mac23

You still have contact with your coworkers at the area where the nurses station is so no I never felt isolated.

I'm a big fan of all private rooms. If your unit is staffed correctly there should be a free floating charge nurse and a delivery nurse that can float around to help. We also have central monitoring plus our secretary has a monitor at her desk. We also have a locator system and we use the vocera system. We also have it to where if any baby is alarming it will show up on each monitor so that everyone can see that alarm until it is answered. If a baby is extremely sick or has alot of apnea, brady spells our nurses are good at telling each ohter so we can all listen out. An extremely sick baby is usually a 1:1 and also everyone is aware that the baby is really sick. Private rooms have some drawbacks but overall I love them. Esp. for the ones that are very sensitive to overstimulation.

I've know many travlerers who signed on staff right after doing an assignment. I did it myself. Usually if there is a clause it's between the agency and the hospital whereas if you sign on with the hospital, the hospital will owe the agency x amount of money. If the hospital needs/wants you bad enough they will pay the money and you'll never know what went on. Some agencies will have something in their contract that says you can't work for another agency for a year after you've worked for them etc etc etc but I know lots of travelers that switch agencies with each assignment with no problems.

Well I did a little of both types of programs. I had a lot of family issues to contend with so I started online at MUSC, then went classroom at Duke, then finally finished my degree online through Rush. The online route was a life saver for us due to my family issues. I enjoyed the flexibility it gave me (I have a kid and a husband) and I could work at my own pace. I guess it would depend on your learning style as well. As for the clinicals the online route will allow you to do clinicals at any NICU in the country that will allow you to do it there. This is where the networking I was speaking of comes into play. While I was on the road I took an assignment at a facility that I loved from day one. While I was there I really tried extra hard to get to know the NNP's and figure out who i might learn the best from. I didn't let them know I was a student at first just so I could feel them out. About 8 weeks into my assigment I asked my first choice. Since she was the director of the NNP's her plate was already full but she did help me decide between two other's I thought would be a good fit for me and we worked it out. She was an awesome preceptor and was as eager to teach me as I was to learn. But even before I did the traveling thing I was doing a lot of networking with the NNPs from past jobs and the one I was working in at the time. I got to know them the best that I could. Asked a lot of questions about how they've been treated as NNP's, how they were treated in their current job versus how they were treated if they worked somewhere else. Asked what they liked/didn't like about being an NNP etc. My advice for you in no particular order 1. Go for it! It's a great career. 2. The learning curve is HUGE. There is a lot to learn and people will be relying on you to know your stuff. Take in as much as you can and never be afraid to say I don't know but try to think through it and offer what you do know and go from there. The attendings expect you to know your stuff; some are harder on you than others. Some respect your education.....some don't. Be confident in what you know and never let the learning process end. 3. Network, network, network! Join some professional associations if you haven't already and be active in them. Attend a conference or two. You'll meet a great deal of people and at the same time stay current in what is happening in the field. 4. Never ever forget where you came from (being a bedside nurse!) I've met alot of NNP's who have forgotten. I try to keep that in mind at all times. I will write more later. Good luck in whichever route you decide.

When I was traveling I worked at a hosp that had all private rooms. I thought it worked ok. It kind of felt like working in the PICU. There was a free floating charge nurse that could help listen out for your patients and it was really unusual for everyone to be in a room at the same time. Also had the tech's that could listen out (I know a lot of NICU's don't have techs). If you had to be in a room to start an IV or something you just let your co workers know and everyone was really good about helping/listening out. I never felt my license was on the line. I liked it for really sick PPHN babies where noise control was an issue and those babies were 1:1 anyway. There was one giant room for ecmo or babies that needed surgery on the unit. They also had central monitoring. At first I didn't like it but as I got used to it it was fine and I didn't see any increase in adverse events as compared to an open unit.

I did travel nursing before I took my first full time NNP job and I loved it. It just depends on where you want to go. I met some of my very best friends on the road, saw places I might not ever have seen (Alaska was simply amazing and Hawaii was paradise), did a lot of networking (which led me to my dream NNP job) and overall had A LOT of fun. Of course each unit is vastly different so you have to keep that in mind first and foremost. Go with the flow and offer advice on how you did things at your old job but always remember you are not there to change that unit so be careful because you are likely to insult someone and make for a tough 13 weeks while you're there. Make sure you ask a lot of questions on your interview about what you are expected to do. Deliveries? Taking sicker kids? Floating? Being called off (how often). etc. Get EVERYTHING in writing and I do mean EVERYTHING I did actually take a job in Cali that allowed me to do transport but I had previous transport experience. There are a lot of units in the travel world that will treat you just like staff and let you take whatever you feel comfortable handling. Some places I hated but had the time of my life when not at work so to me even though the job was crappy my days off were amazing. Overall I think my travel experience made me a better person and a better NNP. I learned 1000 ways to skin a cat and am much more flexible and relaxed at work. I wouldn't trade my experiences for anything. Once my husband is done with his residency we're going to hit the road only this time I'll be a traveling NNP! If you have any other questions I'd be happy to help.

In San diego try Sharp Mary Birch. Wonderful NICU. They are having interviews April 4th for June starts.

Is this MUSC? I'd just keep checking because I know they use travelers....there are several positions posted for travel nurses in the NICU at MUSC. If you're interested in the PICU, the unit at MUSC is fabulous. Great docs and nurses plus you'd be building your skill set not losing it. PICU would allow you to work with oscillators, jets, vents just like NICU but with a bigger age range (0-18, sometimes older) and a broader diagnosis. I did a year in PICU and learned a ton but eventually went back to NICU. GIve it some thought you may end up loving it. Also once your foot is in the door it would probably be easier to transfer to NICU. Just be sure to ask about how long you'd have to stay in the PICU (if you did it) before you could transfer. Good luck!

We will do this if our baby is too small or too sick to survive a transport to surgery.

How's it going finding a hosptial in SC to work for?

Wow, that's scarey. What do you do after you "read" a bad xray. Do you just decide for yourself what kind of changes if any need to be made or do you call the doc and they come in and decide. I understand no MD coverage after hours, I've worked a few places like that, but is there no NNP coverage. Do the RT's help you decide what kind of changes to make? What happens when a baby is going bad do the docs come in? Or what happens when you "read" a bad xray and the baby needs surgery? Is everything you're doing within your scope of practice for your state. Just curious.

DHEC does still have the staffing ratios for nurseries. When I worked in Columbia, our nurses would call all the time if our ratios weren't right and we were fined and if we couldn't staff DHEC would require us to close some of our beds until we had the proper staff. I will have to look through my old stuff to see if I can find the paper that lists what kind of assignments were acceptable. We had access to this information that's why the nurses knew when we weren't in compliance. Hope you guys can get things straightened out in Spartanburg!

i've used both Carevue and Cerners powerchart in the NICU setting. Liked both of them a whole lot better than paper charting.

I recently left a NICU that went to only OG's due to an outbreak of MRSA on the unit. The ID doc said placing NG's was contributing to many of the babies getting it.

Sorry for the delay, You should be able to get a job at Richland. They use travelers, not sure about agency, but have been trying to get away from using travelers. I'm not sure how that is working out so far. I liked Richland much better than Baptist, can give you more details in private, but since you've seen the unit I guess you know aobut it. 56 beds +Ecmo, transport team etc etc etc. Feel free to ask me more specific questions and I'll try to help.

I've taken care of a 450gr baby that did very well over his course in the NICU. He did perf on dol 2 and went through the whole vent/sepsis thing while he was with us. He had no bleeds and went home at 4.5lbs at 4 months old. My daughter was 500+ grams 23 weeker and also did very well in NICU. I know a lot of the little bitty ones have problems but I've seen my share that have done amazingly well. You just never know.

Well from what I know about MUSC the new grad thing will be to your advantage unless they are changing the way they hire. For the last few years they have prefered people with NICU experience. Don't worry about the ECMO thing. Before I could even take the test to do ECMO I had to have been a NICU nurse for a year, been on that unit for a year and have done transport for a year. I'm sure different places have different requirements but you won't be expected to do ECMO. In my old NICU the only responsibility you had if you were assigned an ECMO baby was to get meds, go get blood or run labs for the ECMO nurse. Just keep in touch with the recruiter and ask her when the best time to apply is. Also as I mentioned before they have some level 2's in the Charleston area and they may take vents so call around and see what your options are.

Hi Kristina, I talked to my friend who just left Charleston. They paid her $24.00/hr as a traveler at MUSC.

Actually MUSC does use travelers. However, if MUSC is part of the South Carolina Hospital association your pay will still be in the 23-25 dollar range as a traveler. I know a traveler who just recently left MUSC so I'll ask her tomorrow what they offered and then get back to you on the pay. All our heart kids from Cola, got shipped to MUSC. They do nitric at Richland and have a transport team but you have to have worked there a year before you can do it. I personally would not exclusively do level 2--too slow paced for me. I like a mixture of both. I just finished NNP school but am currently just working as a travel Rn until my husband finds a job. So I can relate to the wife's job taking a back seat. Hang in there I'm sure it'll work itself out. Bon Secours St. Francis and Roper Hospital both have level 2 nurseries. There was a travel company offering $38/hr for a level 2 in Charleston; I'm guessing it was for one of these. I had a friend that worked the level 2 she said it kept her very busy (she was a traveler) and she had to attend all deliveries. Also some level 2's take vents so call around and ask. You could always do prn at MUSC to keep your level 3 skills up. Good luck! You're right! Pay at MUSC is low! I talked to the nurse recruiter through email today.....$20.00/hr for experience....I am in Alabama and as a new grad, you start at $18! The NICU I work in has 40 beds...we do nitrous oxide, but not ECMO. I have only seen this once at Children's Hospital in Birmingham, AL, so I would be brand new to that. My boyfriend went to USC in Columbia....I think he told me it would be about an hour and a half commute from Charleston....but, if I worked prn or did all my shifts in a row, I don't think this would be too terrible. Sounds like the hospital in Columbia has a much better reputation all around compared to MUSC. I don't know if I would consider doing Level II after being exposed to Level III.....I would be scared I would forget everything I learned and that it'd be that much harder to get back into it again. I guess this is part of the whole military thing...the spouse's career usually has to take a backseat. I guess I will just have to consider all my options. I was thinking of talking to a travel company, but I'm unsure if MUSC uses travelers...my guess is "No". Well, I thank you for replying to my post. Do you feel that after working at the Level III in Columbia, you would want to do Level II?? How long have you been doing NICU?? I love it! I'm just a little disappointed about the hospital situation in Charleston. Oh well, decisions, decisions! ~Kristina, RN, BSN~

I know the NICU in Charleston as recently as a year ago was only looking for people with NICU experience so if you move there you should be able to get a job since you will have experience. You have to stay on the nurse manager though if it's the same one I dealt with. Pay at MUSC is low; probably a lot lower than your current salary. There is another NICU in the area but it's a level 2. As for Columbia, I'm more familiar with that NICU (palmetto richland) as I used to work there. It's 56 beds + ECMO on the unit. 27 NICU beds and 27 special care beds and the 2 nesting rooms. I loved it there. There is also Palmetto Baptist in Columbia, the sister hospital to Palmetto Richland. It also has a level 3 NICU that I heard they are getting ready to renovate. I liked Richlands NICU better. I think Baptists NICU was about 25 beds. Can't remember I only stayed there a short time. If you're looking in the upstate Greenville Hospital system has a level 3 NICU as well as Spartanburg Regional. The GHS NICU is new and it's a nice hospital. Hated the dress code but I liked working there. That wasn't much info but hope it helps some. Thank you for replying. Do you think I will have a difficult time getting a NICU job in SC??? I will have a year of experience by the time I am moving there. Also, what kind of pay can I expect?? I'm working a "Limited Benefits" option right now and with night shift diff and ACLS, I'm making $26/hr from 7-11p and $27 from 11p-7a. Is SC pay comparable?? I have been told since day one of nursing school that Alabama is one of the lowest paying places...hopefully, SC will match?? I am new to Nursing, so I don't have much experience in the pay bargaining area. What are your thoughts/opinions?? Thanks! ~Kristina, RN, BSN~

Can you recommend a recruiter with on assignment?

We are using the cooling blanket. I've only personally seen it used twice and but we've been trialing it for the last 6 months. Now that the trial is over they are planning on using it more often.

Where do you work?

Congratulations on your new baby boy!

I started MUSC's program before I transfered to Duke and I thought it was great. The more you do in the NICU as a staff nurse the better off you will be. Do as much as they will allow you to do. You need that foundation to be successful as an NNP.