Starting March 13th

[bluepenguin]

I'm starting my first nursing job on March 13th (this monday) in the NICU. It is an internship at a level III surgical /EHMO NICU. I am super excited and also scared. I had my senior preceptorship in a NICU and I feel like a learned alot, but there is still so much to learn. The NICU I was at in school didn't have ECMO so I am not sure what to expect with that. Also, I feel like IV's are my worst thing because we weren't allowed to do much with them as students in the NICU. I don't just mean starting them, because we never did that and I know I'll have a class on that at work, but I mean just giving meds and fluids and stuff through the IV. I am confident in alot of my other skills, but IV's and ECMO scare me a bit. Any advice for how to deal with my first days?

[prmenrs, RN]

You'll learn IVs soon enough, and I doubt you'll be anywhere near an ECMO circuit in the immediate future.

They will (or should) give you a very THOROUGH orientation, and you'll have a preceptor w/you. S/he will help you acquire all the skills you need.

ECMO is usually done by specially trained and very experienced RNs and RTs.

Congratulations on the next step in your nursing journey! You'll be terrific!

[NicuNightRN]

First, congratulations on getting into the NICU! It's a wonderful place to work!

I also did my senior preceptorship in a NICU. Even though it was not the one in which I currently work, it made a huge difference when I started working in the NICU as a new grad. The one I was in during school had ECMO, and just looking at it terrified me. We don't have ECMO where I work now, but I agree with prmenrs...it will probably be quite some time before you take an ECMO baby. I started working in June, and did not start taking vented babies until December.

I also did not get very much experience with IV's during school, although most of the experience I did get was on babies. Starting them will come with time. Management is not much different than it is in adult. We assess our IV sites hourly for signs of infiltration. When you start your shift, if the baby already has an IV, look at it with the nurse who is giving you report from, so that they can confirm that it looks like it did during their shift, which gives you your baseline to assess any changes. Your unit will have its own policy on how long IV sites and tubings are good for. For us, TPN and med tubing is good for 96 hours, and lipid tubing is changed daily. You should also have access to a Neofax or hospital drug formulary, which will tell you what meds are compatible with each other, how long to run them over, side effects to look for, etc.

The only other thing I will suggest is to ask LOTS of questions!!! If you are the slightest bit unsure about something you are doing, don't hesitate to ask your preceptor. He/she was new, once, too...even though some of them don't like to admit it.

Good luck, and let us know how your first days go!

Sarah