NurseAmy

I don't think that the job you do to earn a living has to always be the thing that gives you the most satisfaction. I think sometimes in our culture we are too career focused and put too much of our idenity into what we 'do' which becomes then the definition of who we are. In actuality, you are more than a cube dweller writing code already- you are a father, a husband, a son, a friend etc. You are doing something "important" already. Never get so busy making a living that you forget to make a life. There are plenty of ways to connect with others and make a difference other than through a career path. Honestly, after many years of working as a NICU nurse, I don't know that my 'job' has really been that important. It has actually been my volunteer work outside of nursing that has made the difference in my life and the lives of others. So my suggestion is rather than rewriting your entire career path, maybe look at other ways to find fulfillment. There are so many organizations that need volunteers and leaders that give as much satisfaction as being a healthcare provider/nurse/etc. If by 'important' you mean fame and fortune, if you create a nursing charting system that really works for NICU, you could name it after yourself and be forever remembered!

http://162.129.70.33/images/scan_039.jpg Not the most dramatic picture (compared to seeing it in person) but it is what I had saved in my bookmarks

Bella, Does your DON have 24 hour accountability? Is she the person who is ultimately responsible for staffing ? Because if she is, I would remind her of that and document everything. And who is her boss, surely she reports to someone? Because if she is telling you that you can handle this crazy workload then I would want it documented for the record that you had voiced your concerns up the chain of command and that you had made the powers that be aware of your concerns. If your state nursing board has practice consultants available to contact I would contact them ASAP and find out if you have any kind of safe harbour clauses in your nurse practice act, etc, and what recourse you have if you accept an unsafe assignment under protest. And I would start keeping an "oh ****" file for myself after every shift, detailing all the events of that night, if I called the DON for help and her response, etc. Document everything. I wonder if anyone in your local state news media would be interested in an anonymous tip for an inside scoop on the staffing levels of their local hospital?...Yeah, I am from the South and a bit of a hell raiser. Nothing like a bit of a scandal and public embarrassement to a hospital board of directors and CEO to get something done! All that being said, you have to decide if you are willing to fight the good fight, or if you are better off to just hand in your notice after your next shift and find yourself a different job. You are in the beginning of your career, it might be time to bow out of that place gracefully rather than raise hell. I can see the virtue of just moving on to a better job-you are young, about to get married, etc. You have many years of nursing ahead of you and you have to pick your battles. Good luck to you!!

What things are you doing to nurture yourself every day? You are taking care of folks all shift long at work, but are you taking care of yourself too? For me, yoga is the key to staying decompressed. If I don't do a yoga class at least twice a week I am too wretched to be around. I also find knitting or other needlework to be a big help to reset my brain into home mode after being in work mode. You have to experiment and find the hobby that works for you-if work leaves you feeling really ****** off and angry, maybe a kickboxing class is what you need! You can also practice a little visualization exercise as you leave work after your shift or when you are trying to go to sleep - I know it sounds hokey, but it helps! Take a few minutes and visualize yourself like you are Mr. Rogers, changing out of your work sweater and shoes and into your play clothes, leaving behind all the work crap. I visualize taking off the work coat, folding it and putting 'it' (aka work worries) into a chest and locking the lid. The more detailed you can visualize the better- like let yourself feel the weight of the work coat, the color, do a little stomp on the chest, etc. I follow that with a breathing exercise (Dr. Weil's program is good) to get rid of the adrenaline overload from being stressed out and to relax, and I am good to go, work forgotten, crisis over, until the next shift. Of course, my visualization for preparing for work involves lacing up combat boots.... :chuckle Take care of you, you are the only one who will!!

Have you considered UNC Chapel Hill, Duke or East Carolina University? East Carolina is closer to the coast, don't think they ECMO, but they have a big NICU unit. UNC and Duke are about two hours from the beach. I have a good buddy who is an NNP at Duke if you need specifics. Asheville NC has a NICU at Mission Hospital, but I am not sure if they ECMO or if they use NNPs. Charlotte has a big NICU at Carolinas Medical, and Wiston Salem has a big NICU associated with Bowman Gray medical school.

The baby has since died: http://www.haaretz.com/hasen/spages/1013192.html

Hey tarheelnurse, would you get a referral bonus if I give your real name on my application? Do ya'll get any kind of recruitement perks there if someone is hired? I am about to apply, if you want to send me your real name via PM I will put it on my application.

Honestly, there is not much happening in Hillsborough. I don't know of any bus tours, it is not exactly a tourist destination. Your best bet might be to rent a car, then you could explore Chapel Hill and the other areas. NC does have some tourist areas, but they are the mountains and the coast. You could also contact the NC tourism board, I am sure they have a website if you google them.

The NC Nurse Practice Act says that for a nurse to be licensed they have to be mentally capable to practice. However, I do not recall having to send medical records or anything to the BON when I applied for my license, but it was so long ago I cannot remember. I would give the BON practice consultants a call (you can find the number on the the ncbon.org website) and see what their take is on this. I have never heard of a nurse with a mental illness that had to have mentor- I don't see why someone with BPD would be singled out when there are lots of other types of mental illness. If you find out more info from the BON, please update because I am wondering about this now.

I don't know of any nursing schools that have evening only classes. You might can find some clinical rotations in the evening, but most programs require full time day attendance. Did you try contacting an AHEC center near you? They have a lot of info for the nursing programs in the area.

Thanks so much for the info! Is staffing time split between the high acuity and the step down nursery, or can you choose to spend most of your time in the intensive care unit? I don't mind taking my turn if necessary in intermediate care, but I don't want to spend half or more of my time in intermediate. I assume that there are also 1:1 ratios, or are the assignments always 2:1? At UNC is rotating shifts required, or can you choose to work straight nights or days? Do you know what the weekend requirement is for UNC?

How are things at the NICU at UNC now? I know they have positions posted. Is it a horrible place to work? What are the ratios? Managment? Any info is appreciated!

I think every NICU nurse finds their own way to deal with the emotions, and I think the nurses who do NICU for years certainly feel it is a calling. I have always been very good at seperating work from the rest of my life; if I didn't the constant emotional drain of bedside nursing would have been too much for me to handle and the other parts of my life would have suffered. Also, for me, if I am so emotionally involved with a patient and their family, I lose some of the objectivity I think is needed to provide the best nursing care possible, imho. I learned early in my career to leave work at work. When I watch those baby stories on TLC, I view them from a purely clinical perspective, never an emotional one. That is not to say I am not compassionate to my patients and the family, and that I don't care for them with a loving heart while I am at work, but when I leave work I don't think about the place or patients again until I clock in for my next shift. And I hate to say it, but for me, after several years of working NICU when the babies have gotten smaller and smaller, outcomes have not been so great, or we have had preemies go home only to come back in to PICU after being abused by parents, I honestly have become less emotional. I don't think that makes me a less of a nurse, it just keeps me grounded in the reality that we can't save them all. Yes, bad outcomes are sad, but as I have gained more experience and seen more outcomes, I have realized that death is not always the worst thing that can happen. If every sad case that came through our NICU made me an emotional wreck I would not be able to do the job that I have to do day after day. Of course I still feel the emotions, just not at the level I once did. Some nurses decide they can't work NICU because they can't get a handle on how to cope with the bad stuff. I have known several nurses who have come to NICU, stayed a couple of weeks and transferred to well newborn nursery or labor and delivery (usually after going to their first 24-25 week delivery). NICU nursing is not for everyone, but chances are if you feel a strong pull toward that area of practice you will be fine. Just don't glamorize that you are going to be the saviour of all these parents and kids and that every shift you will have beautiful meaningful interactions with your patient and the family. Some families have so many issues you just wouldn't want to touch with a 10 foot pole! Some of them have such poor coping skills and don't want your love and attention! In my unit nurses have had things thrown at them, death treats made, etc. due to the extreme stress parents are under when faced with a dying baby or bad outcomes. I am afraid that if you have unrealistic expectations of what the job is like you will set yourself up for a quick burnout. Most families are great, but the stress can bring out the worst in all the parents and other family members. NICU nursing is one of the areas that you have to balance the good with the bad. I think for most people who consider NICU to be 'home' for their nursing career, the good definately outweighs the bad. NICU can often be bittersweet, more so than other areas of practice. The only way to find out if it is for you is to give it a whirl!!

Look into clinical research jobs. I work in "Drug Safety" at a clinical research organization and I have no desire to return to direct patient care nursing.

Hi all, it looks like I will be relocating this year to either Melbourne or Brisbane with my homesick sweetie (he was born and raised in Melbourne, has been here in the States too long by his estimate), so I need to find out about some job options Anyway, my clinical background is in neonatal intensive care. But I have been out of clinical practice for about 5 years now, 1 year working as a consultant for a government agency and 4 years working in clinical research/pharma safety. I am not absolutely opposed to going back to the neonatal intensive care in Oz or some other patient care role, but I am afraid I will have trouble obtaining licensure because of my time away from a clinical setting. How much of a problem will this be for me? I am really not able to pick up a second job right now to get my clinical skills back up to speed. I will probably try to stay in my same pharma industry, but all those jobs seem to be in Sydney, and I really want to explore my options in other non-traditional nursing jobs. So are there any non-bedside nurses out there who have ideas of a career/job I could be suited for without a nursing license in one of the Australian states? Thanks so much for any advice/words of wisdom!