No longer shadowing, but WORKING :-)

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Specializes in Cardiac Nursing.

Well, I started working with my preceptor Sunday and so far so good. She has a primary in the Level III so that's who I've been working with. This little one is a 25 weeker, weighs 850g and is cute as a button, stubborn as heck too. Must be the red hair. She is now off the ventilator and is on vapotherm, so she is just growing at the moment. Her neighbor, a little guy is a 26 weeker, weighing in at 1260g is not doing as well but is just as fiesty (aka stubborn). He is on the ventilator, has a ropogle, and has been made NPO again due to now having stage 2 NEC despite getting po gentamicin.

The learning curve has been a steep one. We had to change the little boy's neofit yesterday and I was nervous about dislodging his ETT despite the fact my preceptor had both hands on it. I have no problem moving our little girl as she only has an NG tube and the vapotherm, but moving him makes me feel like I need four sets of arms.

LOL I am better at suctioning his ETT than changing his diaper, somehow I end up getting it secured below his little but. They are both little squirmers who when I'm doing my cluster care or full assessment, manage to wiggle away from where I place them.

My preceptor lets me do all the care, and is there as my resource since I do know most of the skills just have never used them on anyone so small. She pretty much has said not to worry about being fast right now, she wants me to be accurate first. Besides, I'm in a whole new world. Also we will be having the same two kiddos for awhile....so I will definately master heelsticks, ETT suctioning and itty bitty diaper changes. I have NRP next week. And I got my first arterial stick on the very first try, the second one I got in but it didn't flow well. My first IV attempt on a newborn didn't go as well. Same kid I did the arterial stick on, I missed his IV. Actually I got it, the vein blew. Having started IV's in older adults I knew IV sticks were not always easy. Heck my preceptor missed her two attempts also, the veins just kept blowing. Kiddo ended up with a scalp IV.

I'm trying to get used to the touching of such a tiny, tiny person. Our primary I feel like I'm going to break or squish something when I gently try to turn her or secure her in her snugglie.

There is so much to learn. I do wish they had formal classes in neonatal nursing. We (myself and the other new grads on the unit) got a huge binder full of information.

Oh, and my preceptor definately doesn't mind my always doing the math on my drug dosages, even though the pharmacy has the dose to be given on the MAR.

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Sounds like you're off to a good start! It will get easier with time. I was very tentative about repositioning the babies at first (and still am, to some degree), but you'll get more confident with time and practice. I'm almost done with orientation and can't believe how far I've come in 12 weeks :)

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Specializes in Cardiac Nursing.

It is just amazing the amount of information trying to queeze itself into my poor little brain LOL. I'm trying very hard to not seem totally inept, and my do feel that way when confronted with repositioning someone with all those tubes attached. When a monitor goes off everyone is looking to see which baby is alarming, you actually sigh in relief when it isn't yours for a change. But then, you also get suspicious when things are too quiet. I am also amazed at the personalities these little guys have, I keep interpreting their expressions.

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Specializes in NICU.

It sounds like it's going well! That's awesome. Those itty bitties don't seem to know they're so tiny. They have a lot of 'tude!

Let me tell you...the first time someone asked ME for an opinion, or for a hand...I was like..."ummmm.....pardon?" I probably looked at her like she had 6 heads. LOL. You really do become great at it, and in a few months, the "newbies" will be looking to you for help. :)

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Specializes in CDI Supervisor; Formerly NICU.

What a great outcome to all of the struggles you had earlier in the year. Congratulations to you.

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Specializes in Cardiac Nursing.

My preceptor's primary has left the "big room" of the nicu and is now in the ccn. I got to work in one of the ccn's today and boy is it different than the NICU. I had 2 babies and noticed that if I had the four you normally get I'd have been behind from the get go. Assessments, feeding, charting, repeat. I did feed my first baby today and she was a trooper, took all 70ml....gave me several good burps too. I also observed the speech therapist doing her feeding evals today and learned from her how to position said feeding baby sideways a bit so the feeding pools in their cheek and not down their throat. Now if I can just get those darn diapers fastened quicker. I feel that the longest part of my assessment....the diaper change lol.

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Specializes in NICU.

Congrats! I've got another 15 more weeks until I'm off, assuming I pass everything ; )

I completely know what you mean about feisty teeny babies. We had this one kid who was a 29-weeker and had a hct of 28%, very floppy, and so we gave blood. 3 hours later, kid manages to pull out his PICC line at the change of shift! With the amount of tape we put on those things, I don't know how he managed to do it.

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