bubbly

There are a lot of babies on my unit who I would like to adopt and bring home. Too bad the parents won't let me because they would rather take them home instead. :chuckle I just wish all the babies go to good homes with lots of love. I know of 2 people I work with who have adopted within the nicu and only 1 baby (lots of special needs) who was up for adoption (but not adopted from anyone in my nicu).

If the baby is your primary, then I am sure you know the baby and perhaps family very well that you can use your own discretion in deciding if its appropriate to give a gift and what that gift is. If it was me and my mangers/board of nursing complained, theres worse things to worry about then a nurse showing their appreciation for a baby they bonded with and cared for. I personally think the best gifts are ones I take time to make, like maybe a little scrap book page to frame of the baby's time in the nicu. But then again, I like the artsy crafty stuff. :) Good luck and congrats that your primary is on their way home!

Age is not a factor to pursue nursing. In fact, the oldest graduate in my nursing class was in her late 50s. I would also recommend applying to multiple nursing schools in your area just to increase your chances for acceptance. I think you have a very good background for a future in nursing. As for affording school, you may want to look in being a nurse assistant as a side job because sometimes the place will pay for tuition and you can gain a lot of good learning experience that way. Most important is that you said you regretted not pursuing nursing earlier. If you don't take this opportunity now, you will always regret it! Good luck!!!!

Thank you for your post. I too chose to work at a large teaching metropolitan hospital because they have experience in teaching new grads and I knew the orientation was going to be nice and long (6 months)! I got a tour of the unit from the manager and got to meet other nurses in that department. I had a great intuition about the place and have had no regrets since. My job has still had its ups and downs, but there are so many supportive co-workers in my unit and new grads just like me who have shared the same fears that I don't feel alone. We get new residents rotating in all the time so I also get to hear the attendings teaching them about diagnoses and procedures and learn something new as well. My only advice to new nurses is be very careful in choosing the first place you want to work at since that will be your first impression of really being a working nurse. Trust your intuition, learn about the place as much as you can, try to get into an area you really have a passion about so it will carry you through the new grad blues, and don't be swayed by other motives like salary or driving distance that is unrelated to your actual nursing experience. :)

Everyone makes mistakes. I just have to put the mistake in perspective and tell myself that as long as the patient is ok and there is no long term damage, it will be just fine. The worst you can do is not learn from your mistakes. If you missed a med, ask yourself why and try to fix that problem the next time you give meds. It will just take practice and a lot of the little things in nursing like labeling and charting stuff will just come naturally to you. Good luck and focus on the things that you are doing right and learning quickly to drown out the mistakes you keep dwelling on. :)

Hello :) I graduated in May 2007, passed my boards in June, and started my internship for a neonatal icu in July. Its been a long journey and lots of consideration if this was what I wanted to do or if I could handle the stress and workload of my chosen career. I now have 18 months experience and glad i stuck through it because I am really starting to enjoy my job, feel more comfortable and knowledgeable doing it, and feeling like I am making a difference for my patients and their families. :) I do not feel regret because I truly love my nursing specialization and patients. :heartbeat

maybe being a school nurse? I know people who have started as a new grad, just have to have a bachelors degree in my state. Hours seem comparable to that of a teacher.

It doesn't really matter which nursing is the hardest and easiest bc it will vary on who you talk to. What matters most is starting your nursing career in something you really want to do and you have passion for. That will make the challenging part more worth it. As far as getting help, try to get a good feeling of the unit during your orientation and how many new grads they hire. Nobody expects a new grad to know everything. You will get the most help if you are eager to learn, optimistic, and even helping others in return. :)

My hospital's incubators have built in scales, like sweeper said. Many of our warmers even have bed scales. We weigh our babies once a shift at night. We are allowed to defer weights if they are critically ill, just had surgery, etc. We use humidity when pts are 26 weeks or less. We start out on 75% humidity and start weaning on the 7th day by 5% each shift until it is 40% (I live in south tx where it is very humid and thats about what our room humidity is at :) ). We only take our premies out of the incubator if they are getting kangaroo care.

Ooooh I had an awful time on my first and only float so far. It was only 8 weeks after I finished my NICU orientation and I was floated to the never seen before PICU unit. Everything was completely different over there and I had no idea what I was doing or where I was supposed to go. It would be a very very long story if I told you everything I had to do that I never even encountered before. I can just say it was a much more difficult assignment than I had done in the NICU esp on my own! It was only 2 patients, but 1 was on isolation for c-diff, which just made everything that more difficult. I ended up using the PICU charge nurse CONSTANTLY in the beginning, my NICU charge nurse to come help me chart all the meds with me over her lunch break, and a NICU transport nurse to take over completely my c-diff pt- which by the way kept her completely busy until shift ended as we were still trying to figure things out in the PICU and the charts. I cried for most of the shift as I was completely in over my head and felt so unsafe and incompetent and embarrased that I was crying. The rest of the PICU nurses were soooo inconsiderate as they just gossiped at the nursing station as they saw me frazzled and in tears without any offer to help. All I cared about was that none of my patients died or turned seriously worse during my care. I do not look forward to any future floats. I would be to the point of quitting than to float again. The day I floated was seriously the worst day in nursing I ever had so far.

I was curious to know what NICU nurses think about visiting and even babysitting your NICU graduates. I have heard of some nurses who will continue their relationships with babies and parents outside of the hospital even though it not encouraged by NICU management. I thought it kind of blurs the line of professionalism, even though I think its great that parents really like and trust their nurses to do that. I don't see any problem with knowing how the babies are doing at home through pictures and mail, or when the parents bring their nicu graduates back for a nicu visit. I'm just not sure about actually visiting them elsewhere and even babysitting. So what do you all think and does your hospitals have policies on the matter? :)

I was curious how long different NICUs kept chronic babies who did not meet requirements for lower level care facilities. Do you transfer these babies to a special pediatric floor in your hospital or do they continue to stay in the NICU until they meet lower level care discharge requirements. I am asking this because our NICU unit has and has had babies in our care for over 12 months, the oldest I think was almost 2 years before discharge. Just wanted to ask your thoughts, esp since by that age they should be treated like pedi and not neonatal.

wee one that is exactly what i do too. We have these bean bags in the shape of an arm for our babies and when I turn a baby prone, i will put the tubing on the face in between the fingers of the beanbag. They look so much more comfortable that way. I am also waiting for your idea of a canula thing that works with CPAP!

I'm from Houston. Having lived in both Houston and Dallas/Fort Worth, I am familiar with both areas. As another post mentioned, good hospitals in Dallas are Baylor, Parkland, and Children's Medical center right next to Parkland which would be the best for pediatric er in my opinion. Houston pays a little more only because many hospitals give an extra 5% plus differential for working in the Texas Medical Center. The Texas Medical Center has excellent hospitals like Hermann Memorial, Methodist, St. Luke for icu and Texas Children's for pediatric er. Good luck in your decision! I think both places are great! :)

we recently changed to 2% chlorahexadine. i don't think that is good for the skin either!

At my hospital, it is common to let parents hold intubated babies, but not ones with UACs. With UACs, you can at least tell parents that the most they usually stay in for is a week (or up to 10 days if Drs really push them for the real sick kiddos). For the intubated babies, we always have 2 nurses - one to hold the baby and one in charge of keeping the ET tube in place and able to reach. Then we will really tape the ventilator tubing securely on the chair to keep it from pulling. I've never seen a problem with that method in the short time i've been a nicu nurse. Good luck and I think it is great that you are so helpful to this mother in assisting her hold her baby for the first time.

Thank you for your post meghan. My educator is new (she actually oriented with me and the other NICU interns when she was hired for the NICU ed position to see what we were learning). So I guess we were kind of her gunea pigs and she didn't really have a good understanding of the way our NICU was operated. I had asked one of the interns about if we were going to get a PICU oriention since that is what I thought I was told during the NICU orientation. She and another girl had asked the NICU educator about the PICU orientation and her reply was that it was not needed now and we were unlikely to float. Well anyways, one of the new nurses that interned with me was floated there one night, but actually ended up coming back to the NICU because she was so upset and overwhelmed by being in the PICU. I had told my charge nurse that if I was floated I wanted an orientation. I had even told my manager that I felt unsafe floating to the PICU and wanted some type of orientation. Unfortunately no one listened to me. When my manager took me to the PICU when I floated, she was like well all the NICU nurses hate it here so I am not expecting you will like it either. It was nice that I did get lots of help from both the NICU and PICU charge nurses and another nurse pretty much took over the care of my second PICU patient. Since I have already had my float shift in PICU, I guess I no longer need the orientation now since I learned some of the things the hard way. I just feel like my managers knowingly put me in a bad position and didn't care.

Hello. I graduated nursing school in May 2007 and I had only been off my NICU orienation for about 6 weeks and was recently floated to PICU. I am struggling enough to keep up with my time management and nursing skills in NICU that being sent to PICU was kind of a shock. Apparently any NICU nurse off orientation is up for floating and my hospital has had a low consensus right now. I was given no prior orientation to PICU and had never even visited the floor before. The charting was completely different along with everything else. The supply room is different, the meds are stored differently, and they even do nursing skills differently (they are not as sterile and don't use mask and cap for changing fluids, drawing labs, etc.) They had given me a full 2 patient assignment. The patients were both babies. One was a neuro kid which i had never taken care of that kind before. Both were on at least 6 drips a piece with meds every 2 hours, assignments more difficult then what I have had in NICU. I asked for help a few times from other nurses, but 1 was a NICU float too and the other 2 near me it was their first week at that PICU. I couldn't keep up and didn't feel safe at all. Even with the PICU charge nurse helping me, I still felt behind. When my charge nurse came to see how I was doing, I just broke down and told her I couldn't do it. Fortunately with her help and the help of some other nurses, I was able to get everything finished and charted. I just hadn't felt so overwhelmed and down on myself before since I started NICU. The good thing is that they said it will probably be at least 1 year before I float again. I just felt so awful that night that I am going to dread being floated again. So anyways, do NICU nurses float at your hospitals? If so, do you at least get an orientation first?

I am just hitting my 6 month mark as well. It definitely is more scary not having a preceptor around me just to make sure I am doing everything right and not missing important details. I think I am in the 6 month slump too. Admits are still scary for me and I am so afraid of a patient dying because I have never had that experience before. I am nervous going into work a lot because I never know if my patients will be fairly good or if they are on the verge of crashing and burning. I am so afraid sometimes of my patients going bad that I often double check things, which I guess just helps me from missing things but is a little more time consuming. I still wish I was a little faster at things, but I am still able to keep up so far. What is comforting to me is having great and supportive coworkers who I can lean on for any questions or help with my patients. Some days I feel really good and confident leaving work and other days I keep going over in my head things I wish I did a little better. LOL sometimes I fantasize about doing a career that is less stressful and people's lives aren't at stake. Deep down I know that I love my job and the positive impact it can have. Sometimes it's just hard for me too see that when I drag myself to work each week praying nothing bad will happen. Good luck with your job and I hope we feel better after our first year is over. :)

As Meghan mentioned, hurry and contact the nurse recruiters. The NICU is competitive in Houston for new grads and some of the deadlines have already passed. I don't think you can even get a NICU job without an internship here if you don't already have NICU experience. You might have to settle for something else or just wait until the summer. Hospitals here hire new grads in January and June. Good luck with your search! :)

It is common for students to think that they have certain "psych" diseases when learning about them, but I am not sure about physical ones. In fact the first lecture of my psych class we were told about how common it is that students will start to think that they have some of the mental symptoms characterizing certain diseases like depression or schizophrenia, etc. My instructor told us all that if we were able to make it to school and learn, chances were great that we didn't have anything wrong with us. Healthy people all have a range of moods. The people with psych issues go to extremes and it strongly interferes with their functioning in life, school, job, and/or relationships with others. Hope that helps! :)

I work in a level 3 NICU. My unit's kangaroo care policy is a lot like csm08mms's unit policy. The only exception is babies under the bililights or babies under oxyhoods cannot be held. All parents get a kangaroo care packet in their admissions folders. Nurses are supposed to ask the parents about wanting to kangaroo care if the baby is able to. We ask the mothers to wear buttoned down shirts and no bra so that the baby gets complete skin-to-skin contact. Parents must hold the baby a minimum of 1 hour so that the kangaroo care is effective. We limit kangaroo care to only 2 people for each baby due to infection control issues. My unit has a great kangaroo care policy and Child life will bring a selection of beautiful, hand-made kangaroo care blankets that the parents can choose from and a mirror to better see the baby. :) The majority of the babies in the level 3 NICU don't get breastfed because they are too tiny, not stable enough, or just have chronic issues and can't tolerate it. If the baby can be breastfed, we need to have orders first. It can get tricky sometimes because it can be difficult to measure breastfeed intake. Sometimes we ask the mother how much she usually pumps, and then after breast feeding, she will pump and we will estimate how much the baby swallowed by the amount the mother pumped (LOL the leftovers) and how empty her breasts feel. Then we will just gavage the amount of milk we think the baby needs to get a full feeding. Breastfeeding is really rare in level 3 though. One of my babies was allowed to nipple feed as tolerated and I had to sneak over to level 2 to grab bottles and nipples because I couldn't find any on my side of the unit! :)

Hi! Congratulations on getting your dream job! It sounds like you will do great! It is wonderful that you already have a feel for the unit since you are working there and will have other girls in your class to relate to. It's going to be challenging. You just have to take it one day at a time and know that you won't be perfect and don't be hard on yourself because of that. Every new grad I have talked to always has problems with time management and critical thinking skills at first. My biggest help has been the extremely supportive staff on my unit. It looks like you will be working with a great team too. Hopefully they will pair you with a preceptor that fits your learning style and personality. I have been in the NICU for 6 months now (wow time has been going by quickly!) and I still love it and am excited to go to work as much as I was when I first started. It's a learning experience and I love how cute the babies are no matter how tired I am! You will do fine! :)

My unit uses humidity for babies 28 weeks or less. Those babies are placed in the Giraffe beds with the built in humidity system. We start them out on 70% and start weaning the humidity by 5% each shift on the 7th day. We wean them down to 40% by the 10th day which LOL is the actual humidity level in my unit. It is so humid where I live! :)

I'm sorry you have such a hectic patient load, but I admire your stamina and time management skills! I think most new grads would have drowned. Congratulations for sticking through it! How much longer do you have left on your contract before you can try something new? :)