tavalon1

I loved nights. I would have retired on nights. And that's all I will say about that.

Now, I need to go to day shift. It is clear that I am one of those rare humans with an inverted circadian clock. So, I am expecting this to be like when a new nurse starts on night shift with all the physical struggles. Just as I did for night shift, I will not change my schedule on my off days. I've had 3 days now of misery and am asking for tricks of the trade for being on a schedule that is bad for your circadian rhythm. What I don't need is affirmations that I will feel so much better! Maybe I will and maybe I won't. Helping me would be giving me tips and tricks for the first three months. If it isn't better by then, I woll go to another hospital and find a safe night shift to work. But I want this to succeed. My fellow nurses? Terri

I was not a new nurse when I started in NICU but new to NICU. I got an awesome orientation. I think it lasted 6 months and when I went solo, I got everything. But we were a soft level 3. We are a stronger level 3 now so I grew with the unit. I left for a while to work in a level 4 and got the worst orientation ever, so mileage does vary. We've recently lost a lot of experienced nurses and are taking a lot of new grads and they seem to be much more eager to push them beyond their comfort and safety level. I'm pretty unhappy about that. Heck, even when I asked, they wouldn't let me do charge for years. Now, three months in and they are pushing them. I think there is a happy medium and I don't think we've got that figured out.

I call the first year in any specialty "Life Shock". It happens to new nurses and nurses moving to a new field. We have a lot of new nurses on our unit and I try to sit down and talk to them about this. It helps normalize it for them. Now, if a new nurse isn't scared, I am.

Don't believe everything your instructors tell you. Spend this time honing your own judgement skills. Or to put it another way, "jackass don't know what he's talking about". We have a Neonatologist on call but the NNPs run the medical side of things 24/7. That's not going to change.

Of course your personal situation (familial, school, life in general) must dictate but as a nurse who has chosen to work night shift or evening shift all of my career, I can give a few tips to ease the pain and actually support your health, though it's possible that even with the things I do, I am at higher risk for cancer, etc. I don't vary my shift at all. I go to sleep at 8:30AM and get up at 4:30pm. I use Melatonin and other sleep aids as necessary and I use a white noise machine. Total black out in my room and no TV in there. I drink one cup of coffee a day, at 4:31PM, give or take a few minutes. I take my vitamins, especially C when I wake up. That's every single day, whether I am working or not. I still get the evening to be social and spend time with my family. Appointments are made for 4pm or later (as much as possible). I use my nights off for chores or Netflix binges or whatever. Like tonight, for instance, I'm not working but I will stay up until 8:30 in the morning. Lather, rinse, repeat. Hardly any nurses I work with do that and they are miserable. Now, I've always been a night owl, so it's going to be a little easier for me, but any time I try to vary, I suffer. All it takes for me to understand how miserable my fellow night nurses are is to flip my schedule. Most night nurses do flip their schedule on their days off. While I understand why, I don't have a clue how they do it.

Level 4, absolutely. I work on a small level 3 and our RTS are not NICU dedicated so we have to know what they are supposed to know because they don't always know it. I learned everything I know about vents and oscillators from the RTs at a level 4 I worked at. They loved teaching and I'm so glad I took them up on it. We mix our own milk. We don't mix our TPN or Lipids or specialty meds but we double check everything that comes from pharmacy because we don't have a dedicated pharmacists. Heck, we double and triple check all meds but I did that on a level 4 too. Our NNPs do PICC placement and line dressings as well as UA and UV lines. We assist. I have no desire to do my own UA or UV lines, but I would love to get trained and be able to place PICCs. I placed PICCs in adults in another life. And when a given NNP doesn't place PICCs, we end up dealing with peripherals that, as you know, go out so easily. Because of those two things, I am an expert at placing peripherals but I hate putting the kids through that.

Actually, studies are happening right now around this very topic and it's because of the burgeoning field of Developmental Care philosophy and avoiding unnecessary trauma. I know it seems like weights aren't trauma but we're re-evaluating that and really, it's noxious stimuli. Besides the most important value from a nutritional standing is OFC. Weekly weight, OFC and length is likely to become standard of care for feeder/growers within a few years. We do nightly weights and OFC and length weekly. We also do nightly blood pressures on every single baby. Luckily, we have one NNP who is extremely focused on developmental care and I've gotten her to sign off on decreasing frequency of BPS and weights on appropriate kiddos.

I left Labor and Delivery about 10 years ago because of an injury to my C5. While I was out on disability, I was faced with the choice of leaving nursing or changing my specialty. I went into nursing because of my passion (a calling, really) for all things birth. Well, all things birth except those scary little babies that I handed over to NICU nurses, a specialty I knew I never wanted anything to do with! But, the reality was that I could no longer care for adult patients and if I wanted to remain a nurse, I needed to move to NICU. Because, while I knew it wasn't sit down work, one more injury to my spine and I might be permanently disabled. I was correct that the work, while not easy, is more protective of my spine. Oh, and by the way, I went in with a determined positive attitude and now, these many years later, I don't miss my first calling and I have a second calling. I love, love, love NICU - the babies, the moms, the dads and my coworkers. I feel so blessed. It didn't hurt that they gave me an awesome retraining. They treated me like the seasoned nurse I was but didn't skimp on helping me to see the differences, both in thought process and practice.

I hate Dr. Browns and I think the whole silly contraption doesn't do a damn thing to limit air swallowing. We have brushes to clean parts and we have bags so that we sterilize them each night. I had no idea they had one use ones that don't include that idiot contraption in the middle.

Ours is within the epic system. I'm not sure if it got programmed in or if it got piggybacked on.

I can tell you one thing not to do. Don't go to a prep course, then convince yourself that you need to study your weak areas as exposed by the course and decide to work on those before you sign up for the test. I went to a course by Rogelet last year and she is so amazing but it felt like she knew more in her little finger than I did in my whole brain. So, I went home to study the things that I was weak on and then life intervened and now I'm so far out from that course that I'm scared to take the test. I'm not saying you shouldn't work on your weak areas but if you take a review course, pay for your test at that time so that you have a deadline. I'm taking another review course this February and that is what I intend to do. And I WILL pass and so will you. Terri