Newborn Nursery to prepare for NICU?

[Bortaz]

The nursery administrator at my clinical site has recommended to me that I precept in newborn nursery before jumping into NICU, with the implication being that it's good to become familiar with a normal baby before you start dealing with the complicated ones.

Is this good advice? Would you NICU nurses recommend a new nurse to grab some NN experience before trying to orient to NICU?

[Bortaz, MSN, RN]

Yeah, it's a really nice city, and the proximity to the grandkids is just close enough that we could see them when we wanted, and far enough away that they can't just pop in!

[Jolie, BSN]

I think an important point to consider is whether you are deciding between NBN and NICU or NBN and something else (like med-surg).

If there is a NICU preceptorship available, then it would be my first choice. If not, then take NBN and run with it.

Most NICUs hire new grads without concern that they don't have experience in well-baby nursery. It can be helpful, but certainly isn't a prerequisite for NICU.

As far as capstone experiences, if your school allows NICU or well-baby, you are very lucky. Most still hold to the ridiculous old-school notion that all new nurses need med-surg.

The type of unit available to you may influence your decision as well. As with new employee orientation, it is best if you are able to work with no more than 2 preceptors during your 160-hour rotation. If you are able to "match" your schedule to that of 1 or 2 staff nurses, then going to a Level II or III NICU may be productive for you, sice they will get to know your skill level and probably allow you more latitude to attempt hands-on skills. If you have to follow a set schedule, and accept the "preceptor-of-the day," a NICU may not work out as well, since a steady rotation of new precepetors will hinder your ability to form a trusting relationship with them. Hence they may not be as willing to allow you to do certain hands-on skills like labs, IV starts, vent care, inserting ng tubes, central line care, etc.

In my last job as a nurse manager, I had a senior student request the NICU for her final rotation. She was with us M-F for a month, and worked her way up to caring for feeder-growers independently during that time. I felt she was short-changed on the more complex aspects of care due to her frequent changes in preceptors, so I spent the last few days with her 1:1 giving her the opportunity to experience those skills. Unfortunately, that as the price to be paid for the scheduling of her time on the unit, and the limitations of staffing our small unit (only 8 beds).

Just more to think about.