aviator411

babyRN: Oh by the way. I neglected to mention that it was a close affiliation with many fine NICU nurses like yourself which inspired me to become a nurse. At age 63. NICU work will probably not happen for me but there is a place in nursing for all to contribute. Thanks again!

babyRN, Thanks for your response. It doesn't appear that there is much we would disagree on. And, please, no need for the apologies. Your observations here have great value for all, especially the many readers who aspire to NICU work. You have just, of course, identified two more of the many moral societal dilemmas present in the NICU. To carry one of your examples a step or two further: Several NICU RNs I know who have 40+ years experience in the specialty now question the merit of much of the work they have done over the decades when they are out in public and see some of the patients they have helped "rescue" being carted around in a semi-vegetative state by aging parents. At some point, sooner or later, someone will be called upon to account for the cost vs benefit to society of such cases, both in terms of dollars and human anguish. Of course, for every case like those above, there are the wonderful success stories which inspire people like yourself and Paco396 to seek NICU work. Like society at large, I am inspired by your dedication and very hard work. Getting back to the point of my original remarks to Paco396, I simply had hoped to call attention to readers here that we in nursing generally have enormous respect and credibility with the general public, news media and legislators, much more so than many of us realize and, being the largest of all healthcare professions, there are enormous opportunities for us collectively to impact all of these moral societal dilemmas if we will only organize ourselves to confront the task. Those who bring specialized experience and training to nursing such as Paco396's legal background should be in a particularly advantageous position to contribute in this area. Of all the things which inspire people to become nurses, political advocacy must surely be very near the bottom of the list. I would hope, however, that professionals like yourself who experience some of the frustrations you have just cited can be inspired to invest some of their time and hard-earned experience in attacking the root causes of some of the many moral societal dilemmas which impact us all. Thanks so very much for your comments!

Hi babyRN, I too am unsure how the irresponsible/criminal behavior of a baby's parents is relevent to whether or not a baby should receive care which differs from the care of any other baby. I certainly did not suggest such. The moral societal dilemma is not the care of the baby, it is the behavior of the parents and the manner and extent to which we as a society condone, allow and even encourage it. We as a society have made the birthing of babies by irresponsible parents who often choose of their own volition to subject their fetuses to lethal and known damaging circumstances a "growth industry". The first time a parent(s) does this, it is the parents' fault in my opinion. Each subsequent time it happens, it is the fault of we as a society at large, in my opinion. We have the means to prevent subsequent occurrences but there isn't a politician in congress responsible enough to even consider doing what needs to be done to prevent this abuse upon the unborn.These people do not meet my minimum criteria to be called "parents". What do you think should be done about parents who knowingly damage their children from before the moment of conception? That is the moral societal dilemma to which I refer. If we as taxpayers are going to pay for the care of children of irresponsible parents then there need to be consequences for such irresponsible behavior, including compulsary prevention. Caring for these often abused babies is and should be inspiring work. But preventing such abuse to begin with should be our focus (again, in my opinion). We as a society are NOT taking this issue seriously. And, by the way, the parents of many of these babies are present in the US in violation of state and federal laws at taxpayer expense (fact not opinion), something which neither major political party seems to be the least bit concerned about. Thanks for your coments; we welcome your thoughts.

Paco, As you and I learned long ago, there are two sides to every coin. Glad I have not discouraged you, perhapes even strengthened your resolve to make it an enjoyable adventure, prepared with some realism. I wish you the best with nursing school; I have no doubt you will get accepted somewhere. I did a similar thing. Retired in '07 and did a 12 month second career BSN program here in Michigan. I'm working on a master's now for FNP as well as OHN (Occupational Health Nursing). The OHN part of the program came with a NIOSH grant which covers much of my school costs. So I have yet to actually work as a nurse but am very excited about doing so. Gotta have something to do for the next 50 - 60 years. LOL! I think the most engaging courswork I've encountered in my nursing education so far was my public health undergrad course & clinical and my graduate course in healthcare policy strategy. Both courses focused my attention on the health of populations, not just individual patients, and gave me a different mindset on the nursing profession. With your background in law I'm sure you'll discover, if you haven't already, that we have a lot of great clinical people in nursing but a dearth of people willing to engage the political system as needed to optimize the effectiveness of the nursing profession. There tends to be a mindset in the profession that we are mere pawns in the grand political scheme about which we can do little. Too few nursing schools are making their students aware that they are joining the largest group of health care providers in the world and that we have enormous potential impact upon our own destiny and that of our patients if we will get organized and exert our influence upon the system. During my graduate healthcare policy strategy class I learned that many politicians, like much of society, have such enormous respect for our profession that they will often go out of their way to satisfy our requests, sometimes without even being asked to do so. I encountered examples where such things had actually happened during this course. One senator, when visited by a small group of nurses from his district, actually said to his aid, "What can we do for these nurses? Let's see what we can do to help them." With your legal background, I predict that you will find enormous opportunity to influence the impact of our profession to the betterment of the healthcare system and the patients for whom we provide care. You'll recognize these opportunities when you see them. Again best of luck. Thanks for your dedication and enthusiasm. I guarantee you will not regret your decision. Let me know if I can ever be of any help.

Hi Paco, Haven't seen activity on this thread for some time. Enjoyed reading your post and looking at your background here, etc. Not sure if you're in nursing school yet but you will certainly prevail if you haven't already. Thought I'd offer some perspective on NICU work, not for the purpose of trying to discourage you (which probalby isn't possible; and that's good) but for the sole purpose of "perspective". A "very close" member of my family has been a NICU nurse since almost the beginning of the specialty; practicing NICU for 40+ years now. Gotta tell you he/she is getting very burned out. In the beginning NICU was new and exciting, forging "new frontiers", etc.. A high proportion of the parents were average folks who just had extremely rotten luck. Saving their kids was both rewarding and exciting. Things have changed over the last 40 years. Yes, there are still very good parents who are the victims of "rotten luck" and those are the clients who continue to inspire NICU nurses. That bad news is that a rapidly growing proportion of NICU neonates are in NICU because their parents should never have become parents and their kids are there because their parents have discovered the benefits of hatching babies at public expense. For these parents, often well-known to the police and other authorities, often addicted to every known illegal and legal drug and for whom the best service is not good enough bringing another infant to the NICU is an annual event and, why not, after all this "fun" is "free" (except for you the nurse who will be contributing their support with every paycheck). But of course, few nurses are wont to punish the infant for the sins of the parent (or "parents" in those instances where the mother actually has a clue whom the father is). As a new nurse you are sure to find the work inspiring. As a taxpayer nurse you are likely to eventually come to appreciate the futility of this moral societal dilemma. And with your legal expertise you will quicky recognize the abuse of our system which takes place in this environment many times daily. By all means, new nurses are as entitiled to enter this nursing specialty with enthusiasm and excitement as seasoned veteran nurse/taxpayers are to see disillusionment. I can only hope that your legal perspective may someday inspire you to help our society find remedies to the abuses inherent in the moral dilemma so often observed in the NICU. And I've only shown you the proverbial "tip of the iceberg. Feel welcome to PM me if you would like further insight. Best of luck to you. Please keep us posted about your progress with nursing education and your observations from the NICU or else where. Thanks for your own insightful contributions here! Go for it!

Well, at 52 you've got at least a couple of good years left. I just became a nurse this August at 64. In grad school now for FNP & NMW and mean as ever! You may find it a little difficult to overlook the youthful flaws of some of your classmates. You'll find that some of the younger ones are not very good listeners and that they have not discovered the value of life experience. Can get a bit annoying when you have to do group projects with them but they'll grow up some day. You've probably found, however, that most instructors do recognize the value of life experience. Good luck with it!

My apologies then. That puts the matter in a substantially different context. While you may have some difficulty meeting the standard for a NICU, you can certainly strive to bring in improvements and it sounds like these could be quite substantial given the resources that you already have. I'll inventory my own resources and see what I can come with. I'm sure there others here who could be of substantial help with references, etc. Best of luck to you!

glimpses, You might do your patients some good by telling us more about yourself and the support available locally. When and where did you receive your nursing education. What sort of medical staff do you have available. What experience or training do you have in respiratory therapy, hemoperfusion, neonatal cardiology? Without a neonatologist and some well-equipped respiratory therapists, your ability to establish an effective NICU are slim to none. CPAP is over 30 years old. These days you need oscillator vents, etc. to be effective. Do you have a lab available to give you arterial blood gas analyses? What you are proposing to do is well outside the scope of practice of an RN in the US. What is your liability exposure in India for attempting to practice in a discipline for which you appear to have no training? How is the nursing profession regulated in India? Are you familiar with the nurse practice act or it's equivalent in India? India is a very bureaucratic nation; if you look into it I'm sure you'll find a substantial body of regulations and legislation pertaining to nursing practice there, especially in such specialties as neonatology. If you are unfamiliar with such basics as jaundice and phototherapy, you will be in serious trouble dealing with anything beyond those subjects. Almost any pediatric nursing or neonatology text will tell you enough about phototherapy to get by, lacking these, google will quickly tell you what you need to know. Be realistic, you can't help your patients by subjecting yourself to the liabilities of practicing beyond your qualifications. I wouldn't assume that my scope of practice is unlimited just because I'm practicing outside the USA. Here's wishing the best of luck to you and your patients. Thanks!

NB, et al, You certainly can't do any harm working peds med-surg for a year or two. Assessments in NICU are so very different, however, that one could easily argue against the relevance of such experience in other contexts. To be sure, if you spend a career in NICU you will find it difficult at best to do other nursing work late in your career. My wife has been in NICU for at least 38 years. She wouldn't consider anything else at this point in her career and would have great difficulty adapting to other environments, just as others would have great difficulty adapting to hers at the same point in their careers. The appeal of nursing is that you have almost unlimited options these days. Do what works for you and don't lose sleep over what others are doing. Best of luck!

Zoobyli, At least you're now aware of some other places which hire new grads in their NICU's so you should be able to use this knowledge as "leverage" in your local interviews. You can tell them "I'd rather work here but it doesn't make any sense to invest a year or two working outside the NICU somewhere to satisfy your requirements when I can go somewhere else and start right away and receive better pay and benefits. Good luck, I know you'll get it done!

Boratz, Wow, a grandfather at 40; you've got me beat by 24 years at this point! I don't expect to become a grandfather before 70 or more. What state are you in? I should caution you; you may find it difficult dealing with 19 y/o mothers with a history of 7 or 8 pregnancies and their entourage of boyfriends, etc. You'll probably be contributing heavily (& involuntarily) to their hospital bill! Good luck; you'll be a great NICU nurse! John

Salaries, by name, for everyone who works for UM can be viewed at: http://www.michigandaily.com There are several links near the bottom of the page to "UM Staff Salary Supplements" for several years. The documents are downloadable and in Excel spreadsheet form so you can sort them any which way you like; by job title, salary, name, whatever. Interesting reading for anyone considering a move. Good luck!

Bigg, You'll never know what you missed if you don't try it. I'm just finishing up a second career BSN program and have loved every second of it so far. Your management training will not be wasted in nursing; it will only expand your opportunities. Go for it!

Zoobyli, Come on up to Michigan; plenty of NICU jobs for new RN's up here, especially with your LPN experience! Sent you PM w details. John

Steve, Indeed, every place seems a bit different. I appreciate you sharing your experiences and observations; it's all very interesting. I've enjoyed reading and have benefitted much from your informative posts in recent years, hope you will keep it up. When I learn more about the division of labor here I'll pass it along for all to share as well. John