Staying alive in the NICU

starfrek1 · Jan 2, 2006

I would have to say talk to your manager. Or ask for a specific baby before you go in for your shift. I found that same thing when I was traveling, they wanted to get "a feel " for me before they gave me the more difficult ones or critical ones. Sometimes I think they just 'assume' that 'older' nurses just would like 'easier' assignments. Speak up for yourself girl!!!!

Gompers, BSN, RN · Jan 2, 2006

Sometimes I think they just 'assume' that 'older' nurses just would like 'easier' assignments.

They do this by us, too. Some of the older nurses never seem to get the very sick, critical babies. If we have a lot of newer nurses working that shift, or if there is any orientation going on, they will get the sicker babies to get experience. Some charge nurses will always give the new girls the sickest babies, while others are old school and don't "trust" them with sick babies just yet. Otherwise, there are always certain nurses working who we *know* really only like sick kids, so they usually are assigned them if no new girls are working. They will complain if they get feeder-growers in stepdown, and who wants to listen to that? So they give those gerbil wheel assignments to the older nurses who don't complain, and just pleasantly do their job.

We do have a couple of older nurses that are always assigned easier babies, and in all honesty it's because they're very slow in their work. They move slow, walk slow, talk slow, mix up meds slow, etc. It's just them and their personalities, and there is absolutely nothing wrong with taking life easy - but this is an ICU. The charge nurses will just not assign them very critical babies because they fall behind so quickly.

So I think it's a combination of wanting to give new nurses good critical experiences, not wanting to p*** off the adrenaline junkies who hate stepdown, and possibly a personality/speed thing.

I hope it gets better by you! Speak up, say you're losing your skills (even though I'm sure you couldn't after 27 years!), or that you're BORED and want a challenge. I know I've done that after following a primary for months and spending tons of time in stepdown - I'll say, "PLEASE give me something juicy, I'm going crazy here!"

sparkyRN · Jan 5, 2006

Our situation is a lot like Gompers.

I don't mind doing my time in step-down--sometimes the change of pace is nice, and you have to give the newbies some ICU experience so they can work on their skills. I always get a little stir crazy after a couple of weeks there though. It's always good to let the charge nurse know when you need a change. If I'm starting my week and I'm not in ICU, I'll check the schedule to see who's in ICU that won't be back and I'll ask for their assignment for the next day. Also, we use a highlighter to mark the days we are in step-down or isolation so the charge nurse can see who needs to do their turn there.

kitty29 · Jan 8, 2006

Thanks for all your replies guys...and hearing that this just seems to happen in someways is reasurring....in otherways not.

I intend to speak up next time I am on a stretch...maybe write "no ICA" on the assignment sheets for the ones making the assignments. If I can only get my foot in the door for a primary pt.....than I would have more power.

I just might present the problem to a unit meeting next time too.

I realize there are many nurses with experience who want to step down from the challenge...but not me. I've worked for my knowledge and feel I have tons to offer.

Thanks again. :)