Nursing Model

Wow! 160 beds! That's the largest nicu I've ever heard of. Our nicu which is a level 3 only has 54 beds at max capacity (which it almost always is). We've been pretty short staffed lately, but it's usually two babies to three babies per nurse unless they're critically ill and then they're singly assigned. We have one charge nurse, one resus nurse, one flow nurse whose job is to call all the level 2 hospitals in the province and arrange transfers, and if we're lucky one resource nurse (usually not).

The turnover rate is pretty high so I'd say almost half our staff has less than 2 years of experience. It can get pretty scary sometimes when I'm considered somewhat senior with three and a half years of experience. Our new staff get two weeks of in class training and then around three months of preceptorship where they follow one preceptor around on all her shifts.

We do primary nursing, so you can pick up primary babies and they try their hardest to assign the baby to you whenever you're on. Otherwise if you have a vented baby, it's usually assigned with a cpap or a room air kid. They try not to assign double vents unless we're slammed. But primary nursing really helps with the continuity of care. I just transferred my primary to another hospital yesterday after three months of taking care of her. I miss her already.

We have PICC nurses (only six out of 160+) that insert PICC lines on their own and a quality safety nurse.

We are a 101 bed Level IV (5th largest, soon to be 6th when yours is done). We are assigned 3 feeder/growers, 1 vent and 1 F/G, or 1 very sick baby. We are assigned the same babies on subsequent days for the week. 2 charge nurses per shift, Infant Stabilization Team that attends all high risk deliveries, day shift PICC nurse, nurses trained in ECMO.

25% of our staff has less than 2 yrs experience. New staff get 2 months classroom/preceptorship, then 1 month night shift preceptorship (12 weeks total) before they go on their own.

I work in an 80 bed single room (with a few twin rooms) unit and we are adding 15 more beds. We have a neonatal OR/recovery in the unit. Lately, we have always been in overflow x 1. We can at max overflow x 3 @ 8 babies each for a total of 104 babies.

How is your NICU staffed? We have over 200 nurses. Charge nurses handle staffing, assignments, OR schedule, incentives, etc. We usually have 3 Level 2 babies, but can go up to 4 in crisis. Level 3 babies can at most be in a 2 baby assignment, of course some babies need 1:1 or even 2 nurses to 1 baby.

How do you incorporate new staff? They hire about 10 nurses as a group 2-3 times a year.

How much of your staff has less than 2 years nursing experience? Less than 20. They were on a hiring freeze for a while.

What is your current nursing model?

Primary nurse assignments with an assigned buddy to cover during your breaks.

How are nurses assigned to patients? Previous charge nurse makes assignments and posts around the break room.

Do you have specialty nurses? (IV team, ECMO, CDH, PPHN, Wound, etc) We have a transport team.

Does your unit attempt to provide continuity of care? How? Charge nurses try to assign you to the same babies if you work several days in a row. Nurses are required to sign up to be a baby's primary nurse (I think 3 babies a year is the expectation). In this case you will be assigned to that baby until they are discharged.

Sorry, correction to my original post….

We currently have 82 beds. We are adding to our unit, but then taking ½ of it away (I forgot about that part!!), so we will have about 100 beds. Big difference!! Sorry!

We are a level IV NICU.

Thank you everyone, for your help!

So you're basically getting a brand-spankin new unit.