Is it like this everywhere??

Specialties NICU

Published

  • by KK7724
    Specializes in NICU.

Well,

I guess this is more of a "vent" your frustration kind of post....so here are my gripes. (Background info: I am a new RN of 9 months and graduated at 21 with a BSN...also..I do look like a twelve-year old) (the unit is a Level III)

At my unit, it seems like special treatment is given to some new grads over others and that assignments are not always fair. Also...my unit manager seems completely out of touch with everything really....I don't think if I voiced any concerns with her that she would heed them....also...I don't want to go to her with anything because she is friends with lots of the people I work with and has betrayed one of my friends before and disclosed her personal information.

Our unit is set up in a way that basically...whoever is assigned to your room pretty much determines how your shift is going to go. I mean...some people can pretty much ignore the fact that one of your babies is satting in the 50's...or if they acknowledge it--it's just to yell it out to you while you are at another baby's bedside...some people are really cool and will bump your FiO2 up for you, or just tell your family that's calling what your baby's weight was..etc..others are hopeless. (basically....not everyone wants to be a team player)

A lot of people leave the room without saying where they're going....a lot of times they leave you alone in the room without telling you.

It seems sometimes that "your baby" or "my baby" are the terms used...aren't they ALL "our" responsibility?? And where is teamwork??

Also...I'm having a real problem with people not being helpful as far as answering valid questions that will help me take better care of my patients. I find myself often times having to leave my room to find the Charge Nurse to get answers that an experienced nurse in my area could have given me.

I also feel like my care is being questioned any time a baby regresses.....and I have found lots of charting errors and missed assessments that senior nurses have done (not measuring abdomens on post-ops and my absolute pet peeve---not giving sedation while on the vent!!!!!) I was even told by one RN that she had in fact pulled my chart before when an incident happened to a baby I had and I caught it.

Also...I have been in a situation before where I stopped what I was doing to help a nurse who had an admission by writing the admit information on our sheet....I was just trying to be orderly like what I had observed other nurses do and go down the list and call out what needed to be filled out on the form...the admitting RN turned to a favored new graduate and said, "did you hear that...we need to get her a blood pressure. What else do you need?" I just responded..."well...I'm just trying to make sure you have everything you need when you are able to sit down and chart on this new baby."

Sometimes it's like people don't even try to hide their disgust or dislike of you because you a new grad...I just can't believe the nerve sometimes. People wonder why I am stressed out. People think it's nothing that one of my babies is on the vent septic as I don't know what...and they don't know why Im behind until they see the m.d. come in and transilluminating my baby.

Also....our techs....that's a whole new thread right there. There is no initiative. I feel like if I do ask the tech to do something as an RN, first of all...I have to put up with rolled eyes and attitude, so I just try to do things myself. I don't see why our techs can't come write the admit info down...anyone who can read can call things out to the admitting nurse. Why does another RN have to stop what he/she is doing to be a "scribe" for an admit when you have an m.d. and an r.t. at the bedside with you as the rn???

I am probably going to regret writing this thread later...but I just have to know...is it like this everywhere????!!!! Also....any books that anyone would recommend that are better than the Merenstein one?? I need something a little more practical. Also...what is your unit policy about art sticks?? I am determined to learn how to do these (i.e. get "checked off" on it by a charge nurse) so I can do them myself because they come up so often.

I guess I am glad to have this website because I really do not have anyone that is medical in my family. I have some good friends I went to nursing school with that can relate to the whole "nurses eat their young" thing...but...please tell me it's not like this everywhere.

I'm sure people reading this might think I sound like a big complainer, but I love my job and I love NICU. I would like for senior nurses who dislike new grads in a unit to stop and think for a minute that he nursing shortage has made it permissable for new graduates to start in high acquity areas like NICU and that for me to learn, I have to be taught and NICU is a continuous learning experience. 10-12 weeks of orientation does not allow for every situation possible to be covered.

I welcome any comments or thoughts~

weetziebat

775 Posts

KK, first want to just say how sorry I am that you are having to put up with this. I think many places play favorites, which is soooooo unprofessional, but your job sounds downright stinky!

In NICU, and any other unit, teamwork can make your job or break it. I worked in NICU many years ago and we had a fantastic team, it was like working as one.

Can't really give any advice. Think I might take my concerns to the NM, but if yours is useless, I'd be really hesitant about going over her head. Certainly hope you find an answer to these problems. The only one these childish nurses are hurting are their innocent patients.

But if its any consolation, I think you are doing the right thing and the others in your post should grow up!

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.

No, it's not like that everywhere. Definitely not.

On my unit, we always say "your baby" and "my baby" just because that's how we are. It's not so much a, "That's YOUR responsiblity" kind of a thing. It's more of an endearment, like a possessive thing. We treat these babies as if they were our own.

That's why we work as a team - we are devoted to giving these babies the best care possible, and that takes teamwork. I don't care if it's "my" baby or "your" baby - if the kid is satting 50, I'm going to do something about it!!! Same with admissions - we want the nurse doing the admission to be able to focus on the baby. That's why she completely gives up her original assignment (usually assigned 2-3 easier babies and they are split up and added to other nurses' assignments) and why we all gather around to help her with admission procedures and mark down her initial vitals, measurements, etc. We don't actually do her charting though - we write it all down on scratch paper for her to transcribe later on when things calm down.

For arterial sticks, we have a small study guide with a short written test. After that is completed, you have to get three sticks before you are signed off. Not try three, GET three. That way, we know your technique is safe and skilled. Once you're signed off, you can do them on your own. But the way we do it, at least, is that we always have another nurse to "pull back" the blood so you always have support right next to you.

BamaGirlRN

106 Posts

First off you do have some valid concerns and as a new RN you should definitely talk to your NM, even if she is "completely out of touch", as you say. She would probablys really want to know because if new grads or RNs to the unit aren't happy and she can't retain these RN's it is ultimately her responsibility to know why or to figure out why. Plus I am sure you would feel better voicing your concerns with her, we all feel better when we get thing off our chest.

Also...I'm having a real problem with people not being helpful as far as answering valid questions that will help me take better care of my patients. I find myself often times having to leave my room to find the Charge Nurse to get answers that an experienced nurse in my area could have given me.

I have only been in the NICU almost two years and I find I am still asking questions. Your Charge nurse is an excellent person to go to. Maybe the other RN's aren't comfortable yet answering new grads questions. I was also very frustrated with this when I was the only new grad on my unit for about a year. Even while orienting I'd get different answers to the same questions from severeal different seasoned RN's.

Same with admissions - we want the nurse doing the admission to be able to focus on the baby. That's why she completely gives up her original assignment (usually assigned 2-3 easier babies and they are split up and added to other nurses' assignments) and why we all gather around to help her with admission procedures and mark down her initial vitals, measurements, etc.

While giving up a whole assignment to admit would be wonderful, it is not always feasible. But I do agree 100% with this statement, those first couple of hours(sometimes more) are crucial and it is always a welcome to have pod partners who are helpful, even if it is just to "scribe". In my unit I have never seen just one RN at an admitting bedside. About 80% of our babies are outborn so they usually already have tubes and lines and abx on board, fluids going, etc. So when a brand new babies comes from LDR it definitely needs to be a team effort.

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.
While giving up a whole assignment to admit would be wonderful, it is not always feasible. But I do agree 100% with this statement, those first couple of hours(sometimes more) are crucial and it is always a welcome to have pod partners who are helpful, even if it is just to "scribe". In my unit I have never seen just one RN at an admitting bedside. About 80% of our babies are outborn so they usually already have tubes and lines and abx on board, fluids going, etc. So when a brand new babies comes from LDR it definitely needs to be a team effort.

Maybe it's because about 75% of our babies are born at our hospital - they come up from the delivery room with an ETT at most. The first couple of hours are busy with putting in lines or IVs, doing labs, starting IV fluids and medications, giving surfactant, getting x-rays, etc. We have always assigned people to pick up the admit nurses' babies so she could concentrate on the admit. If it's really crazy busy, in a few hours when things calm down she might pick back up one of the original babies, but usually not.

To the orginal poster - are there any other NICUs near your home? It just sounds like this is a bit of a toxic unit. Talk to your manager, and let her know that you are not having a supportive experience. Maybe don't outright say that you want to leave if things don't get better, but you could imply it.

KK7724

115 Posts

Specializes in NICU.

To the orginal poster - are there any other NICUs near your home? It just sounds like this is a bit of a toxic unit. Talk to your manager, and let her know that you are not having a supportive experience. Maybe don't outright say that you want to leave if things don't get better, but you could imply it.

Well...not really. It would be about an hour's drive. I haven't told anyone on the unit this yet, but I am moving out of state in the next several months to South Carolina. There is a fantastic university hospital there with a Levell III that does ECMO, but it seems very hard to get on with them. They currently don't have any NICU positions open according to their website. I got the nurse manager's name and number from the recruiter, but I"m not sure if it's okay to call and let her know I'm interested and when I'd be coming to the area?? Like, I said...I'm new to Nursing and especially the whole market yourself kind of stuff. Here in Alabama--it's no problem getting a job anywhere!

Also, I am nervous that if I do get the job, I won't be as proficient as they'd like. I have never been given an oscillator yet in an assignment and I'm still learning things every day. I really want to work with the higher acuity babies. I do like to be sent to work with the grower-feeders every now and then because it is a nice change of pace sometimes.

By the time I move, I will have been an RN for a year. The one thing I have going for me, is that this university hospital does NOT hire new graduates into the unit...so, that is one good thing I have going in my favor so far.

Any suggestions?? I think you mentioned your hospital was a university hospital??

Thanks-:balloons:

KK7724

115 Posts

Specializes in NICU.

Well everyone...

Just wanted to type a quick update. I did call the Nurse Manager at the hospital in Charleston. She said that they are fully staffed at the moment and have no positions open! I prepared and wrote a list of questions down. I asked her and she was very nice and answered all my questions. It is the dream place to work! Kangaroo care, in-house residents and NNP's, great patient/nurse ratios.....university hospital etc.

I am bummed! I asked if I could still email her my resume` and she said yes. I don't know what to do. I can't see myself doing anything other than NICU....Level III Nicu.....i'm not sure what to do. There is a pediatric ICU position open....maybe I could do this until a position became available?? I don't want to lose my skills and I have to hold down a job....the nearest Level III Nicu besides the one I want is an hour and a half away. My fiance does not want me to do this...and I understand why.

.......bummed!

mac23

107 Posts

Is this MUSC? I'd just keep checking because I know they use travelers....there are several positions posted for travel nurses in the NICU at MUSC. If you're interested in the PICU, the unit at MUSC is fabulous. Great docs and nurses plus you'd be building your skill set not losing it. PICU would allow you to work with oscillators, jets, vents just like NICU but with a bigger age range (0-18, sometimes older) and a broader diagnosis. I did a year in PICU and learned a ton but eventually went back to NICU. GIve it some thought you may end up loving it. Also once your foot is in the door it would probably be easier to transfer to NICU. Just be sure to ask about how long you'd have to stay in the PICU (if you did it) before you could transfer. Good luck!

Well everyone...

Just wanted to type a quick update. I did call the Nurse Manager at the hospital in Charleston. She said that they are fully staffed at the moment and have no positions open! I prepared and wrote a list of questions down. I asked her and she was very nice and answered all my questions. It is the dream place to work! Kangaroo care, in-house residents and NNP's, great patient/nurse ratios.....university hospital etc.

I am bummed! I asked if I could still email her my resume` and she said yes. I don't know what to do. I can't see myself doing anything other than NICU....Level III Nicu.....i'm not sure what to do. There is a pediatric ICU position open....maybe I could do this until a position became available?? I don't want to lose my skills and I have to hold down a job....the nearest Level III Nicu besides the one I want is an hour and a half away. My fiance does not want me to do this...and I understand why.

.......bummed!

KK7724

115 Posts

Specializes in NICU.

Thanks for your advice about PICU. I am definitely interested and I thought that it would give me a broader skills range too! I will check into the committment involved. I know at my current facility, it's 6 months.

I'll keep ya updated! Thanks for the encouragement. :)

I just wanted to type you a quick note to tell you not to be discouraged. I am also a new grad (May of '05) working in NICU. I absolutely LOVE it and everyone in it. They are all very helpful, willing to pitch in at any moment (but not over run you) and answer any questions imaginable without degrading you. This includes the NEO's.

So I guess what I am saying is, there are places out there that don't treat you the way your Unit is. Hopefully you find one soon! I just hope I can find another one with such great morale and team players. We are looking to move when DH graduates nursing school.

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