Pay Close Attention!

[Bezoars]

I am an RN with just about 4 years of experience. I spent my first two years in a Med/Surg Float Pool and the last two years in a Perinatal Float Pool (where I work currently). Along with that (I'm a per diem employee) I have also worked in Endo, IVF Lab, ER Overflow, etc. I have some pretty well rounded experience at this point. Well, they are now training me to the NICU. I don't have critical care experience up to this point and this is a whole new world. I will be "floating" to NICU sporadically, so I will only get NAS babies, Feeders/growers, and stable CPAPS. So, my question is.... what do I want to pay close attention too with these little ones? Tips and advice are much appreciated.

[APL&D]

NAS - get familiar with the scoring, meds you are giving, your hospital policies on when to notify a provider.

Feeders/grower - make sure they are gaining weight, maintaining temp, monitor for feeding intolerance, measure their abdominal girth, inspect their residuals and stool for any complications. Read up on nec. It is a freak tragic thing, but it happens.

CPAP - learn the signs and symptoms of pneumothorax and know what to do, have a pneumo kit at bedside, monitor respiratory status.

Hope this helps.

[prmenrs, RN]

You sound like an excellent nurse who loves challenges and learning. Very commendable. As a new grad, I would have love to have done that much variety.

That said, I hate to be the discouraging word here, but, babies are whole nother species. I don't think it's a good idea to "float to NICU sporadically". It's too hard to pick up subtle signs of sepsis, NEC, and other disasters if you don't have a really good grounding in this specialty. NICU is vastly different from adult nursing: normal VS, calculating dosages, and pathophysiology.

If you do decide to take this on, try to go there more than you go anywhere else. Get a copy of Merenstein and Gardner (look on Amazon for it) find a good drug reference like Neofax, and study them. Wash your hands a lot!

I wish you the best. If you like this area of nursing, try to get a position that doesn't have you going all over the hospital, with an occassional visit to NICU.