Quote from my2sons
Seeking Nursery/NICU view on my situation (also posted to management forum):
I'm a BSN CCRN with 10 years ICU experience, started in ICU as a new grad way back when they were not hiring new grads in the ICU. I did not have a formal internship, I had a preceptor for 6 weeks and then I was on my own. I feel like I have accomplished all that I had set out to accomplish in adult ICU and now I'd like to move on and change specialties. I've applied at a fairly small hospital (lots of deliveries though) for their Level II Nursery. The recruiter contacted me and said that I was not a candidate fot the Nursery position since I don't have NICU experience and they do not do internships. Then she all but begged me to interview for her open ICU positions. (UGH!)The Nursery position has been open for weeks and she admits that they are very short staffed ( another reason they are seeking experience, I'm sure). I am thinking about bypassing this recruiter and contacting the Nursery Nurse Manager directly, forwarding my CV, and asking (I'm willing to beg!) for an interview. I am practical, I realize that NICU/Nursery is VERY different from adult ICU. I am an extremely motivated, responsible, and self directed learner. I succeeded (shone!) in ICU as a new grad with an extremely limited amount of clinical training, and really think that I could learn quickly in the Nursery as well. Any comments, opinions, thoughts would be greatly appreciated.
I agree. You have nothing to lose by contacting the nurse manager directly.
As far as the advisability of starting out in a Level II nursery, I would have to say that as a manager, I would not recommend it for everyone. If I were interviewing you, my decision would be based on 2 factors: 1)the census and acuity of patients in the unit, and 2)my impression of your ability to learn in less than ideal circumstances. Let me explain, and please don't think that I'm dissing Level II NICUs. I'm not. But they are very different from more intensive units.
I started out as a new grad in a 45 bed Level III NICU way back before it was fashionable for new grads to do that. The unit was able and willing to accept new RNs because they had a never ending supply of learning experiences in the form of critically ill preemies, cardiac babies, surgical cases, full-term meconium kids, as well as the relatively straight forward r/o sepsis babies and IDMs. We also had over 100 full-time RNs on the unit, about 1/2 of whom were willing and able to precept, so it was no problem to offer a 12 week 1:1 orientation to new grads, as well as a 2 week class on fetal development, normal and high-risk pregnancy, delivery room stabilization, resuscitation, pathophysiology, pharmacology, etc. All the things that were just glossed-over in nursing school. It was an amazingly thorough and well-planned orientation period. In 2-1/2 years of working there, I only saw 1 or 2 RNs "wash out" of the program. After orientation, we were expected to work full-time ffor at least 1 year, in order to hone our skills. Even with a wide variety of patients to care for, and never-ending support from more experienced staff, it took about 2 years before I began to feel like an "expert".
After 3-1/2 years of NICU, I took a job in a Level II nursery. It was in a small community hospital which did about 2500 deliveries per year. Most of the patients had reasonably good prenatal care, so our high-risk population was fairly low. Good for the moms and babies. Not so good for the NICU staff who were trying to learn and maintain critical care skills. Literally months would go by between vent babies. We would see a chest tube twice a year. Despite their best efforts, most of the staff had very limited IV and blood drawing skills. Even for those of us who came from NICU backgrounds, it was hard to keep our skills up. For those who had not previously worked with infants and children, it was virtually impossible to learn the necessary skills.
So, would I hire you? If the unit has an adequate census to allow you access to critically ill babies on a daily basis, then probably yes. I would require that you take NRP (which the hospital should set up and pay for). I would also seek out a NICU theory course at a teaching hospital or referral center, since it is not possible for a small unit to provide that kind of classroom education for you.
You should insist that you not be floated to any other unit, except L&D to do baby care, for at least the first 6 months of your employment. You can not be expected to learn NICU care if you're on med/surg for the day, just because "it's your turn".
Good luck to you, and deep us posted on what you decide.