NICU and the nursing student

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Hi everyone! I just recently (only 2 shifts in!) started my senior practicum in the NICU and am loving it! The unit is top notch, the nurses are wonderful and my preceptor is great! I started this thread to ask a specific question, but am also considering using it as a running "dialogue" of sorts for my time on the unit since I'm sure I will have many questions.

I was told by my preceptor that during our next shift we will likely be taking care of a patient that is 500 grams. I believe 503 grams was the exact weight when I was last on the unit about 3 days ago. Is this considered micro preemie status? Also, what should I read up on regarding care for an infant of this size? What are my preceptor and i likely to do with and for this patient during a 12 hour shift? I wasn't given any other information about the patient so I won't find out diagnoses until I am back on the unit.

Additionally, I Would like to show my preceptor that I am taking the initiative to learn about our patients before the start of shift and to illustrate my current level of knowledge, especially the things I am learning during my time spent reading on the unit (even though I am aware that as a student nurse what I don't know could fill a book.) I have heard and read that it is important to remain humble and to not act like I think I know everything, which I definitely don't think I do. However, my preceptor doesn't ask questions to test my knowledge the way other nurses during my clinicals have. Instead, she just tells me everything she thinks I should know about the diagnoses, pathology, or treatment plan. I'm sure part of this is just me trying to jump the gun and impress her since I would absolutely love to work on this unit, but the other part is that I genuinely like being tested on the information. It lets me know where I stand and, depending on the types of questions asked, I feel that it helps me to develop my critical thinking skills. Is this something I should mention to my preceptor or should I just wait and see if she is simply waiting until I've had more time on the unit?

thanks in advance!

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Specializes in NICU.

I finished my capstone in a level IV NICU last week. It was a great experience and I sent applications for NICU job at another hospital and a new grad residency in a NICU (graduate in 3 weeks) out of state a couple days ago.

Now if Meanmaryjean would put a good word in for me at her hospital, I will be set :yes:

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That's great you are loving NICU! I've been a Level III nurse for 14 years and I'm on a couple of committees and I precept new grads. Here are a few tips:

1. Core Curriculum for Neonatal Nursing is a great reference. Reading is great and at this point you should be asking questions not trying to show you know anything. We all know NICU is not learned in school, it's on the job. If you try to show you know too much this early, you may be perceived as cocky. Follow your preceptors instructions and ask lots of questions IV you have them. Taking notes looks good. Definitely remain humble!

2. Show that you are grateful for the opportunity. This goes far!

3. At the end of your rotation, write thankyou notes to manager and preceptor.

Hope this helps!

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Specializes in CDI Supervisor; Formerly NICU.

Yes, 500 grams is a micro preemie. Read up on developmental care of the premature baby, and be careful when you have your hands on her. Watch the lights. Watch the temperature. Watch the head and be careful with it.

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Don1984- Congrats on having finished your capstone! I'm glad you enjoyed the experience. I'm obviously a little biased, but I can't imagine anyone not loving a NICU rotation. Keep us updated on the job hunt progress!

Bear1001- Thank you for the advice! I originally purchased the Merenstein and Gardner book, but my preceptor has lent me her copy of Core Curriculum and I am finding that to be a much easier and more helpful read. This experience has definitely been humbling! There are so many disorders and poor prognoses and so many of the babies I have worked with have been sooo very tiny! I think 4 out of my 6 patients so far have been micropreemies. And I am beyond grateful for this experience. I am definitely hoping that this preceptorship opens the door for a possible job once my hours are over or when this hospital posts openings for their new grad residency. I would be over the moon to work on such an amazing unit! My preceptor hasn't yet introduced me to the unit manager yet, or if she has, she hasn't referred to her by that title. Is it okay to ask to be introduced to the unit manager so that my name and face can be familiar to her? I am about 60 hours in to my practicum so far and only have another 70 to go.

Bortaz, RN- I was hoping you might comment on one of my posts! I have followed many of your postings on this site and have always enjoyed the posts you have created and the advice you have given others. I also downloaded your brain sheet and have found it to be very helpful!

I was so nervous performing my hands on assessment of the 500 gram baby. Moving her head was so very unnerving because i could feel the split fontanels and it felt so....strange. I made sure to be very careful though while doing anything with her. Working with her was by far the most humbling experience I have had so far in the NICU.

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I have been making myself a medication reference document with some of the most common NICU meds (found on one of the previous allnurses threads), their indications, dosages, things to watch out for, etc. The Neofax for the unit has been missing/misplaced since I started and that book is, unfortunately, waaay to expensive for me to afford right now. One of the meds I had a question about was Zemuron (Rocuronium). I know from the -onium ending that it is a neuromuscular blocking agent/paralytic. However, several sites I have looked at state that Rocuronium isn't recommended for the pediatric population. I have seen at least two of the babies in my NICU on this med though. Does anyone know more about how common it is for Rocuronium to be used on neonates?

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Specializes in CDI Supervisor; Formerly NICU.

We always used Norcuron (vecuronium). Sounds like the same thing.

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We use Rocuronium on bigger babies that have a high tolerance for sedation medication. They tend to be older BPD/ PPHN babies.

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