Some questions I hope you can answer

justjenny · Nov 2, 2006

1. What are some of the biggest challenges you face as a NICU nurse?
2. How do you work to incorporate the families into the patient's care?
3. What are some of the criteria for moving a baby into the NICU?
4. I understand that there are different "pods" in the NICU. How many areas are there typically and what determines when a baby moves from one place to another.
5. What are the general staffing ratios in the NICU?

I think by browsing pasts posts in this forum you can find many, many answers to these questions.

1. My biggest challenge is my inexperience and sometimes that I can get more emotionally involved than I would like.

2. In every way possible, we are constantly teaching and encouraging the parents to care for their infant(s) whenever possible and when appropriate.

3. You have asked this question in another post. #1 reason: prematurity

4. We have the "NI" portion of our unit (intensive care) and the "Special Care" portion with muliple "pods" in each

5. Depends on the patients and the acquity. Sometimes a baby is 1:1 other times we can have up to four patients (this has been discussed multiple times in other posts)

Jenny

Gompers, BSN, RN · Nov 2, 2006

1. What are some of the biggest challenges you face as a NICU nurse?

It's an intensive care unit - these babies' lives are in your hands. You've got to know what you're doing and not be afraid to speak up and ask questions when things don't seem right. It's also hard to not get attached to these babies and their families.

2. How do you work to incorporate the families into the patient's care?

First it's all verbal - explaining everything that we're doing for their baby. Then we have them slowly start to take an active part in their baby's care as it becomes appropriate - changing diapers, taking temperatures, helping weight and change linen, etc. Once the baby is doing well, then they start to learn things like bottle feeding and bathing. We try to let them do as much as possible but don't want to overwhelm them either.

3. What are some of the criteria for moving a baby into the NICU?

There's another post on this board about the reasons a baby might need the NICU. Agree that #1 is prematurity. Basically, any condition where a baby needs monitoring or support.

4. I understand that there are different "pods" in the NICU. How many areas are there typically and what determines when a baby moves from one place to another.

Every unit is going to be different. Some have pods, some are open units, some have separate rooms, and some have private rooms. Each unit has their own set-up, so there really is no distinct answer to this question. The only thing is that some have step-down areas as well as intensive care beds - while others combine all the babies together. If there is a step-down area, usually the biggest criteria to move there is to have no IV lines and that the baby be either on room air or a nasal cannula.

5. What are the general staffing ratios in the NICU?

Again, there are other threads about this in the NICU forum. Generally, it's 2 patients to each nurse. If the baby is very sick, it'll be 1:1 and if the baby is a "grower-feeder" in step-down it might be 3:1 or 4:1.

Feel free to look through the posts here on the NICU forum because there is a ton of information available about all of these topics. We tend to "talk" alot here!

momto2beauties · Nov 7, 2006

Thank you very much for taking the time to help!

SFRN · Nov 16, 2006

1.) Some of the most difficult challenges I have faced usually center around ethical issues: withdrawl of support, etc. Also as mentioned before--getting attached to babies and families, especially if you are a primary nurse for a baby.

2.) I always allow parents to do what they feel comfortable with: changing a babies pants, taking the temp., bathing the baby, etc.

3.) NICU criteria: #1 probably RDS (prematurity), congenital anomalies, CDH, PPHTN, gastroschisis, and the list goes on.

4.) Where I work there are three pods: North (special care babies: "flip and feeds", "feeder and growers" on there way home still need to be in the hospital, East: Premature babies (my least favorite place to be: CHRONIC desats) and the West: babies that are there for surgery, ECMO, etc.

5.) Ratios where I work usually 3-4 babies in special care per nurse, premies 1-2 per nurse depending on whether they are intubated and on pressors etc, surgical babies 1-2 to a nurse depending on acuity. And ECMO babies have two nurses to themselves....one for the ECMO machine and one providing cares.