New Grad RN

NurseKait_11, BSN, RN · Oct 16, 2018

Hey there!

First off, congrats on your upcoming graduation!

I just completed my first year as a NICU new grad and glad I came across your post. I honestly think that if NICU or infant care is what you want right off the bat, then go for it. I found that a small percentage of people that I graduated with went into med-surge and the majority of my class went into the specialties they wanted (NICU, L&D, ED, ICU, peds). That was something that I struggled with when I was applying as well, but I definitely don't think that med-surge experience in something that you have to have.

I work in a Level IV NICU and that means we handle some of the most critical patients and some babies are with us for months and months. We get a mix of critical patients, feeders and growers and full term babies who just need some help within the first 48 hours of life then we send them back up to full term. For me, the good days outweigh the bad and I think we see more positive things than sad. I find that working in the NICU is very routine. We do "cares" (feeding, assessing and doing vitals on the babies) every 3 or 4 hours, depending on how stable they are. Working in the NICU has really allowed me to improve in time management since sometimes you may have one critical baby and many things that need to be done or three babies, all with families there who need something, so I've learned to work efficiently and prioritize. I have also bettered my communication skills when talking to providers and patients.

I work days and night shifts and we have different tasks that each shift does apart from the other, but other than that it's routine for the most part. I over-all think that NICU is a good work environment and working with babies is very rewarding. Hope this helps!

I don't know much about mother-baby, but if you're looking to work with infants, look into couplet care positions. You'll look after both mom and baby instead of mainly the mother. Also look for new-born nursery or full-term nursery positions to apply to as well! I know some hospital are starting a neonatal assessment nurse position which looks after the new born after deliveries in the first few hours of life and its your job to do baby vitals and make sure that they are adjusting appropriately.

Hope this helps!

Preemie 2 RN, ASN, RN · Oct 17, 2018

Hello and congrats on your upcoming graduation! I would suggest applying to multiple hospitals and apply for newborn, mother baby and NICU positions if that is where your passion is. Some hospitals love hiring new grads into these areas and some hospitals do not. Most hospitals do internships in NICU though so look out for those positions as well. Getting hired into a hospital anywhere is very competitive but can be done. Just keep applying, brush up on your interview skills and don't give up if this is what you really want!

For me personally, I was not able to obtain a hospital position right out of nursing school. I interviewed for newborn, NICU, Labor and Delivery and even SICU and other adult ICUs trying to get my foot in the door but again, it was very competitive. I also only have my ASN and not BSN so that makes it even more difficult. I didn't give up though. I took a job in private duty nursing for a pediatric patient in her home so I could start making money. I worked there for 2 years, continuously applying to NICU positions as they came up, NEVER giving up. Finally I got a NICU internship interview, got the job and I've been a NICU nurse for 2 years now. I hope it doesn't take you that long to obtain your goals but I just wanted to show you that it may not happen right away, just keep trying :)

I absolutely love my job! It's hard to tell you what a 'day to day' shift is like in the NICU though because it is critical care, you never know what will happen! Usually though you are assigned 1-4 patients (at least on my unit you CAN have a 4 patient assignment but that if all 4 babies are VERY stable feeder/growers.) and usually you do cares on each baby every 3-4 hours (depending on how sick they are). You are constantly monitoring their vital signs, meds, oxygen, etc. but in between their care times you want your babies to get as much rest as possible so you don't mess with the babies if it isn't your care times. There are those moments though in between care times that a baby needs you attention like if a parent is at the bedside, a baby is crying/irritable or those times when the baby's vitals are low (they are having a desat or brady) where you need to be hands on to stimulate them or give them blow by/PPV. Most of the shift though is very scheduled around these care times I've been talking about. In between these care times you catch up on your charting, stock supplies, doctors do rounds to check on all the babies, you might get parents in that you have to update or you call parents to give an update, etc.

If you have any other questions or want a more specific example of routines in the NICU, let me know! Good luck to you :)

NICUmiiki, DNP, NP · Oct 17, 2018

Don't feel obligated to do medsurg. If you can get a job in a NICU right away, take it. Don't turn down the job you really want. PICU nurses are the most prepared, but even they have a bit of a learning curve. No other nurses really have a shorter orientation than the new grads where I'm at.

**NICU Guy, BSN, RN** · Oct 18, 2018

Adult Med/Surg experience will do little for you in the NICU. NICU is it's own little world. I was fortunate to get a Level IV NICU job as a new grad (being male probably helped). I had a 135 hr Preceptorship in another level IV NICU in my final semester of nursing school, which also helped. If you are willing and able to relocate, apply nationwide. You stand a better chance getting a NICU job as a new grad if you apply to many hospitals.

Here is a job posting that I came across earlier today for a new grad NICU position.

New Grad NICU Registered Nurse (RN) Careers at University of Maryland Medical System in

NICUNewGrad19 · Feb 21, 2019

I graduated nursing school (ADN program) in August, passed my NCLEX by October. I was VERY picky with what I applied to for a few months and only focused on applying for what I wanted like ICU/ ER. Where I live there are 6 hospitals but very limited spots open for new grads, especially in those specialties. After about 2-3 months I accepted a tele position with an amazing educational program that somewhat “grooms” their nurses into becoming ACT/ICU after 3 years or so. However, my first day of work I got called about a NICU position and accepted it. It was the first time this hospital opened a NICU nurse residency orogram so I’ll basically be a guinea pig. My advice is to think about what kind of nurse you would like to be and where you fit in. Then volunteer! Or ask to shadow. I volunteered in a NICU during two semesters of school and I think that really helped me. I didn’t have any previous medical experience either.