question about nicu orientation

lmcnabbkv · Jan 27, 2005

here is a link to UCLA's site, the RN residency seems to be catching on in many hospitals...http://www.childrenshospitalla.org/11246.cfm

i hope the link works!!

Gompers, BSN, RN · Jan 27, 2005

We start them off with classroom time for the first two weeks - the first week is purely classroom and the second week is half classroom and half hands-on in the unit. It's like a mini-course in NICU, teaching all the stuff that wasn't covered in nursing school. After those two weeks, people are precepted for an additional 12 weeks, and then for 4 weeks they are assigned a "buddy" for each shift, someone who keeps an eye out on the new nurse and is there to answer any questions she might have. For our preceptors, it's supposed to be someone with 2+ years experience who WANTS to precept. Most of the precepting is done on days, with maybe a week or two on nights, even for those going to straight nights.

If the new nurse, preceptor, or management feels the new grad needs more training, we just keep them in orientation a bit longer.

BittyBabyGrower, MSN, RN · Jan 27, 2005

We have some class time, but it is mostly those gotta do things, like breavement, breastfeeding, code pink, NALS, etc. The first 4 weeks we go from 3 feeders to easy vent assignments. Then they are on their own with 3 feeders for 2 weeks...this gives them a feel of what it is like to be by themselves( there are mixed feelings on this concept), but the preceptor is always within arms reach. Then back with the preceptor for another 4-5 weeks and proceed from easy vents to heavy assignments to criticals and admits. During the two weeks on their own, we can and do pull them in for interesting kids that we don't see often. We will often take these kids, even if they aren't up to it yet, with the preceptor doing the majority of the work, as some opportunities are too good to pass up! At some point during the last two week, they take their NICU based med test and the last week they take the core test. We use Core Review for NICU and they are assigned readings thru out their orientation and questions from this book are on the test. Also on the test are blood gases and the such, esp unit specific things that they should know going out on their own.

We formed a preceptor group and we want to redo a lot of our check sheets and things. We devised a check sheet for vent compentency that respiratory does with the new person, we have a check off for IV's , blood draws (heel, vein and line). We have also developed, with the help of our director, a "cheat" book with almost everything you need to know. It is a little 3 ring notebook that they had published and give to all new people. It has unit policies, guidelines, what you need for different procedures, what type of tube for what blood and how much, fast reference for cardiac, nutrition, etc. Even the new residents get one. You might consider doing something like this. One of the formula companies sponsored it just to get a little blip in it LOL.

To be a preceptor, you have to have over 2 years experience and you are interviewed by several people and have to submit paperwork, etc. We also go to a class and receive $1per hour that we precept (although with some people it should be like $10 LOL) . We have a core of 12 people, 3 on each shift. We will also share a person...we found that most people like this and it gives you a break...it is tiring to precept for all that time.

I hope this helps!

fergus51 · Jan 27, 2005

The best orientation is one that is structured. My orientation to the NICU consisted of 2 weeks of class time followed by two weeks with a preceptor looking after level 2 babies, then two weeks working with level 2 babies on my own (had a buddy to ask questions, but was considered as regular staff). Then back to class for a few weeks to learn the level 3 baby care issues (practice suctionning techniques, vents, etc). Then 4 weeks with the preceptor in level 3 followed by 4 weeks working on my own with a buddy again. The time frames could be increased or decreased depending on the needs of the orientee. I know at least on hospital in the area did the formal NICU specialty courses offered through a university and they were great. If you are interested, go to http://www.bcit.ca and look for distance programs then find neonatal nursing specialty. The first two theory courses are meant to prepare nurses to work in NICU and I can't recommend them enough!!!

The most important thing was having the same preceptor throughout the orientation. There is nothing worse than moving to different people like I did when I started at my new hospital. Also, I think it's best if they orient on the shift they will be working on. That way they get to know the people they will be working with and who they can go to for help.

BittyBabyGrower, MSN, RN · Jan 27, 2005

I forgot..we do orient on the shift they will be working, but we do send them to days for a week to get more experience with taking kids off the unit, surgeries, etc.

Finallyat40 · Jan 28, 2005

Initially two weeks of classroom and lab guided activities directly related to NICU care. Then we start a 4 week preceptor guided clinical, then back for another week of classes, another 4 weeks of clinical, another week of classes and 4 more weeks of clinical. At the end of that time, and based on the outcome of our tests (there are three plus a final exam) and evaluations, we move out on our own, with "buddies" available to help when needed. From what I understand we will spend more time with the vents/sicker babes initially to allow us the opportunities for skills, etc., then transition to the step down units, etc. Our classes are taught by a variety of people, some are educators, some are staff nurses, some nurse practitioners, etc. It is very organized and I, at this point, feel very supported in beginning my career here. I'd be glad to give you a list of the topics we have lectures on if you'd like, but I don't have my paperwork here, so if you want it, let me know.

Jamie