and a good source for people to learn from. If you stop learning, get out, you should always learn something new.

Don't give up, give it at least two years before you go somewhere else. And, it takes years to feel like you know what you're doing, and then sometimes you feel like you don't.

RNOTODAY, BSN, RN · Jul 5, 2006

Be a maniac about checking your IV's. They go bad notoriously fast, and a child can lose a finger, toe, even a limb. (worse case scenario, but ya get the point)

Respect that ET tube. Be afraid of it, and always be mindful of it. Pretty soon it will be second nature.

Dont be afraid to handle the babies, the faster you learn to handle them, the faster you will be comfortable being their nurse. I remember my first day, I had a 5 lb feeder grower, and I was afraid to touch her!!! But I did it, and months later when I was flipping micropreemies over like it was nothing to reposition them, it was awesome.

Remember, even 1 cc of a med can be a lethal overdose, you will be dealing with very very small doses based on very very small weights.

Never be afraid to ask for help, advice, or have a more senior nurse double check an assessment for you. NEVER.

Dont think the more oxygen the better.... only use as much as you need to keep sats up... too much can make a kiddo blind!!!!

Ask any and all questions, no matter how stupid you think they sound. No, really.

Nicu is a different world from nsg school, and any other part of nursing. You might actually have to UNlearn alot of stuff you already know to grasp all of it.

Never ever forget the priveledge that you have of taking care of those babies!!!! Good Luck, keep us posted!!!! You are so lucky!!!

You will be fine, I am assuming you have a good orientation?

TFRANCIS · Jul 5, 2006

Be a maniac about checking your IV's. They go bad notoriously fast, and a child can lose a finger, toe, even a limb. (worse case scenario, but ya get the point)
Respect that ET tube. Be afraid of it, and always be mindful of it. Pretty soon it will be second nature.
Dont be afraid to handle the babies, the faster you learn to handle them, the faster you will be comfortable being their nurse. I remember my first day, I had a 5 lb feeder grower, and I was afraid to touch her!!! But I did it, and months later when I was flipping micropreemies over like it was nothing to reposition them, it was awesome.
Remember, even 1 cc of a med can be a lethal overdose, you will be dealing with very very small doses based on very very small weights.
Never be afraid to ask for help, advice, or have a more senior nurse double check an assessment for you. NEVER.
Dont think the more oxygen the better.... only use as much as you need to keep sats up... too much can make a kiddo blind!!!!
Ask any and all questions, no matter how stupid you think they sound. No, really.
Nicu is a different world from nsg school, and any other part of nursing. You might actually have to UNlearn alot of stuff you already know to grasp all of it.
Never ever forget the priveledge that you have of taking care of those babies!!!! Good Luck, keep us posted!!!! You are so lucky!!!
You will be fine, I am assuming you have a good orientation?

:typing That is good to know because i start a level III NICU next week, and do not have the foggiest idea where to begin

NICU_Nurse06 · Jul 6, 2006

These responses make me feel a little better. I'm a new grad as well and I've been working in a level III NICU for 2 days...and I'm scared to death. I just hope I get the hang of everything.

usameisje · Jul 10, 2006

Always trust your gut feelings. That little voice telling you that something is wrong. Almost every time I get that feeling... there is a sepsis starting or some other process has begun.

Be willing to get help immediately if you need it. Ask questions. Always be willing to learn. Nobody knows everything, and it always helps to know multiple ways to do something.

Respect all members of the team. Everyone. The housekeeper came to me one time saying that she noticed a hole in a IV bag was dripping...the baby's nurse wouldn't listen... dopamine was running all over the floor! The lab techs and RTs have taught me a lot of useful stuff and my skills are better for it. Not everyone follows this rule.

Most babies survive. Some do not. Remember your successes to get you through those tough moments.

And everything everyone else on this thread says too!

USAMEISJE

tanaynicole · Jul 11, 2006

Thanks, for the input everyone!!

If anyone else has any ideas they are very welcome.

Is there any 'studying' or reading I should do before I start?

Thanks again,

TanayNicole :redbeathe

prmenrs, RN · Jul 11, 2006

http://www.amazon.com/gp/product/0323033008/sr=8-1/qid=1152635087/ref=pd_bbs_1/104-0295210-8200749?ie=UTF8

This and some highlighters----

and websites:

http://www.nann.org

http://www.neofax.com

http://www.academyonline.org/

Best wishes for success, too. Keep in touch and let us know how it's going.

Gompers, BSN, RN · Jul 11, 2006

I'd definitely pick up the book that prmenrs suggested - if nursing schools taught a course in NICU, that is the book they'd use. It's basically a textbook. Very good resource to have during orientation and to keep in your locker or bag when you work to use as a reference.

But honestly, they're going to teach you everything you need to know when you start working. They don't expect you to come in the first day and know much about NICU because they know you don't learn anything about it in school. As long as the unit you're working on has a good orientation program that includes both classroom and hands-on time, plus has you working with a preceptor for at least three months...you should be fine. Just go in with an open mind and be ready to learn.

My best advice is to ask questions. Don't think your preceptor will think you're stupid - they're there to train you. Ask away. Sometimes it might be best to hold your questions until later on in the shift (like after a crisis has been averted or after the baby's family goes home) when you can really talk about things at length. But don't get into the habit of smiling and nodding your head, while in your mind you're thinking, "Whaaaaaaa???" This is your time to learn. I always get a little leery when I'm precepting a new NICU nurse who doesn't ever ask questions.

Also, seek out learning experiences. If there is a code going on, ask your preceptor if you can go observe from the sidelines to get an idea of what is happening. If people are starting IVs or drawing labs, ask them if you can watch to see their technique. If there is an interesting case in the unit, ask your preceptor if you can be assigned to that baby so you can learn more about it. The more you see, the more you'll learn.

Good luck.

rnpilot · Jul 12, 2006

Whenever I had a baby that had something unusual going on, I pulled out the unit reference medical textbook - Fanaroff and Martin. It was the only thing available back then, but there are others now. Any time I had a little free time, I read it. I also tried to go on rounds when I could. I used Harriet Lane as a reference, too. Definately invest in Merenstein and Gardner if your unit doesn't have a copy. Nursing Education of America offers CEU's in neonatal nursing using Merenstein and Gardner's text, so you might want to consider doing that as the textbook is included. Best wishes!

justjenny · Jul 12, 2006

I would recommend reading the book that prmenrs suggested, but be prepared to RE-READ it also. I read most of mine before/during orientation, and now find that after being "on the job" and off orientation for a few months things that I read make more sense and I am able to understand them better - because I have seen many of the things I am reading first hand...make sense?

Jenny

Good luck!! I just started in Jan. right from nursing school..it is the hardest job and I couldn't imagine doing anything else!

BabyRN2Be · Jul 19, 2006

http://www.amazon.com/gp/product/0323033008/sr=8-1/qid=1152635087/ref=pd_bbs_1/104-0295210-8200749?ie=UTF8
This and some highlighters----
and websites:
www.nann.org
www.neofax.com
http://www.academyonline.org/
Best wishes for success, too. Keep in touch and let us know how it's going.

Thank you for the books and sites, prmenrs. I've bookmarked them and I'll look through them later on.

Does anyone happen to know if anything like the book above comes in a format available for PDA's? That would be very handy to have. I've love to hear of any PDA software strictly for the NICU.

Thanks!

Kat