Nurse with 10 years adult experience starting NICU ..... help!!!!

Specialties NICU

Published

I always wanted to work in the NICU. Well, the opportunity has presented itself but I am so scared. I was a premie myself and wanted to work in this area out of school and was never able to get in. The hospital I am going to start at orients using a hands on approach. There will be less classroom, but individual certification classes, online courses etc, accompanying hands on throughout the training. So exited, I accepted in a heartbeat. Please help me. Are there any tips or suggestions to help me make the transition smoother and less painful?

Thanks in advance...

Excited and Shaking in my boots at the same time.:scrying::wacky:

I am an ER nurse. Could an experienced NICU nurse describe for me what a typical day is like?

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Specializes in Progressive Care/Tele, ICU/CCU.
notsosupernurse , congratulations!!! I know exactly how you feel. I just found out today that I got a position in my hospital's NICU after 2 months of applying! And I had applied for the position 2 years ago also but at the time they only wanted experienced NICU nurses. This has been a dream for me and so I'm beyond excited but also terrified. I am now just feeling confident in the CCU I work with and I know that starting in the NICU is a completely different world and I will feel like a brand new grad again. Best of luck to you and I will be on here looking for more advice also!
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I went into NICU after about 10 years in adult care, everything from LTC to ICU. I never really was happy with nursing until I started in the NICU. My son was a patient for 4.5 months and that got me interested. You can do it!

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Specializes in NICU.

Nursed40- I'm a former new grad nurse and landed a job in the NICU right off the bat. I've been at it a little over 1.5 years now. While there's no truly "typical" day, I'll do my best! :)

I usually get there and check my assignment and duties about 10 minutes before my shift starts, then do housekeeping type things- belongings away, grab blank report sheets, and track down the day shift nurses so I can get report. After report, I check EVERYTHING- orders, meds, weights, corrected gestational age, labs needing to be collected, most recent progress notes, etc. Sometimes things get left out in report and I don't want to be the "Well they didn't tell me" type.

If there are parents/ family at the bedside I introduce myself to them after report (so I know a bit about them and their baby) and tell them I'll be the night nurse taking care of their baby. I ask if they have any questions and go from there. Also, I tend to do a lot of teaching with my parents. I explain what the monitors/alarms mean, the different I've fluids, etc. Most are very curious/ apprehensive about asking, but want to know. Once they know it helps to decrease *some* of their anxiety. It also helps to establish a trusting relationship with them.

Our feed times are every 3 hours, 8, 11, 2, 5, around the clock. I cluster my care around these times. I do my assessments, meds, lab draws, etc as close to these times as I can get it. Babies grow and develop during sleep, interrupting there sleep (especially unnecessarily) can make them slower to heal and progress. Not to mention highly irritable. I tend to do my feeder growers first, this gives the Respiratory Therapist for my sick kids a chance to get over to my sick baby. I also coordinate with the RT on all care for the sick babies- vents/oscillators. We suction/turn/draw blood gases/labs etc at the same time so we are only touching the sickest babies for as short as possible. The micro preemies get overstimulated extremely easily and will drop their vital signs in a heartbeat with too much stimulation.

I do baths during an NG feed if the kiddo has one- much easier that way. If they don't, I bottle feed them after a bath. Feed--> bath = puke if they're moved around too much. :wacky: They tend to hate the baths, but are calm and sleepy afterwards.

I'm sure I'm forgetting a bunch of stuff, but it's nearly 0600 and I haven't slept yet. :up: If you have any questions/want more details, etc- let me know! Hope it helped and gave you some insight to our days/nights!

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Specializes in NICU.

Sorry, message posted twice. Have no idea how to "tag" nursed40 in my original post.

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Thank you so much for taking the time to share your nursing care. It definitely takes a special person to care for sick babies all day!

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Hello Everyone, I appreciate all the advice and came to say how wonderful the NICU has been to me. i am glad I made the switch I have enjoyed it all. I was very sad when I experienced 2 of the babies dying since Iv'e been there. They were not my assigned babies but it was sad nonetheless. Everyday is a new experience and I am excited to go to work each day. There is always something new to learn!

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I just started in the NICU in February and i'm still trying to get the hang of the "daily routine". How to you balance trying to learn what you're supposed to be doing and working with a preceptor who isn't always understanding about you not knowing anything about nicu? it's hard to learn when I feel like she thinks i should know things by now, it's only been a few weeks. I don't want them thinking I don't "fit" well with their unit, I'm just struggling making the switch

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Specializes in NICU, PICU, PACU.

What kind of things are you talking about? A few weeks in we expect our newbies to be able to follow our daily routine and not be horribly behind. We have a pretty regimented orientation that last 12 weeks. We also have reading assignments and classes. Do you have good reference books? Also, make yourself a "cheat" notebook to put commonly used policy/procedures in and notes to yourself. Also use a good work flow sheet, separate your patients into individual pieces of paper and put down the side every hour you will be there and then fill in what you need to do every hour and tick it off. And sometimes you have to put yourself out there and talk to people, strike up conversation at lunch or break. Do you have any conferences or meetings with your CNS or manager during your orientation? We meet with both of them weekly and then the orienter meets with them privately. If there are issues our CNS will bring it up us and make a switch of preceptors if needed. None of us get offended as not everyone meshes with each other. And don't be hard on yourself, take a step back and look at the big picture.

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I'm getting the hang of the every 3 hours routine, have my own daily "brain" that keeps me straight on everything I need to do that day, my preceptor tends to just toss me on my own and disappear. That's not hard to handle with the "feeder/grower" babies, but one with a CPAP that i haven't used before is a little more daunting. And then she gets mad when I'm not quite a "pro" and knowing what to do with that particular kid. I was thinking about switching preceptors, we met with the charge nurse and the director so that helped, but it's still overwhelming sometimes. No classes, just following the nurse around and getting a kid of my own the last week or so.

i talk to people, I just tend to get caught up in my own thoughts in my own world a lot to try and put the whole picture together with what i'm being taught, and they took that as i was not being "proactive" enough...maybe with a new rn to learn from i can change that thought, just feels like they want me skipping down the halls singing and flitting around in order to look like i want to be there.

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Specializes in NICU, PICU, PACU.

I'd ask to change preceptors.

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I'd ask to change preceptors.

I think I'm going to, hopefully that helps, otherwise it's running up and down the halls flitting around I guess

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