NICU VS. Newborn Nursery in your hospital?

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Specializes in NICU- now learning OR!.

It seems as though the NICU and the "well baby" Newborn Nursery should have a close relationship and work well together, right? Not where I am at. I never know how I will get treated when I am bringing a baby to newborn nursery. Sometimes they are super nice, other times I literally stand there and am IGNORED until I finally have to say something.

They can't start IVs on babies per policy (so I am told) so we go and start their IVs, but if we bring a baby at a time that is "inconvenient" - WATCH OUT! I have literally been yelled at because they don't want/can't handle another baby. Guess what? If the baby is D/C from NI to be transferred to the nursery - its going - like it or not.

Anything similar in your hospital? Teams/groups of people who *should* be working well together but aren't??

Jenny

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Specializes in Community, OB, Nursery.

Where I am, ICN and wellbaby work pretty well together. ICN helps with our IV sticks and generally answer any questions we have about funky stuff that they see more than we do. I can't speak for dayshift, but the nightshift ICN nurses are by and large great. I hope they would say they same for us.

From a wellbaby nursery perspective though, there are times when I feel like if anyone -- and I mean ICN, L/D, or a parent going to smoke -- brings me another baby, I am going to explode. When I (and one other nurse) have 4-5 babies under warmers, 2 of those needing heelsticks, another one of them forgetting to breathe, and a methadone baby having a meltdown, not to mention the seven other babies in there needing feeds/diapers because parents are sleeping (or partying, or out smoking), yes, it can be overwhelming. Especially when we don't get any heads-up from ICN that another baby is coming, which does happen sometimes. Sometimes I do go "AAAAGH!" out loud when somebody -- anybody -- walks in w/ another baby.

I don't mean to make this into a NICU vs wellbaby debate. I love most of our ICN nurses, and I hope they like us too. And if I do go "AAAGH!", it's not meant personally. Sometimes it's the only way I will stay sane -- since I haven't eaten, peed, or sat down in the last 9 hours.

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Specializes in NICU- now learning OR!.

Thanks for the reply. that is a different perspective, I must say. But on our hospital the apneic babies, methadone babies, etc. are in NICU not in the well baby nursery. If a baby is even *thought* to be sick,cold, apneic,etc. they ship them to us so fast your head would spin. (except of course for the sad cases where they "sit" on a cold baby for days and THEN send them to us for a FULL septic workup, lumbar puncture, etc. )

Jenny

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Specializes in Community, OB, Nursery.

I guess I should clarify...

The babes under warmers are new admits/deliveries, though we do get the occasional cold one too. If s/he stays cold too long, I'm on the phone with somebody. And usually the apneic ones are newly delivered and we DO ship them out most of the time -- or Narcan them if NP says it's ok.

I really don't mind the methadone babies. I feel sorry for most of them & it makes me feel good when I can comfort them enough so they'll sleep well. They are just so labor-intensive sometimes....ok, most of the time. They really need to be 1:1, it seems.

One night I had a kid whose ax temp was 103-point-something. Eating fine but otherwise acting very poopy. I fought to get him transferred and the NNP wrote some Tylenol orders and asked me to watch him. I really wanted to get him out of there. Eventually he DID go to NICU with.....HSV. Not exactly a wellbaby. He survived but with some deficits.

Every unit has their challenges, it would seem.

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Specializes in NICU.

I can see it from both perspectives, as I'm now a NICU nurse, but I started out in a well-baby nursery at a different hospital.

In the well-baby nursery I worked in we didn't do any IVs or anything of that sort. We kept all the well-babies in the nursery while mom was sleeping, or if she was a recovering c-section and couldn't keep the baby. We also kept all the borders that didn't have a mom in house (e.g. the prisoners, etc). We had phototherapy and methadone kids too. Then we had to transition all the new kiddos that came in. It was very overwhelming at times. Like Arwen stated .... sometimes you'd just want to scream.

At that place the NICU nurses looked down on us. They felt like we weren't "real nurses" and that all we did was babysit all night. Sometimes it felt like it, but sometimes it'd get crazy .... when you have a kid trying to die during transition and you've got all of this other stuff going on at the same time (your other 5 babies all went to eat RIGHT NOW!), it could be incredibly stressful and hectic. We always had 6-8 babies in our assignements. I never ran my butt off more than when I worked in that nursery. Yeah I have some real crazy nights in NICU, but I've always been able to at least take a bathroom/snack break if I need to and I sit on my butt a lot more now than I used to!

So now (working in the NICU) when I hear comments about the CCN nurses having it easy, I just realize these people don't know what they're talking about. And it makes me more understanding. I haven't had to deal much with the CCN nurses in my current hospital ..... only one time that I can remember. I had a baby that came up to NICU for transition as she was having a slow start, but then transitioned fine so I was given the OK to send her down to CCN. I called CCN to give report and the nurse that would be taking the baby said she was swamped and asked if I could call back in 20 minutes so she could finish some stuff. I told her no problem, that I would go ahead and feed the baby, and then she could call me back when she is done. She was so thankful for that and she just called back when she was done.

Both units are busy and can be crazy at times. But they're so different too. I've noticed in the NICU we help each other out more because we have more resources (than in the well-baby nursery that I worked at anyway). If someone has a lighter assignment they help out with the sicker kids/admits. We also have a charge nurse that doesn't have an assignment, and that wasn't the case in the well-baby nursery. Whereas in the well-baby nursery we all had pretty heavy assignments and admits were coming to us CONSTANTLY.

Also in our CCN, they do IVs and antibiotics. Generally we don't work real close with the CCN nurses though, we work closer with the L&D nurses .... if they're having trouble transitioning we'll take them to the unit and then decide if they need to stay in the unit or if they're good to go to CCN or with mom to couplet care.

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Specializes in NICU/Neonatal transport.

Our "developmental unit" and acute unit don't always get along.

Partly the problem is the perception of the parents, which stepdown nurses then think we also have. A lot of the parents sometimes view the stepdown nurses as less competent/able to handle their complex babies. It's less that they can't do it, but it's switching from their primary nurse that they've had for months to a new primary, who doesn't do everything the same way we do it. So, the parents are hesitant and suspicious, and I think the nurses think that we encourage it. Which we don't.

So now there's a rift between the two units. hopefully it will be improving as we get more used to transitioning our chronics over.

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Specializes in NICU.
Our "developmental unit" and acute unit don't always get along.

Partly the problem is the perception of the parents, which stepdown nurses then think we also have. A lot of the parents sometimes view the stepdown nurses as less competent/able to handle their complex babies. It's less that they can't do it, but it's switching from their primary nurse that they've had for months to a new primary, who doesn't do everything the same way we do it. So, the parents are hesitant and suspicious, and I think the nurses think that we encourage it. Which we don't.

So now there's a rift between the two units. hopefully it will be improving as we get more used to transitioning our chronics over.

Not to get completely off the topic here - but when our chronics transition to the part of our unit that is like a stepdown unit - the primary nurses always stay with them. Primary nurses are with the baby until the day that they go home. I can't imagine having to leave the baby that I've been taking care of for 3 months and not get to take care of them until they are healthy enough to go home...

As far as NICU vs newborn nursery...

We seem to have a pretty good relationship with the nursery. When we call them to say that we are ready to bring the baby to the nursery they really don't seem to have a problem with the timing. If the nurse that is taking care of that mother/baby duo is busy, then the nursery nurse will get report from us, and then pass that info onto the other nurse. We do go to the nursery to start IVs, but they manage all the med administration themselves.

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We fight a lot. Our newborn nursery is filled with the bitter and burned out nurses. I sometimes think it's amazing they've managed to find that many angry people to hire for one unit. Fortunately, most places I've worked in have had good relationships between the two units.

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Specializes in Neonatal ICU (Cardiothoracic).

We had a pretty good relationship at my last job... They would get a little snippy when we'd send up the little ones who were holding their temps up, and eating like little pigs... they'd also get upset when we'd come to evaluate a baby only to leave it up there. (NO, we can't admit a baby to NICU because he "looks funny") Otherwise, they were a pretty calm bunch who just added our transfers to their passel of screamers as we bolted for the relative quiet of the NICU (except for the "helicopter landing pad" of 15 oscillators)

Stephen

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To Elvish:

Your post really upsets me; I have had a baby in long term care and the way "burned out" nurses like your self act are really disturbing to the families. Myself or someone in my family would take care of our newborn as much as possible. However, new mothers and their families need sleep also. This is a profession that if you are not passionate about and compassionate for that you need to get out of immediately. Either take a vacation or quit this profession, please!

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Specializes in NICU.

1. This thread is more than 3 years old.

2. Don't you think your comment is more appropriate for a PM?

3. This thread is more than 3 years old.

seriously...

edit: this is your first post...troll posting??

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Specializes in Neonatal ICU (Cardiothoracic).
To Elvish:

Your post really upsets me; I have had a baby in long term care and the way "burned out" nurses like your self act are really disturbing to the families. Myself or someone in my family would take care of our newborn as much as possible. However, new mothers and their families need sleep also. This is a profession that if you are not passionate about and compassionate for that you need to get out of immediately. Either take a vacation or quit this profession, please!

Sdhayes,

I agree that this post could have been written in a more sensitive or private way. You need to walk a mile in a NICU or NBN nurse's shoes before you post things like this.

At the end of the day, the vast majority of us go home, knowing we did right by our patients. I agree that new moms need sleep, but the hospital is not a hotel, and more and more families treat it like one these days.

And P.S., this thread is 3 years old. Seriously.

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