Still not comforatble with NICU

RNin2007 · Jan 21, 2009

I've been in the NICU for a year now (this month) and I feel the same way you do. My orientation was very slow...we are a small unit as it is, and I had NO admissions on orientation, and only one level 3 patient. I feel exactly the same way you do and i'm glad i'm not alone. We are finally starting to get busy and i'm trying to take as many of the micros as I can. I am starting to feel slightly better, but still not very confident. I also go home and my brain is spinning...wondering if I forgot something or didn't do something right. I feel slow at some skills that I haven't gotten to do much (e.g. assisting with line placement). I think it will get better as time goes on and everyone learns at a different pace. I don't feel like i'm unsafe or anything like that and i'm never afraid to ask questions, but wish I had more confidence.

Sandwitch883RN · Jan 25, 2009

I've been a nurse for a little over two years and feel the same way you do. I'm not a NICU nurse. I'm L&D. It's a huge responsibilty working in a specialty such as ours and i'm sure it takes time. I just didn't expect it to take so much time to reach a comfort level. I feel fairly secure in having the "basics" down, but I to worry about forgetting something, or not realizing there is a problem. Also i'm so much slower than my coworkers. They all have many years at the facility i'm at now and make everything look so easy. I'm sure though that most "newer" nurses feel the same way we do. I look forward to being one of those confident nurses one day!:typing

Sweeper933 · Jan 27, 2009

It does take time to become comfortable. It took me about a year until I truly felt that way. Keep asking questions though. I still do. I'm always learning different ways to do things, different ways of explaining things to parents - the learning never stops!

Believe me - it's much better to be a little bit cautious as a new NICU nurse. You end up taking your time and not missing something because you went through your assessment too fast. I'm much more scared of a new NICU nurse who thinks they know everything right off the bat. There's a lot to our job, it's called a specialty for a reason.

Keep it up! It does get easier. It just takes some time!

NFB2008 · Jan 27, 2009

I started orientation in July as not only a new NICU nurse, but as a brand new nurse (graduated in May 2008). I went on my own at the beginning of December. I always take advantage of being in the same room as a more experienced nurse. If I hear them explaining something to parents, I always listen in. You can learn a lot that way. I know I have.

dawnebeth · Jan 30, 2009

I was so incredibly nervous the first year I was in the ICN as a brand new nurse that I made myself physically ill. I did many things wrong and even a really bad med error and was threatened with termination. But I persisted--made sure that I always asked questions, double checked what I was doing and slowed down when I was feeling scared or agitated. And I'm still in the ICN 21 years later (this week), and I've been one of the main preceptors for new nurses for over ten! lol. I guess I finally learned something!

It is very normal to feel scared of the tiny preemies. Do you have biannual skills labs in your unit to help hone skills? Is there someone who you feel has really good skills with micropreemies who could give you tips? Have you simply tried getting a primary baby that is under a kilo so that you work with the same baby every day? That could lower your level of discomfort because you will come in every day with prior knowledge of the baby and his care so you feel more prepared.

Maybe take some online ICN ceu online courses to firm up knowledge that you feel is lacking?

I found that primary care was for me. I love being in a 'rut', having the same baby day in and day out (hopefully, anyway, because it's possible to be bumped out of that assignment). I got really proficient with vents, especially HFOVs this way, which helped build my confidence level.

But I still ask questions, every day, to this day. I don't remember every single step of every single procedure--that's not possible.

Look back to what you have learned from the first day you worked in your unit. Do you understand a blood gas now and what it implies. (I still recall the thrill I felt when I explained a baby's blood gas to a parent and realized that I knew what I was talking about.) Have you drawn blood or started an IV successfully many times? (I cannot do IVs to save my life. I've accepted that. I can draw blood from an artery, though.) We all develope certain skills and never quite master others. That's normal. Find your own strengths and have pride in your awesome ability to nipple feed the most finicky eater or to put in a foley catheter. (My friend calls me the queen of cathing. lol). What are you most interested in? Working with a vented micro preemie? Dealing with the complex meds of a cardiac baby? Maybe you can concentrate on one sort for a while and then learn something new. That's why I am such an advocate of primary nursing.

Dawn