New grad in the nicu

RainDreamer, BSN, RN · Oct 24, 2006

First off, congratulations on passing boards!! :)

It takes A LOT of time to get a routine down and have good time management skills.

I've only been in the NICU for 7 months. I remember those first few months when I was on orientation, wondering how I was ever going to handle 2 babies by myself because when I'd get behind my preceptor would help out .... and I knew after orientation I wouldn't have her to help out all the time. Just believe me that it gets better with time, I'm sure you hear that all the time .... but it's true!

By the time I was on my own I was able to handle my own assignment. But I had experience working in a well-baby nursery for about 5 months before I came to the NICU. That helped out with time management skills because we'd have 6-8 babies at a time. So even with that experience, I was still running behind sometimes with my 2-baby assignment in the NICU. So it may take you a little longer since you had no other nursing experience before now .... it's just part of being a new nurse, getting the time management skills down, and that's totally normal.

I write EVERYTHING down! Even in my round blocks I still write everything down that I need to do so I don't forget. I used to forget so many things. I'd get done with a round, get the baby all tucked in, isolette closed up and covered, lights turned off and then OOOPS, I forgot to take the temp! So I write everything down in those blocks. Under 2100 I'll make a list ..... temp, diaper, abd girth, BP (I used to always forget to take a BP too, so I write it down now), weight, chem strip, and whatever else I need to do during that round.

Do you know what it is exactly that takes you so much time when you get in there to do your assessment? At first, I found that writing everything down, so I could work in a certain order helped.

I start my rounds a little early too, especially if they're on feeds. So if I have a round due at 2100 and the baby is due to eat, I'll start my round at 2045 or so, depending on how much stuff I need to do. My first round always takes me longer because I get all my "extra" stuff done then. We only have to take BPs q shift, so I get my BP in that first round. Same with weights and chem strips ..... just once during our shift, so I try to get in there and get that done the first round. So I know my first round takes longer, so I start it earlier. Then with my next rounds I just get in there and do a quick, but thorough assessment, looking for any changes. Get a temp, change the diaper, etc. But before I ever get into the isollete I make sure I have EVERYTHING I need right there, so I don't have to run around to get stuff, I just have everything there and ready to go. If milk needs to be heated up for the feed, then I put it in hot water and let it warm while I do my round.

The best advice I can give you is to start your shift by getting organized and writing all your stuff down. Get all your ducks in a row, so to speak. Get your sheets all filled out and all your times filled in. Know what you need to do and at what time.

I hope this isn't too scattered and helps some. It will get better with time. Good luck to you!

BittyBabyGrower, MSN, RN · Oct 24, 2006

You have to come up with a system that works for you. The previous poster is right, make lists. We have our new people write out every hour on a piece of paper for each patient and fill in what needs to be done and use it as a check list. At this point you should be past 3 kids and onto intubated patients. Yes, even us seasoned people start our kids 1/2 hour early. Always start with the easiest kid first and save the more time consuming one for last IE do the ng feeder first and then the poor feeder. Get out all your stuff you need for the next feed, we take out two feeds at a time and meds also. Organization is so critical before you get to sick kids.

Good luck!

rainbows4me · Oct 24, 2006

Congratulations on passing the boards!

It takes a long time to become comfortable in NICU. Some people are more natural with organization and time management than others, and as a new grad, you're likely to have a few kinks to work out. Don't let that get you discouraged, as it doesn't indicate how well you will eventually be as a NICU nurse. Time management, while obviously important, will come with time and experience. Keep up the hard work, and I'm sure you'll find yourself improving in speed and organization. As I'm sure you've read on these boards, it usually takes a couple of years to feel truly comfortable as a NICU nurse. I've been at it for over two years, and there are certainly days where I feel overwhelmed and wonder if it'll ever feel completely comfortable... And of course I know that when you're taking care of sick, sick babies, it is not 'comfortable'. That's the crazy love/hate realtionship of mine with NICU. Adrenaline rush and all...