Published Mar 5, 2004
I have been in adult critical care for 11 years, mostly recovering fresh hearts and other surgical patients. I have an excellent knowledge base and feel quite comfortable when I walk into an ICU.
I have always wanted to work with the little ones and have managed, after much patience and more than a few years' persistence, to acquire a full-time position in my hospital's NICU. My new manager has promised me a lengthy orientation with an experienced nurse, and I'm very excited about it all.
BUT, now I'm getting nervous. I start orientation in 2 1/2 weeks and I almost feel like I did when I graduated from nursing school - like a total ignoramus. :uhoh21:
I know that I will ask a lot of questions; I'm not afraid of doing that. I guess what I'm looking for is some pointers to make sure I'm starting in the right direction. WHAT should I make a priority in this learning process?
llg, PhD, RN
I have spent many years coordinating NICU orientation programs and have worked with many experienced nurses trying to make the transition to NICU. The actual nursing skills are rarely a big problem -- you'll learn those just fine. What causes some people (but not everyone, of course) is the emotional and cultural adjustments.
Some nurses who have been experts in one field have trouble becoming a beginner again. On an intellectual level, they understand that it is temporary and they will soon (in a year or so) acquire sufficient skills to feel comfortable in their new environment. However, they are emotionally unprepared to "feel uncomfortable" in their new environment for that long. They talk about being "afraid they are going to hurt the babies" because they don't have the same level of skilled judgement that they had in their previous setting. They forget that it took years to develop that level of skilled judgement and it will take more than a couple of months to develop that same level with a whole new patient population. Most of the nurses whom I have seen not make it through orientation or who leave NICU soon after orientation leave for this reason. They can't emotionally handle being out of their comfort zone. They acutely miss that feeling of confidence and comfort that can only come with time. They go running back to their old unit because they feel comfortable there and receive a lot of positive reinforcement from their old friends and employers about what a great nurse they are.
My suggestion is to identify some people who have made similar switches in their careers and to talk with them regularly as mentors. Sometimes it is difficult for someone who has always worked in the same field to be totally understanding of how it feels to switch. Find some people who have done it and talk with them regularly to learn how they did it, etc. Also, someone who has switched fields maybe able to help you clarify some of the subtle differences in practice and culture that may be irritating you on a subconscious level -- making your new unit seem "not right" somehow in a way you have trouble putting your finger on. Getting those things out in open will help you to deal with them head on. Sometimes, if those people who have worked only NICU can have trouble seeing that what they take for granted as normal is actually something unusual for a nurse from a different background. (Does that make sense?)
It makes perfect sense. I didn't think of things from that perspective, and I will definitely keep what you said in mind.
Thanks for the excellent advice!:)
I made a switch about a year and a half ago from a peds unit to an adult ICU/CCU.I had been a pediatric nurse for 10 years and needed a change. Not quite the same as your situation, but culture shock just the same! My advice to you is utilize this orientation period to the fullest. Seek out learning experiences and ask lots and lots of questions.I think because I had been a nurse for so long I thought things would be easier, but it was just like starting over. I had a great preceptor who looked for patients that I would learn from. LLg had some great advice. Good luck in your new direction!
Wow, is it that hard to get a job in an NICU? Right now I work as a Med Surge nurse on a unit that has a VARIETY of different patients, including Peds patients. (it's a small community hospital). I would love to do NICU eventually, but I guess I'll have to wait awhile, maybe get some more experience?
I'm all about taking care of children and babies. Should I perhaps get a job at the children's hospital and start out on the Med Surge unit, or in the ER?
Those jobs are a bit more readily available.
You will do just great ! I will pray for u you got what you worked so hard to achieve!
Best of Luck !
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