NICU Preceptorship

[HyperSaurus, RN, BSN]

Hello all,

I am in my last semester of nursing school. Our school is piloting a preceptor program this semester--basically we put in our top picks of units at the local hospital, we get assigned, do 90 hours with a preceptor, you get the drift. I have been assigned to NICU, which I am thrilled about.

Now I am wondering what I should study up on in order to prepare my self. I've only been to the NICU three times previously (one of which to observe an admission). Any ideas?

Thanks!

[HyperSaurus, RN, BSN]

Reading "A Day in the Life of a NICU Nurse" as I type. I'm just more curious regarding how I can best prepare myself.

[Yoda RN, BSN]

Congrats on your preceptorship in the NICU! I was fortunate to land one of 2 slots in my nursing program just this summer. I graduated in Aug., passed the NCLEX last week, and begin my new role as a NICU RN next week! So, from my experience...

If you haven't done so already, definitely know your newborn/premie vital sign ranges. They are basically the same, and will vary slightly between institutions--but are very different from the adult values you've become so used working with.

Since most of the patients will be ventilated, it could help to get an idea about the different modes/types of vent settings and what they mean. It's not crucial to know, so nothing too in-depth, just stick to the basics. Additionally, I guarantee you will work with with tube feedings (if your program permits.) Eventually, you will learn about the different isolette settings, so if you want to get ahead...

Also, be familiar with newborn head-to-toe assessment: checking of fontanelles, newborn reflexes (moro, babinski, etc...), acceptable measurements (head, chest). Know in what order to perform your assessment (do least invasive first) so as not to distress the infant.

I think it would "wow" your preceptor if you knew something about infant positioning. This plays an important role in the care of these patients, especially when they need routine turning. My NICU unit improvised with blanket rolls, wedges, gel pillows. So just get an idea of the possible options you may run into in your NICU.

Be prepared to deal with distraught parents. This was my biggest concern. I found that some nurses (unfortunately) found their presence to be bothersome, but just keep in mind that these families are in crisis. Imagine if this were your newborn...

Don't be afraid to get in there and try new things. Just be mindful of your limits. Your preceptor will observe your willingness to learn, but don't feel forced to overstep your boundaries if you're not comfortable.

I kept my drug book with me, in case I wasn't familiar with a new drug that was being administered.

The most common problems I experienced were: respiratory, retinopathy of prematurity (ROP), and congenital heart defects (like ASD and PDA).

Avoid challenging your preceptor on subjects while he/she is teaching you. From my experience, some of what I learned in the classroom and texts (and NCLEX!) completely contradict "real world" practice. But refrain from arguing with your potential future place of employment and just learn all that you can. Consider this experience a 90-hour interview, because this is what it essentially boils down to be. Of course, you may change your mind about the NICU altogether once you finish. For me, my experience reinforced my dream to become a NICU nurse. Your preceptor(s) will be your strongest references.

These are just a few really basic ideas that popped into my head. Good luck. Hope this helps. I wish you the best!