gibson0726

I've guess the units I've worked on are opposite from everyone else! If in an isolette, we have the feet towards the wondow/wall and the respiratory equipment by the head. I feel all out of sorts if they're in the bed "upside down". If the baby is in a crib, we can do a little of everything because the rooms are pretty big.

I was also taught that top is clean and bottom is dirty. No dirty diapers by the babies heads!

Baylor pays very low especially considering how heavy their PRN requirements are. One major and one minor holiday plus 4 shifts per month. That may not be the requirement of every unit, but that is the most common one I have seen. If I were ever to look for a 2nd job, I think I'd go the per diem route.

We are currently trialing the Penguin warmers on our unit. The rep who did the in-service told us that the liners can be used for a whole shift - up to 12 hours. She said they recently changed this from q feed changing. I wish they were good for 24 hours, as I feel very guilty throwing away so much plastic.

You sound so much like me after having my clinical day in the NICU! When it's the right place for you, you just know it in your heart. I graduated in December '09 and had to move to get a NICU position..it was SO worth it. I love my job more than anything, and I am grateful everyday that they took a chance on me. If you are in the position to move for a NICU job, I say go for it! Good luck with the rest of school! :)

Before I ever dreamed of going to nursing school, I knew I wanted to do NICU. When I told my mom this she told me, "You can't handle that. You're too sensitive and babies die." Being as my mother is always right, I listened to her when I started nursing school and decided to pursue OR nursing instead. Once I had my OR day, I knew my heart didn't belong there. The next semester, I shadowed in the NICU and I KNEW that was my calling. Luckily I got hired in the NICU straight out of school, and honestly, I felt like I hadn't even gone to nursing school! Everything was completely different. I spent my entire last semester of school in Ortho, and absolutely nothing transferred over. I am still extremely sensitive, but when I see sad things I don't crumple in to a heap and bawl my eyes out. I tear up a lot when I see sad things or the worst for me is when I see and hear mothers crying. I give then a hug, comfort them, and if a tear or two falls then so be it. I had a baby code and afterwards I cried in front of MANY people. I just couldn't help it. They were understanding and encouraging. Also remember that sad things aren't going to happen every single day you work. I love my job more than anything and do not want to do anything else. If you really want to pursue NICU, I say go for it!

Lots of patience. Although we learned skills in nursing school, it is so much different doing it on a "real" person the first few times. Rationales behind the things we are doing. I know nursing is more than skill sets and tasks. That is the biggest thing I struggled with in the beginning. I am finally starting to connect the dots and see the big picture with my patients. Introduce your preceptee to the other people on the unit. This is way more important than I ever realized. It is so hard being the new kid on the block, especially in a tight knit unit. Constructive criticism and praise when it is deserved. Nothing kills confidence than constantly hearing the negativity..unless the new person is having major issues. Allow the nurse to figure out things on their own, within reason. This builds a sense of confidence and strengthens the "nurse brain" as I call it. You know, our ability to store tons of facts in our brains at once. Lead by example! Please do not yell, demean, or show anger towards the new nurse. Yes, this happens! Be friendly and approachable..this goes a long way. I never felt uncomfortable asking "stupid" questions of my preceptors because they wouldn't judge me for it. Well, maybe they did, but never showed it!

I am a very sensitive person and I decided to pursue a nursing career. I'll tell you my story. :) I always knew I wanted to be a NICU RN, even before I decided to go to nursing school. I vividly remember telling my mom this and she said "You're too sensitive to do that. You know those babies die, right?" I thought it over and, since my mother really is never wrong, I agreed with her. Fast forward ~10 years and I am finally in nursing school. I was telling myself that I wanted to be an OR RN. All through the 1st semester and part of the 2nd semester, it was my goal. Then I shadowed an OR nurse... And I just knew in my heart it wasn't for me. There is nothing wrong with the specialty at all, but there was no way I could do it and be happy. I started to reconsider my original NICU aspirations. My next semester was OB/Pedi. I started with OB and one of the babies had a few problems after birth, and all I cared about was the baby. Mom kind of fell into the shadows for me. We also toured a NICU. From the moment I stepped foot in that nursery, I knew. Then a few weeks later I got to complete my clinical time and I knew, without a shadow of a doubt, I had to become a NICU nurse. I landed my dream job right out of school and I couldn't be more in love with my job. I love everything about it. I have been there almost a year now, and I cannot believe how fast it has gone or how much I have learned. I am still very sensitive. I have cried more times at work than I care to admit. You will see some sad things, and it is ok to cry. I mean, don't break down to the point that you cannot care for your patients, but sometimes you just can't help it. I saw a nurse who has been there for over 15 years cry while she was charting. We are humans, it's normal, and I don't think that sensitivity should exclude a particular specialty. Also realize that you aren't going to be surrounded by death and suffering every single minute that you are at work.. I do agree with the above poster about the seizure sensitivity you have. I am hoping that your RN training will help lessen your fear of them, once you know what to do in that situation. I wish you all the best!

Hi Smashley! It really sounds like you have the job in the bag. I have been a NICU RN since January, on my own since the beginning of June..gosh, I can't believe it's been that long already! I won't be considered a new grad for much longer. Crazy how fast time flies. I work in a large level II/III unit. The hardest part for me when I started was the feeling of not knowing what I was doing. Also, I was really scared that I would miss a change in condition and a baby would die, and it would be all my fault. I don't have kids, so even just picking them up and handling them was so awkward for me in the beginning. I only spent 8 hours total in the NICU during clinicals and even then, I was not allowed to touch the babies. I honestly felt like I went to nursing school for nothing, as the NICU is an entirely different world. The vital sign ranges are different, meds are very specialized, even the amounts you give of some drugs are hard to wrap your mind around (a 0.05ml dose of something is very common)! I spent about 4 weeks under a preceptor on the level II side before I worked a couple of shifts on my own..and it was terrifying! Just the responsibility of taking care of someone else's child weighed on me. After that, I oriented for 3 months on the level III side. Talk about scary! I was really intimidated by ventilated infants and I hated moving them. Now, 4 months later, I am putting them prone without a problem. Starting IVs still prove to be a challenge, I'm about 50:50, but I haven't had many opportunities to start them. You will learn a lot from the nurses that have been there a long time. I have been awed by some of the nurses who "just had a bad feeling" about a baby, and sure enough they were right. I want to get to that point, where I call a doc and ask for a bunch of blood test because I have a "feeling" that a baby is going bad. I guess that will come with more experience. Granted, I have called a doc because of assessment changes (up on O2 or green residuals) and gotten new orders, and that always makes me feel good! :) Since you will potentially be working on the level II side, apnea/bradycardia will be an issue you will see a lot. Also, feeding intolerances and NEC are common problems you have to be vigilant about. I am always so paranoid about their little bellies! NEC can claim a life in a matter of hours. I've seen it and it's horrible. I don't mean to scare you in any way, but these are all things you will probably see. I love my job more than anything in this world and I cannot see myself doing anything else. It is amazing to me how much I learn every day. I love my little peanuts and there's nothing more rewarding than seeing a little one go home! Sorry for writing a book, heehee. Let me know if you have any more questions.. I really hope that you get the job!

You can absolutely get a job without prior experience in the NICU. A lot of NICU managers are aware that we do not get a lot of exposure to the NICU during nursing school. Honestly, I have only been a NICU nurse for 7 months and I have already forgotten much of the "adult" stuff I learned in nursing school. I had to relearn so many things and it is like a whole different world. It has been extremely challenging and I am just ready for it all to click..the seasoned RN's tell me that won't happen until I have been working for 2-3 years! I have also talked to nurses who started in other areas prior to working in the NICU. They said it was pretty hard to shift their thinking to neonates because it was so different, however their time management was already ingrained. Good luck and if NICU is really where you want to work, I say go for it! It the passion for your job that will get you back to work after a hard shift.

I worked as a pharmacy tech for many, many years and it is a BIG no-no to say the patient's medication out loud. How violating! I know the last time I was at my OB's office, they have mammogram scheduling at a desk right next to where you check out. The person working there asked a woman "do you have breast implants?" and I was standing behind her in line. I thought that was so inappropriate. What if she did have them and didn't want the whole world knowing? Just my

I work at a teaching hospital, but no residents are allowed in the NICU for precisely this reason.

This NICU really needs to focus on developmental care! It drives me nuts to see these poor babies laying in their isolettes all sprawled out and flailing around. I'm extremely disappointed in this show.

For those of you asking for interview tips, I highly recommend taking a look at this: http://www.brockport.edu/career/behave.htm I was asked questions extremely similar to this in my interview. During my peer interview, I was asked a lot of situational questions mainly about how we would deal with the families (especially when they were upset with the care their baby was receiving), since a large part of our job is centered around caring for parents during one of the most stressful times of their lives. I think it is extremely important for a NICU nurse to not only tend to the needs of the patient, but also for the families. I love teaching and I made sure that these points were emphasized during my interview. As for what you need to know when you hit the floor: for me it was just a healthy dose of fear. Fear of taking care of a tiny 23 weeker, or even just being scared of handling a ventilated infant. My nurse educator told me she didn't care what we learned in nursing school, she just wanted us to learn what she was teaching us. Sometimes I think, why did I even bother going to nursing school? It is like a whole different world in the NICU and you will have to relearn a lot of things. With all that being said, I love my job more than anything. Even after having to call a code or having an extremely unstable, high maintenance kiddo, I still look forward to going to work. This is a 2nd career for me and I have never dreaded a shift like I used to. That is how I know I am in the right place. :)

It looks like it's going to be a series! I will definitely be watching http://press.discovery.com/us/dhc/press-releases/2010/baby-week/

Hello everyone! I am a December graduate and have been working in a level 3 NICU since early February. I spent 4 weeks of my orientation in level 2 and then spent the following 8 weeks in level 3. I have been on my own for about 3 weeks now and I can't believe how much I have learned so far! Some days are more stressful than others but regardless of how bad a shift goes, I ALWAYS look forward to going back. I call those babies my "little BFF's". I love them and they amaze me constantly. Good luck to you, southern.belle, go rock that interview! And best wishes to those of you starting soon. I hope we get lots of participation on this thread, I think it's a great idea!

I'm new as well, I have been off orientation for 3 weeks. It has been challenging to say the least, but I absolutely love what I am doing. I really like the idea of a support thread!

I also have a BS and my ADN. Back when I was first looking into nursing school, the schools near me didn't offer the fast track BSN they have now. I have decided that I am not going to pursue a BSN. I was lucky enough to find my dream job before I graduated at a magnet hospital with an ADN, and quite frankly, I have no desire to go back to school. I already did that! After about 3 years I plan on going to CRNA school or becoming an NNP and both will accept my bachelor's + associates in lieu of a BSN.

In my NICU, each baby has their own stethoscope at the bedside. We use the Littman Neonatal stethoscope and I clean it right before I do my first assessment. Sometimes even the neonatal stethoscope takes up almost the whole chest of a tiny 23-24 weeker. I agree with the book recommendations. The Merenstein & Gardner text didn't start to make much sense to me until I had been on the unit a little while. I also purchased the S.T.A.B.L.E book, but haven't really read much of it yet. Congratulations on the job!

this is all you ever need to know for the nclex. i found it somewhere here on allnurses, but don't know who originally posted it. airborne precaution my - measles chicken - chickenpox hez - herpes zoster (disseminated) tb - tb private room negative pressure with 6-12 air exchanges per hour uv mask n95 mask for tb droplet precaution think of spiderman! s - sepsis s - scarlet fever s - streptococcal pharyngitis p - parvovirus b19 p - pertussis p - pneumonia i - influenza d - diptheria (pharyngeal) e - epiglottitis r - rubella m - mumps m - meningitis m - mycoplasma or meningeal pneumonia an - adenovirus private room mask contact precaution mrs.wee m - multidrug resistant organism r - respiratory infection - rsv s - skin infections w - wound infections e - enteric infections - clostridium defficile e - eye infections skin infections: v - varicella zoster c - cutaneous diptheria h - herpes simplex i - impetigo p - pediculosis s - scabies, staphylococcus private room gloves gown

I have been working nights for about a month and a half now. I love the shift, it's my days off that I can't get the hang of. I tend to stay "up late" until about noon and then sleep until 7pm. This messes up my errand running! I then feel like a prisoner in my apartment, staying up all night alone with only the tv and computer to keep me company. I need a hobby or something! I have tried flipping to a day shift schedule on my days off and it just doesn't work for me. I have always been a natural night owl and it feels incredibly natural for me to stay up all night, I just get really lonely.

Parkland in Dallas still had a few June internship job postings up last time I looked. I graduated in December and the Seton network (primarily Brackenridge) interviewed a lot of my classmates after graduation. Perhaps they are doing the same thing again? I also know that St. Davids did a lot of hiring late as well.

You have gotten some really great advice already from the previous posters, so I don't have much to add in relation to that. However, I would like to tell you that it's NOT impossible to get a job in the NICU without completing an internship/externship. I have a previous BS and graduated with an ADN in December 09. I only spent about 6 hours in the NICU during my pediatric clinicals and I didn't volunteer or complete and internship before graduation. I was willing to move any where in Texas for a NICU job because I knew adults just was not for me. I wound up landing an interview in a different city and got offered the job while driving home from the interview. They had over 250 applicants and only hired 5. I think having a true passion for taking care of babies and self confidence goes a very long way. I have a love for parent teaching and taking care of their needs along with the baby's and I believe that truly helped me land my job. I also graduated with 3 other girls that got hired into the NICU without additional experience! Now, I'm not saying that completing an internship is worthless, I'm sure it will give you a leg up on the competition in a tight market but I'm just giving you my experience. I wish you the best of luck! I :redbeathe the NICU more than anything and I will work there for the rest of my career. It's such an amazing place to work and if it is where you want to be, definitely do whatever it takes to get there.

First off..I'm going to give you one of these..:hug: I kind of know how you feel. I am a new grad that just started in the NICU in January and I have cried after a shift because I felt like I didn't give my patients the best care possible. Well, I felt ok until I gave report and the oncoming nurse made me feel that way. I think a big part of it, at least for me, is the fact that my patients are these tiny, innocent humans that have no control over what we are doing to them. They depend on us for absolutely everything and it breaks my heart when I think that I have given them sub par care. Sometimes I feel like they deserve a better nurse than me, and that is because I am so new that I don't quite know what I am doing yet. We all have to start somewhere! I think the worrying and guilt is just a part of being a new grad? I have only worked 1 shift on my own with level 2 babies and I was a nervous wreck the whole time. Hopefully those feelings will decrease with the more time we spend working on our own? I don't know, but I hope so! I am also ready to not feel like a complete moron on a daily basis. I definitely can relate with you on the sterility thing, we use sterile gloves for changing tubing and stuff like that, but it's not technically a sterile procedure. Admissions scare the crap out of me too. I have only assisted with 1 and it took over 3 hours. It was nuts! I hope that when you do get them, that you have lots of support and help surrounding you. The NICU world is so different than the adult world. I hope that aside from the feelings you are experiencing, you are enjoying your job! I love it and cannot imagine working anywhere else. I wish you the best of luck.

That is totally understandable. :) I am a new grad and I had an experience with one of the preceptors, not mine, and I vowed I would have asked for a change had she been assigned to me. I really liked the feel of CEC when we would go there for pre/post conference, if that makes sense. I think it was because it's actually in a hospital. For what it's worth, the paperwork gets better after level 2. Levels 1 and 2 were horrible for me, just because they were so busy with SO MUCH paperwork. I wanted to die sometimes..but it was all downhill from there. Take a summer class if you are able to. You will be sitting pretty while everyone else is stressed out. Level 4 is the best because we only had 4 weeks of paperwork! Plus, you're so busy looking for jobs that it will fly by. ACC has a great program and it really prepares you for the real world. Just make sure to study infection control like crazy for NCLEX. I wish they had put more emphasis on that during school. I also hope the job market is better once you graduate! I had to move to get the specialty I wanted. Enjoy spring break and good luck with the rest of the semester.