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Psych, NICU
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Back2PsychRN has 5 years experience and specializes in Psych, NICU.

2 years male psych.. NICU 3 years Just started adolescent psych Feb 18

Back2PsychRN's Latest Activity

  1. Back2PsychRN

    finding positions by specialty/area

    You can also look at indeed.com. I also found nurserecruiter.com.
  2. Back2PsychRN

    Does anyone else just take their housing?

    My first assignment was to Alaska. Like you, it was pretty short notice, and I didn't have money saved up, so I took the company housing. It was a nice 1 bedroom apartment. Nice area, close to the hospital. I really liked it. I decided to extend as well and told the company the only way I would extend was if I was moved because I wanted my pets and I couldn't have them where I was at. So, we redid my contract and I took the stipend. It was a huge difference. Before I accepted the assignment, I knew what my stipend was, but didn't know how much they were paying for my housing. My stipend was about $800 week and they were paying about $500 week for my apt. I went from making $1200 week to $2000 week. I found a short term, month to month apartment that I was able to rent for $1000 month, so I was definitely making out. The first few weeks were rough because all my money went to moving in, and then you have to turn on utilities, furnish the place if it's not furnished, it was definitely a hassle. Then when I left, it was a hassle getting rid of everything. I gave my couch and a few other things to some neighbors and a nurse who I became friends with. So, if you can afford it, definitely take the stipend. Maybe save up as much money as you can the rest of this assignment and use it for you next one. Try to find a furnished place. Right now I am in a 2 bedroom house from Airbnb. It's definitely expensive, but I don't have to share an apartment and I can have my pets. Good luck
  3. Back2PsychRN

    Is this a fair offer?

    I think the OT rate is very low. Like NedRN said, the best way to gauge if an offer is reasonable is if you have offers from different companies. I learned the hard way to have a couple different, at least 3, quote you and give you the #'s for the same hospital before you are even submitted to them. That way you know if that particular company is going to give you the best rates. The hospital will pay any of those companies the same amount of money so it's just whether you are getting the money or the company. Good luck. I'd be interested to see the difference if you check out other companies though. Keep us updated.
  4. Back2PsychRN

    My first long term baby going home

    I have only been in the NICU for a short time, since December. I have only been off orientation since March. I want to start out saying how rewarding this career is. I absolutely love coming to work each night (work nights) and love there's something different even single night I'm there, especially in level III. I feel so blessed, and sometimes just watch a baby sleep, on the far and between nights I have more than 5 minutes in between things, just to think about the precious little angels we take care of. I love learning new things every single night, rushing to a vented baby when he/she desats not really knowing what to do, (we cant care for a vent baby for a year), then realizing it's only a matter of a few months before I'm thrown in to the next level of acuity. Ok sorry, got a little carried away. I only have a few friends, and none of them understand my love for my work. They don't understand how insanely tired you can be after a night, caring for only two little babies. They don't understand how you can be tired after "working only 3 days a week" when the rest of the world works 5 days a week. When I was on orientation, we got a delivery. A 24 weeker who's had PROM like 6 weeks earlier. This infants main problem was hypoplasia lung. She also had many other problems and all I remember and understood at the time was nurses didn't understand why we were even trying. This diagnosis was very bleek. Well long story short, after roughly 4 months, she went home, without oxygen support, almost unrecognizable from admit. She is my first long term infant to go home. I have waited for this wonderful feeling for a while. I just wanted to share how amazing that feeling is. Most I have taken care of stay a few weeks, maybe a month, but nothing compares to this feeling. Sorry to be so mushy on here, but I had to tell someone how wonderful this is. Anyone else want to share a first for them that just make the job worth every ground pounding night, continuing care on a baby when no one gave him/her faith.
  5. Back2PsychRN

    How does your NICU unit run?

    Yeah, it definitely is because we have so many travelers, I am sure it is good for them to come in and only get orientation to the unit and be expected to take care of babies on their own after 3 days. I also enjoy reading posts that show the differences. I have only been here for 7 months and I'm always thinking of ways we can do things better.
  6. Back2PsychRN

    How does your NICU unit run?

    Well I live in Florida, our NICU is similar. We are a level III NICU. In level 2, our babies eat on an 8 or 9:00 schedule. 8,11,2,5 or 9,12,3,6. We do hands on each of those times. In level three, we have the same feeding schedule, unless they eat on other than q3 hour feeds, then it's different. We do hands on every 4 hours on our level III babies (8,12,4), unless they are too critical, we get an order for hands on less frequent. We also do weights and lengths at night. We do labs all day long, just depends if it's needed stat or what, whenever the doc orders it obviously. Our routine daily labs are at 0400. Our fluids are done on day shift. Hope this helps
  7. Back2PsychRN

    Not cut out for NICU

    Well it's one of two things, either you like the NICU and you are just worried about making a mistake or you don't like the high acuity, stressful, intensity of an intensive care unit. If you are just worried about making mistakes, not knowing enough, hurting a baby, things like that, then yes, I totally believe you should give it more time. Don't be so hard on yourself, there is no way to know everything in NICU. But you stated you might be better in well baby or level II, that tells me you don't like the high acuity of the unit. You might be worried of making mistakes or doing something incorrect, but I don't think that's the main issue. And no about of time will ease that. You either like the ICU atmosphere, or you don't. It's not a bad thing, it just means it's not for you. If you still want to work with children, then I would definitely look in to transfering. Don't wait until you completely hate your job. Be honest with yourself. There are plenty of other departments you can go in to. As for the NNP. You can still be a NNP for newborn. there's other options like lactation consultant, and there are so many other things you can transfer in to related to infants. Sorry, I can't be too helpful on the NNP thing, but like I said, if ICU atmosphere is too much, too stressful for you, then definitely try to transfer out of it. Good luck to you.
  8. Back2PsychRN

    Bad night in the NICU

    I read your comment a few weeks ago and remembered it after a night I had about a week ago and wanted to respond to your post. I've only been in the NICU for 6 months, a nurse for 2 1/2 years (but the 1st two years was in a psych hospital) I absolutely love working in the NICU. Our hospital is wonderful, doctors are wonderful, co-workers are great. We are a level 2 and 3 unit, with a newly added 12 bed unit where we now have our most critical babies. It's great because newer nurses are able to be in level 3 and gain experience. That was me last week. I always ask to be in level 3 if possible for the experience. I was admit 1, very excited. About 830pm (I work night) we got a call for a transport from a hospital 10 minutes down the road for possible seizures. Sounded fairly simple and not too complex that the coordinator let me keep the admit. When she got to us she was clearly in seizures, we hooked her up to EEG, started an IV, antibiotics, phenobarbital, and 2 fluids. a few hours later, no change, gases showed major acidosis, our PA put in lines. I was getting so overwhelmed. but I had 2 nurses in the room with me that just jumped in and started doing things for me. This was my 2nd admission, and I was lost, but they helped without me even asking. The doctor and PA helped me, explained things to me, and was very patient with me all night long. She was in no respiratory distress but was grunting. The doc said it wasn't respiratory related though. All that we were doing did nothing to help her, We all felt a little helpless, didn't really know what was going on. Well I had to wait each time I needed to do something because by this time she was so critical I didn't know how to do things. I felt bad, but no one complained or anything. They finished their 400 assessments on their little ones and started helping me. None of us had charted since about 11pm. We did all we could until day shift arrived, I gave report and then we all started charting. The other 2 nurses didn't leave till about 830 almost 9:00 when we are generally out about 7:45 at the latest. The day nurse picked up where I left off, did the admission history for me, did the Kardex for me, all the little things I didn't have time for. My admission was now a 1:1. I came back the next night and was waiting for huddle. We are all sitting talking and one of the nurses mentioned a code earlier in the day. Someone mentioned it was my admission. I was very shocked, as when I left my baby was on RA, no respiratory support at all, sats were 100%. Now she was on an oscillator, had coded, respiratory system completely shut down. She was on the brainz monitor and the monitor was flat, her brain was extremely swollen, fluid around her lungs. She was now the sickest kid we had in the unit. Doctors finally figured out she had HIE. The hospital she was transferred from thought she was having seizures but still fed her twice, and just said they were going to "monitor" her for the entire day before they called up. If we would of received her within 6 hours our cooling team could have cooled her and possibly had a different outcome for this little angel. I wrote all this to say I know how you feel. I left her with sats of 100, no respiratory support, possible seizures, and thought we would figure out a cause and start treatment. When I returned she had coded, on an oscillator at 55% o2 and our sickest baby in the unit. I felt like a failure. Was there something I could have done, something I should have noticed? I felt so bad but everyone has stressed by the time she came to us it was too late, she was already 12 hours old and the swelling was already taking over, and we couldn't have realized it at that time. It was a horrible night for me, I went and checked on her whenever I had a chance and she looks like a totally different little baby. Thankfully the mother and father still thank me every time they see me for giving such good care when she arrived and I try to just comfort them as much as possible. It is really hitting me hard because it was only my 2nd admission and it was just really rough. Also, I would talk to a coordinator or someone about others not helping. That is horrible that they would not help. It is ok to leave things for day/night shift because it is a 24 hour revolving unit and you can not finish everything, but there are things that you should do. Your co-workers should also be willing to help you, especially in a situation like you were in. I'm sorry that happened to you.
  9. Back2PsychRN

    Not cut out for NICU

    I've only been in the NICU For 6 months, so I still make mistakes every single night (I work night shift) and learn even more things each shift. Like everyone else has said, don't beat yourself up. Our orientation is generally 12 weeks long, older nurses have less and some nurses need more. Some people learn at different levels, some just take longer to catch on but don't just throw your NICU career out the door because of that. If they didn't think you had it in you, and if many other nurses didn't need that extra time as well, then hospitals wouldn't even offer it. NICU is so specific, it not only depends on your learning curve, it depends on the babies you have at the time, if you don't have babies with lines, PIV, PICC, vent's, things like that, then you can't get experience so sometimes it takes a little longer. Our hospital doesn't nurses handle micro or vents for a year so I don't worry about that, but I still go and learn as much as I can when I have time. The only thing I would say is it sounds like you might not like the NICU. Like you said, you don't like the vents, micros, and level 3 or 4 definitely doesn't seem like your niche. It definitely isn't for everyone, it is very stressful, that is for sure. It is exhausting, even level 2 because it's so busy from the beginning of your shift to the end. You stated you need someplace of lower acuity, so that tells me right there that the NICU might not be for you, because even in a level 2, you can have a baby aspirate, and brady's or desats, and it's still important to be very quick and diligent. What about L & D or mother/baby nursery. Even think of that. You still get to be with babies, but you take care of the mothers as well.
  10. Back2PsychRN

    NICU RN as a new grad

    I've only been in NICU for about 2 months but I'll try to answer your question best I can. I came from 2 years of psych so I was basically a brand new nurse. The only downfall was I wasn't straight out of school so I forgot so much that I learned. First of all don't let inexperience discourage you. The other 2 nurses that started with me were straight out of college. We are a level 2 and 3 hospital, the only children's hospital around. We get a lot of transports from other locations. Most nurses say the only advantage they had moving to NICU was that they knew how to manage time, deal with other nurses, and what most medical terminology meant. NICU is so different though, it will take a while to learn the different lab levels and things like that. I know some hospitals refuse to hire new admits, and some love to, just depends on the manager I guess.. But to answer your question, my biggest problem is learning the disease processes, the conditions these beautiful young souls have. I don't know about your school but my school spent about 5 minutes going over neonates and things like that because it's so specialized (hence why training is 12 weeks long). Now that I'm in level 3 and hearing the doctors bark out orders in an emergency when we get a new admit, when there's 5 nurses doing 5 different things and I felt like I hadn't spent a minute in nursing school, I realized I have a lot of studying and learning to do. Find a book about neonates and learn it. Learn about IV's, meds, central lines, definitely learn blood gases, what high and low lab values can mean and cause. Just read and learn things like you were already hired.. Read read read and learn everything you can.
  11. Back2PsychRN

    Dr. Order for elevated head of bed?

    Hey all, I'm fairly new to NICU. I was a psych nurse for 2 years and had to most amazing doctor possible. He definitely was not the stereotypical doctor you hear about in nursing school. Now I switched hospitals to work in the NICU and all I'm hearing is how the doctors treat and think the nurses are stupid, questions everything a nurse does. We had a desat, down to about 42, a little over 30 seconds. Mild stimulation was needed. The on-coming nurse asked for every detail because the doctor is going to ask if it was a true desat. I work nights so do not have much interaction with doctors other than the 1 rounding done during my shift so I haven't encountered anything like that yet. The baby I had been taken care of finally got out of her isolette, I was so excited. She has reflux pretty bad, spits up all the time, so to me, the 1st thing to do it put the head of bed up right? We left her head of bassinette up almost the whole time she was in the isolette. So when I went to work and she was out, I put her head of bassinette up. My preceptor came by and told me technically couldn't do it because I didn't have an order. Where I work, we don't have to have an order to elevate head of bed in an isolette, but if in a bassinette, we do. My problem is, I thought elevating the head of bed was a nursing measure. It's one of the first things we do for aspiration, SOB, etc. I have asked nurses but no one seems to know why we an order. I asked, and all they say is that "Nurses don't know when it should be elevated and we can't say the baby has reflux because we would be diagnosing the baby. I thought that was "treating the symptoms" though, which is the primary practice in our scope of practice. We treat the symptoms. Is there something I am missing here?
  12. Back2PsychRN

    I just accepted my dream position

    Well don't know how much I can really help you, I just started in NICU about a week ago. I was like you though, wondering what I could study or learn in the month before I started in the NICU. I bought 3 books, Neofax, which is about drugs and medication, S.T.A.B.L.E. which I found out we learn in training anyways, and Core Curriculum for Neonatal Intensive Care Nursing. That one is my favorite, has a lot of good information in it. I had to learn the infant/neonate vitals because I am used to adult vitals. Other than that, I learned that I can never learn all the diagnosis, what to look for, things like that, until it comes up in my patient. So I take the book with me and look things up when I am at work, as it relates to a particular patient. For me, just changing a baby, doing the assessment and learning to swaddle a baby was enough, lol, cause I have no kids and no experience, it was totally new for me, but I love it so much. I wouldn't trade this job for anything. For me, so far, the hardest thing is probably formula and breast milk fortification and converting grams to lbs, things like that, but there are cheat sheets all around that help with that.
  13. Back2PsychRN

    New to special care

    I absolutely know how you feel. I wake every day (well night b/c I work nights) so excited to go to work. I know I'm new, but I love going to work and taking care of these helpless babies, even the NAS babies who didn't ask to be hooked on drugs when born. No one else around me understands how I feel. I get on here often, just hoping there's a thread I can write in because I know I sound crazy just saying "hey everyone, I feel so extremely blessed and happy going to work each day." People shouldn't be paid to do the work we do. Sure, it's work, its hard, it's sad at times, and it's constant, but it's wonderful at the same time. Better than anything I could ever have imagined when I started nursing school. I thought I was the only weird freak who loved me job like this. So glad I"m not alone.
  14. Back2PsychRN

    Interview coming up

    Congratulations on your interview. I have only been in NICU about a month, so I remember how nervous I was to get the interview and wondering the same questions you are asking. I have been a nurse 2 years, but I was in psych, so I didn't handle babies at all, or anything intensive care related. We didn't learn much in school about neonates or NICU, so I was exceptionally nervous. Something obviously stood out because HR called and offered me the job before I even left the parking lot. The interview was like all other interviews, pretty basic, besides I was able to shadow a nurse for about an hour to see what NICU is like, and fell in love, I know it was all over my face, I was ecstatic during the peer interview and I think that showed through not having any experience. They asked the basic questions, how do you solve disputes with colleagues, how many times were you late or absent, how to you handle tough situations, patients, family members, etc. There were 2 other nurses hired with me, both brand new out of school. They will know that you need to learn a lot if you have no experience. I was not asked one questions that related to my knowledge of anything related to infants, NICU, or anything like that. Good luck.
  15. Back2PsychRN

    Why I Want to work in the NICU... is this enough?

    I just wanted to put my two sense in here about motives and what not. I will admit it, when I decided to go to college (at 26) I decided to go into nursing because of job security and it's a good living. I didn't grow up wanting to be in the medical field, I didn't take medical classes in high school, not interested at all actually. I went through nursing school and wanted psych because I thought I would be helping the patients (mentally), emotionally, and I loved the idea of learning about psychotic breaks, schizophrenic episodes, etc. I was there 2 years, absolutely loved every minute of it, never felt I was going to work, I loved my job. I left because of management was changing and a lot of things was happening, and I wanted to get some other nursing experience. I applied everywhere except med-surg, got a call from NICU. I shadowed a nurse for an hour and absolutely fell in love with the NICU. I had my peer interview after that. The manager said it would be a week or so after everyone is interviewed before they had an answer. In reality, I received a call from HR before I even left the parking lot offering me the job. I haven't been there long, but still absolutely love it. You definitely have to love babies to be in the NICU, you have to be strong enough to be able to get through a death, and quick thinking enough to handle a code situation, you have to be diligent enough to see signs of a baby going down hill. I agree with another poster who said all patients in all areas need the same care you described. I think all nurses are compassionate and caring, it just depends on what age bracket you want to work with. Some people will never work with infants, children, adults, or geriatrics, some will never work in psych or L&D, some could never handle oncology. Every one has different reasons for different wants or dislikes, and all is ok. That's why there is different fields with different nurses and you are required to work any certain floor in a hospital. Good luck to you
  16. Back2PsychRN

    Nicu nerves!

    Hello, congrats on a NICU job. I start in about 2 weeks at my new position in the NICU. I don't have experience yet, I actually am coming from adult psych, with no other medical experience. I've only been a nurse about 2 years, all here in psych, so I am totally freaking out. Everything I did learn in nursing school that can possibly help me, I"m hoping I didn't forget. So, I can't really answer your question, just wanted to say congrats.