Nursery and NICU

[jagalu100305]

I couldn't find a nursery forum so I posted this here and the NICU forum.

Hello all I need some advice. I have been a NICU nurse for the past 7 years. 4 years I worked full time in a small level 3 and level 2 NICU and then 3 part time agency work. I decided to go back to the hospital full time and went back to the hospital I worked at before. They did not have NICU openings so I started back in the nursery and found I really enjoyed it and will stay. Well I have found that when a baby transfers to the NICU the NICU nurses act very superior and treat the nursery nurses like we do not know what we are doing. Being a NICU nurse before this bothers me especially as I am treated the same way. Yesterday after a long hard day at work I had to transfer a baby to the NICU at 645 pm. I was attacked when I walked through the door for something very minor and left work literally in tears. If they can make, me, a former NICU nurse feel this way I can only imagine how someone else without that experience feels when they enter the unit. It is a well known problem with management and she has talked to them but it doesnt seem to help any. I don't want to be part of the problem but part of the solution. Does anyone have any ideas of how to build respect and cohesive teamwork between the two units?

I know both specialties work very hard having done both. For us the incidents are not isolated it's every time I or anyone else walks through the doors. The past few times for me I have not even gotten report when I get comments like "Does this baby really need to come over" or just generally attacked for things that are largely irrelevant. When I worked in this same unit before I did not feel like we acted in such a way. Maybe it is just the staff in this unit at this time. That's why I want to come up with something, some way we can bond as sister units and grow mutual respect for each other. I just don't know how! Thanks for advice!

[everthesame, LPN, LVN]

I'm sorry you are experiencing this. When I worked on a postpartum unit I also experienced this from a few NICU nurses and a neonatologist. One day one of my babies was "rejected" twice by the NICU before they finally kept him. The baby had been having seizures but the NICU staff did not think a mere postpartum/well-born nursery nurse would know what a seizure was. :smackingf Since the baby didn't have a seizure in front of them in the five minutes they took to assess the baby, they kept sending him back. After the third time, and a call from my nurse manager, they kept the baby. It turned out that the baby had a rare neurological defect and only lived a few months.

I think it is much trickier to catch things like this in the newborn nursery. In the NICU the baby is usually hooked up to monitors...the NBN nurse can't see if the baby is starting to brady during a feed or they have to figure out if something the baby's mother tells them is "normal" or signs of something more ominous.

Another thing, it depended on who was working in the NICU. Some nurses were much easier to work with.

Also, my hospital went through a lot of changes and construction and for a while our NICU census was low due to not being able to take level 3 babies. Most of the NICU nurses had to take shifts in the NBN or work as the baby nurse in L&D. I believe a lot of them had a different opinion of NBN nurses after having to consistently work on our units. Maybe you could suggest some cross orientation for both NICU and NBN nurses so they could each have a better understanding of the other nurse's roles.

[Irishobrn]

I don't work in either of those units, I work in L&D...but have had my share of problems with the NICU. In our hospital it seems they are annoyed each time we call them over...even though the reasons we call them are all defined in the hospital policies. Then when they come they act like primadonna's who must be served. The other day we had 6 nurses total due to call outs...three delivering at the same time and 8 other patients on the board. My patient was delivering with a vacuum assist and had meconium...so NICU was called. The neonatogist and nurse stood there and said the stethoscope was not the one she liked (bell size?) and she wanted another...I'm the only nurse in the room, vacuum handle in hand while doc was applying the cup....so I looked at the NICU nurse and simply said, "oh you can go to the next room and get another one." The next day I came in to an email from my manager about the "incident". I was livid, demanded a meeting with both the nurse who complained, the neonatologist and the director of nursing. Amazingly they decided they misunderstood my comment as being nasty and over reacted...so no meeting would be necessary. These people constantly leave us with retracting babies, blue babies, and babies that we need to repeatedly call them back for over and over again. We can't transfer an unstable baby to Newborn nursery...they are not set up to deal with that, they have 6-8 babies to care for and can not stand over an unstable baby to monitor them. But for some reason they continue to leave before the baby is stable.

I have to say some are better than others but overall they are not team players at all! If you figure out how to fix it please let me know too.

[applesRN]

Please tell me there are NICU nurses that are team players, as I am trying to get into this area!

[klone, MSN, RN]

Apples, I'm sure there are. But we do see a lot of divisiveness. I think it stems from having totally separate departments. Where I used to work, everyone was cross-trained in the different areas (it was a level 2, not a 3, so it was a feasible thing to do), and there was far less of that, because it was all one team. But when you have totally separate departments, the nurses often have little understanding of the training of the other nurses. No, the L&D nurse is not an expert on NRP the way the NICU nurse might be, but she has lots of areas of expertise that the NICU nurse doesn't have either.

I think it just comes from a lack of understanding/appreciation of the different roles.