I am a nicu nurse in Kansas. I work at the largest nicu in our region and receive transports from the outskirts of town. I LOVE the patient population, but have realized I have zero autonomy in decision making. Perhaps I feel this way because I worked in MICU prior to transferring to nicu.
I am not allowed to put in any orders, even if my baby appears to be hypoglycemic and their lab values show glucoses that are trending down. I have to call the doc for permission to check the blood sugar. Respiratory therapists don't trust the nurses and they have to be present almost all the time during skin/skin with vent babies. They also have to be present when turning the babies who are using the neofits because they fear of extubation. In Micu I turned and manipulated patients as much as I like. RT only came to do their checks or came only when I called.
I've been in nicu for a year and still can't start an IV. You have to be accepted onto the IV team first and there's a waiting list from a year ago. Apparently the infection rate is high. We do all med administration and IV starts in a sterile manner. It's ridiculous. We don't use drips, maybe dopamine here and there but we do not titrate without a doc's order. Sedation is not even an option. I miss drips, I miss titrating and calling the shots on even the smallest things, like checking a blood sugar.
Are all nicu out there micromanaged like this?? I am considering leaving the specialty and I hate that im considering it because i love the population. I just hate being a brainless slave.
You may find switching to PICU will scratch your itch for lots of autonomy as well as taking care of some babies and all the families...particularly if the PICU you go to is also a CVICU, because then you get all the really sick congenital cardiac babies who are post-op with an open chest and sternum, with a temporary external pacemaker, and on continuous PD, paralyzed, sedated, and on every pressor or vasoactive drug that your heart desires...all with standing protocols so you get to titrate and trouble shoot to your heart's content. LVADs, spinal drains, ICP bolts, ECMO, DKA, trauma, burns...there's lots to learn and a WIDE scope of what you see.
I did NICU for 7 or 8 years...I ended up on the high risk delivery team, admit nurse, PICC line insertion nurse...but ultimately did leave because I was bored off my rocker. Tried other pedi options for a few years (peds float pool, etc) and then landed in A PICU/CVICU/Transplant Unit for several years. Sounds like it really may be up your alley.
PixieRN1
183 Posts
You may find switching to PICU will scratch your itch for lots of autonomy as well as taking care of some babies and all the families...particularly if the PICU you go to is also a CVICU, because then you get all the really sick congenital cardiac babies who are post-op with an open chest and sternum, with a temporary external pacemaker, and on continuous PD, paralyzed, sedated, and on every pressor or vasoactive drug that your heart desires...all with standing protocols so you get to titrate and trouble shoot to your heart's content. LVADs, spinal drains, ICP bolts, ECMO, DKA, trauma, burns...there's lots to learn and a WIDE scope of what you see.
I did NICU for 7 or 8 years...I ended up on the high risk delivery team, admit nurse, PICC line insertion nurse...but ultimately did leave because I was bored off my rocker. Tried other pedi options for a few years (peds float pool, etc) and then landed in A PICU/CVICU/Transplant Unit for several years. Sounds like it really may be up your alley.
Food for thought.