Precepting in NICU Step-down

SteveNNP, MSN, NP · Jun 8, 2007

There's nothing wrong with gaining experience in a Level II nursery. I recommend to the students and nurses I precept to learn how to care for normal/near normal babies first, so you can better pick up on abnormals when you get to the NICU stage. Most new employees here start orientation on feeders and growers and work their way up to the more intensive babies. Level II's sometimes handle vents, usually have IVs, meds and gavage feeding.. Its a great place to start, especially if the pace is a little slower. It'll help you form a good base for when you graduate and get into a NICU. Best of luck!

Stephen

lilbug · Jun 8, 2007

Thanks for the comments!! This step-down unit usually takes babies once they are off vents/CPAPs and they usually don't have IVs anymore. They are typically just the feeders and growers. There is a level III NICU upstairs and they transfer the babies to Step-down once they are stable, off the vents and don't need too much medical intervention. They do need to continue to grow, get stronger, and be weened off O2 before they go home.

You are right, I will learn more normals which will help me pick up on the abnormals. I just wont learn the more intense medical interventions I am assuming.

cathys01 · Jun 11, 2007

But even in the level II unit, you'll still get some exposure to procedures. Kids are always getting sick and needing "sepsis workups" done (blood cultures, start IV, urine culture, maybe even ABGs). You'll also get good at placing feeding tubes (gastric and duodenal), assessment skills, etc.

There are lots of good skills to learn that will definitely come in handy when you start in the level III NICU.

cherokeesummer · Jun 11, 2007

Congrats! What I've learned is that you probably won't learn nearly as much in precepting as you will when you graduate and go into orientation. I've spent every other weekend for the past 5 months in the NICU, level 2 and I feel like a newwwwwwwwwwwwbie most days! I worked mostly with feed/grow babies and did assist with some of the more unstable ones but I have asked and everyone has told me that you really learn on the job. Especially with our school b/c you do not get acute care exposure really until the end and its not that much!

So rest assured I think you will be ok!

RainDreamer, BSN, RN · Jun 19, 2007

Precepting in a level II NICU will be PERFECT!

I did my 144-hour preceptorship in a small level II NICU and it was the perfect experience, it was just right. I couldn't have imagined going into a busy level III with critical babies, I would have been so scared I wouldn't have learned anything!

So I went into the level II, did the 12 shifts, and I learned so much. Just learning the simple things is so important because you will learn everything else in your orientation once you get a NICU job. Just having the 12 shifts to help me get comfortable with just working with babies was a huge help! You don't realize how intimidating those little guys are until you're standing there working with them, having to flip them over and reposition them. Things like that make a level II a great place to precept in because you might not get to do all that stuff in a level III with the kids being so sick.

In your preceptorship just have them go over how to do a good assessment. My preceptors let me do assessments all the time, even on the well-babies. That's such a great skill for a good NICU nurse to have. Good assessment skills, knowing when something is wrong, and letting someone know ..... those are the key things. Everything else will come with time.

Good luck to you, I wish you all the best!