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Nursery nurses?


Hi :)

I am considering applying for a job in the Nursery at my local hospital, and was wondering if there are any Nursery nurses on here who could give me a bit of information about your typical duties in that unit? I would just like to be a little more familiar before I go for it!

Thanks everyone :D

(Oh and sorry if this is the wrong place to post this... I wasn't sure)

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

Is this nursery a newborn "well-baby" nursery or a special care nursery? There are some things that are the same and some that are very different.

In the newborn nursery, you would admit the newborn and perform a newborn assessment. This is a head to toe examination looking at weight, length, skin integrity, color, pulses, facial features, oral cavity, extremities, abdomen, chest, genitourinary system and so on. There's an assessment form that is completed so that any variations from the norm can be documented. (We recently admitted an infant who had an imperforate anus who subsequently died of sepsis. His anomaly had not been picked up in time and he perforated his bowel.) You may also do an assessment of gestational age if there's some question of dates. Then you'd give the Vitamin K injection, apply the eye ointment if ordered and any other physician orders. The baby may remain in the nursery for some time if Mom was sectioned or is ill. Some babies you might feed, others you would take to Mom for feeds. When it's your turn, you would provide a bath demo, do teaching about normal baby care, car seat assessments and so on.

In the special care nursery you would do all of the above, more or less PLUS. Babies admitted to the special care nursery may have craniofacial anomalies such as cleft lip/palate or choanal atresia, tracheoesphageal fistula, micrognathia, Down Syndrome or other problems that make feeding a challenge. They could be infants of diabetic mothers and require close glucose monitoring. They may be premature but not requiring intubation and ventilation, they may have been exposed to illicit substances in utero and be in withdrawal.

Does that help?

Oops, sorry about that :imbar It is a well-baby nursery (I live in a pretty rural area, so any special needs babies are shipped out... but I know we are responsible for stabilizing them beforehand, so I am glad you elaborated on the special needs nursery as well).

This information is extremely helpful! Thank you so much :D

I just wanted to ask a question about the baby you mentioned that died... is the assessment for imperforate anus done just by doing a rectal temp (I think that's what I remember from school - of course it's been awhile LOL)? Just curious because it seems like something that would be hard to miss... but then again, I am new to newborn nursing so I don't know for sure.

Thanks again for all the information :) I definitely know more of what to expect!

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

You can assess for imperforate anus by doing a rectal temp and also by direct visualization. One major assessment is whether or not the baby has passed meconium. With the baby I mentioned, he was born unexpectedly at home and although he was taken to the hospital and assessed in the ER, they don't usually do newborn assessments so it was missed. There was nothing else obviously wrong with the baby at that time so he was d/c'd from the ER. He was reassessed a day later after he started vomiting. And the rest of it just snowballed. The move to ever-shorter post-partum stays has created all sorts of interesting problems, like hyperbilirubinemia after discharge. You may see some of those babies too, but typically once they've been home they'd go to peds, not the nursery. Some heart defects also pop up after discharge (when the ductus arteriosus closes) and the kids are REALLY sick then. So you wouldn't likely see that.

I haven't worked in a newborn nursery for a long time. Got floated there from the PICU once and it was such a nice break!

Okay that makes more sense now! Yeah, I know having babies is a natural thing and all (and don't want to start a debate), but I am not a fan of earlier releases for that very reason... I mean, I'm a nurse and I was still scared to death bringing my babies home! There are just so many things that can go wrong... but I guess I did okay since my kids are still doing good LOL

Oooh I bet it was a nice break... I think I would have to work for a looooong time before I attempted PICU or NICU. I definitely think it takes a special nurse to work in those areas, and as far as I can tell, that's not for me. I love kids but think I would have a hard time handling the ones that were seriously ill. Not to get off topic, but did you start out there or did you have other nursing experience first?

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

Hey, this is your thread. If you wanna take it off topic so be it!

I graduated into the last big nursing purge so didn't find a job until I'd been out of school 7 months. I was hired by an agency to do pediatric home care and staff relief. It was a horrible way to start a career and there are posts in other threads that expound on all the reasons why. I didn't start hospital work until exactly a year after graduation when I took a casual position in a special care nursery. It morphed into a series of temporary part time positions but my main goal was always PICU (my 26-year-old son is a PICU grad - 6 1/2 weeks of PICU when he was just little). I wasn't sure I'd ever make it there though so I was looking for the best in the nursery so I applied for the neonatal resus team and was turned down three times because I wasn't in a permanent position. The third time I was rejected they decided that they'd train one of our casuals though so that was it for me. I started looking for options. I was offered a temporary position in PICU about halfway through one of my many temporary positions in the nursery but the manager of the nursery wouldn't release me. So then I was more ready than ever to get out of there. As luck would have it, when my term was nearing its end, there were no postings for PICU so I applied for a position on an adolescent medicine ward. Right after I dropped that application off there magically appeared a temporary full time position in PICU and although I really didn't want to work full time I applied for that one too. All of a sudden I had two offers and had to choose. PICU it was and I've been there ever since. I moved to a new city 7 years ago but still work in PICU. It's my niche for sure.

Oh man, it sounds like you had quite a time getting to where you are now! I think it's awesome that you always knew where you wanted to be and all your hard work finally paid off... it gives me some inspiration :)

To be completely honest, I am not sure where my "niche" will be... I have so many things I want to try, but don't think employers will like it much if I get hired then change my mind ;) So I am doing as much research I can about the positions I *think* I will like.

I have been out of nursing for a few years (had to stop working when I got pregnant with my first child, then decided to be a stay at home mom, but now that my 2nd is 18 months, I am ready to go back) and only had just shy of 1 year of Med-Surg experience before that (definitely not my niche lol), and that makes me that much more unsure, I think. But I am determined to find where I belong :D