Nursery to NICU.... ?

Specialties NICU

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Specializes in NICU.

Ok I have a bit of a dilemma and I'm looking for some advice, suggestions, insight, experiences that you can share ..... anything.

Here's a bit of background. I graduated in May of '05. I didn't start working right away ... I took time to study for boards, then I enjoyed the summer vacation before starting my new career.

At the end of Sept. I landed a great job working in a newborn nursery. I had thought about going into NICU right away and seriously considered it. I did my preceptorship in a Special Care Nursery and I really loved it. After talking to my manager we both agreed that I could start in the newborn nursery where I could get some good assessment skills. Then, as time goes on, I could move up to the step-down unit, then to NICU.

Since then I've been working in the nursery and I'm loving it. I've been off orientation since the end of Nov. .... so about 2 months now. I'm starting to feel more comfortable.

Now they are talking about going to couplet care. No more nursery. I know this is the norm for all the hospitals around here. That's why when I was offered this job to start with I was surprised it was available because I didn't know they still had newborn nurseries. But our postpartum rooms just aren't conducive to a couple care environment. Well they're talking about going ahead and trying it. They're having a meeting about it later this week, so hopefully I'll learn more then.

So of course all kinds of rumors are flying. Supposedly they want to start this in 2 weeks. Everyone is wondering what they're going to do and it's been said that we can either join the postpartum nurses and do the couplet care. Or we can go to NICU.

I was hoping I'd be able to train in the step-down unit first, but they're saying that we need to train in NICU. I know that I'd want to go to NICU rather than work postpartum .... I'm just now starting to feel comfortable working with babies, I want to keep working with babies rather than adults. The prospect of working in NICU excites me .... it's something that I've wanted since I did my preceptorship in the Special Care Nursery. But on the other hand, since I've been working in the newborn nursery, the idea of sick babies scares the crap out of me! Any time I have a baby that isn't transitioning too well or that gets sick or something just isn't right .... it scares me. And we don't handle it any more than that. If something isn't right, then we call the resident and they get sent to NICU. It just really, really scares me :rolleyes:

I'm just so unsure of myself and what I should do. Did you all start out in the NICU? I know new grads generally do great in the NICU. Did any of you start out in a newborn nursery and then go to NICU? How was the transition for you?

Any suggestions or advice you can give me I would really appreciate. Thanks for reading!

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Specializes in NICU.

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Specializes in pedi, pedi psych,dd, school ,home health.

Rain, i dont work in NICU, but have read your post regularly...you are a very intelligent young woman, and i bet an excellent nurse....this transition, i think will not be taken lightly by your hospital, and i am sure that many share your apprehension. I think you will do fine in NICU with some additional training. Maybe you could assk about the traing plan at your meeting? good luck, keep us informed! Mary

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Specializes in NICU.
Rain, i dont work in NICU, but have read your post regularly...you are a very intelligent young woman, and i bet an excellent nurse....this transition, i think will not be taken lightly by your hospital, and i am sure that many share your apprehension. I think you will do fine in NICU with some additional training. Maybe you could assk about the traing plan at your meeting? good luck, keep us informed! Mary

Thanks, Mary :) Yeah there is a lot of apprehension in our unit, because our jobs are basically being taken away and we'll all have to deal with a big change. Even the postpartum nurses aren't thrilled about this.

Hopefully I'll learn more tomorrow about what the plans are.

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At my hospital we have hired 6 new grad nurses into the level II NICU. All have been working from 1yr-2yrs now in the unit. One observation that I have made is that most were having some difficulty determining "when" an infant was needing a higher level of care than the nursery. This happens when the NICU nurse is floated to cover transition nursery. (We do all admission assessments in the nursery). When we asked these particular nurses what they thought was causing the problems....the answer was NOT having enough experience with NORMAL infants and their variations. All of these nurses have done well in the NICU otherwise.

just something to ponder. :) I wish you well.

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Specializes in NICU, Infection Control.

This happened @ our hospital a few years ago. Most of the "nursery nurses" came down to the unit, and some did fairly well. Some of the older ones really never adapted well--they had been in NBN, doing their "time" til they could retire. Some did the best they could, but it was obviously a stretch for them.

You, my little chickadee, are a whole 'nuther story. You're young, well educated, and, hopefully, flexible. You'll feel a little nervous @ first, but you will do fantastic! Even tho the change is unexpected, start doing your homework: Merenstein and Gardner, Neofax, some Neonatal Network magazines are now your assigned homework. And don't forget what you've learned about assessment skills in NBN, they'll come in very handy!

We're rooting for you!

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Specializes in Neonatal.

I would think that having newborn nursery experience would be a great asset in transferring to the NICU. Does your hospital offer an internship program for the NICU and if so is that an option? Good luck in whichever you choose.

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I think you will do great as well. You are already ahead of the game because of your experience in NBN. If NICU is what you want then I say go for it. It sounds like the opportunity is upon you. I wouldn't pass it up. It will be quite an adjustment for you, but even if you were able to stay in NBN for another year or so it would still be a big adjustment to go to NICU.

As unikuelady already mentioned it will be too your advantage to be familiar with what "normal" is in the newborn baby.

I say GO FOR IT!!!!!!!!!

Good luck!

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Specializes in NICU.

Thank you all so much!!

It's official ..... I'm a new NICU RN!! :)

I realized I didn't want to stick around and just settle for couplet care (nothing wrong with it, but it's not the area I wanted). I started in the nursery so I could move my way up to NICU, so why should I have to settle for something I don't want to do (couplet care) just because my hospital is making changes? This is MY career and I need to do it for myself.

So I took a huge leap and applied to a different hospital .... they have an AWESOME orientation program that I've heard nothing but great things about. I interviewed yesterday with the NICU nurse manager and she offered me the job on the spot! I will get a minimum of 12 weeks orientation. Then they will be having an 8 week new grad class once a week (but since I'm starting in mid-semester I won't be able to start that until May or June ... but she said it won't affect anything, it's just kind of a supplemental thing they do).

I cried on the drive home after my interview .... this is a dream come true, I've wanted this all along! I've read many threads and posts on this board because this area interests me greatly. I'm so glad to be joining you all! So expect me to be asking lots of questions and looking for advice here in the next few months/years ...... I know it's going to be rough, but I'm so excited!! :)

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Specializes in NICU.

Ok I start my new job on the 27th! I met with the lady in HR yesterday and got all my paperwork done, and we're all ready to go!

I ordered the Merenstein book (I studied that book a lot during my preceptorship and found it easy to read, so I ordered my own) and a Neofax. Are there any other books that I should go ahead and get? I looked on the list of recommended NICU books, but there's just so many. I'm not sure which ones would be good to have starting off .... I don't want to get bogged down by too many. Any suggestions would be great! :)

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Specializes in NICU, Infection Control.

http://www.academyonline.org/

http://www.nann.org/i4a/pages/index.cfm?pageid=1

Join either one of these groups, or subscribe to their journals. (I personally recommend Neonatal Network.) That way, you'll get new info regularly.

Or you can see if there's a NANN chapter in your area.

You should probably wait a while before investing in more books to see what you want. You might want something from parents point of view or something on breastfeeding, or developmental? Who knows at this pt.?

Congratulations on your new job!

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Specializes in NICU.
http://www.academyonline.org/

http://www.nann.org/i4a/pages/index.cfm?pageid=1

Join either one of these groups, or subscribe to their journals. (I personally recommend Neonatal Network.) That way, you'll get new info regularly.

Or you can see if there's a NANN chapter in your area.

You should probably wait a while before investing in more books to see what you want. You might want something from parents point of view or something on breastfeeding, or developmental? Who knows at this pt.?

Congratulations on your new job!

I think I'm going to sign up and join the Academy of Neonatal Nursing .... it sounds like it also comes with a subscription to the Neonatal Network. I will definitely do that.

Thank you so much!! :)

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