Tell us what you want from your friendly NNP

ittybabyRN, RN · Mar 19, 2010

I am very much a newbie but I LOVE when my babies are NP babies, it makes life so much easier. They are usually easier to get a hold of, know the baby better (especially kiddos that have been there longer than the residents 4wk stent), and always assess my baby properly. I often never see the residents even look at the baby, and simply read my morning assessment during rounds, one time my baby's belly had gone up 3.5 cm! it was distended, tight,veins dialated, the whole deal, when I told the res about it she said she didnt notice anything different about the belly...but the baby had been laying on her belly and the res hadn't flipped her over! (0.8 kg, just started feeds?? argh) :banghead:

Personally I like having the NP's better, for the most part, sometimes the newer ones seem pretty nervous but aren't we all when we start?

Good luck and congrats!

Elvish, BSN, DNP, RN, NP · Mar 19, 2010

Ok, I'm not a NICU nurse but I have to call NNPs A LOT where I am because I work nights and if parents are using hospital peds, it's the NNPs that cover nights.

All I ask is when I have to call you, please take me seriously. Just because I'm a 'well-baby' nurse doesn't mean I don't know a problem when I see one. If I'm in charge in the nursery I have anywhere from 25-45 babies (average) to worry about. I really try to not have to call you about any of them, but when I do, please don't give me any **** for it. Oh, and anytime you want to teach me something new - something else to assess next time, something I can do differently, anything at all - please do!

I know you are going to be awesome, SteveNNP!

iyqyqr · Mar 19, 2010

Thanks, Steve, for this post!

I work in a 58 bed level III NICU community hospital with a NEO/NNP group that covers 2 NICU's in town. I have 27 years in NICU and choose to work w/end nights. Our NNP's used to work for the hospital and when on call would stay up throught the night. Now they work for the group and the NEO and NNP on call both sleep all night when on call, if there aren't admits or they aren't bothered by phone calls.

When you round in the evenings, please act interested, and don't treat the night shift like they are just babysitters. I know what can wait for the baby's Neo in the am, but I also have a good eye and sound judgement, and my goal is to move the baby forward, so he can get home sooner, rather than later. Sometimes condition's change at night and action can't wait till morning. Please respect me enought to hear me when I say I am worried about a kiddo. I promise I respect your need for rest and I do understand how busy your days can be. I don't feel I should have to be afraid to call you after midnight. On a sick infant it really means a lot if you come to the bedside in the am before I leave and ask me for a brief report before I go home. Nurses on nights want to feel they are a contributing part of the team and you (and the Neos) can help us feel that way. We may have questions about our patient or his labs and we all want to be able to learn and grow, EVEN those of us on nights. We continually have night staff leave and go to days, or just leave period, and often it is our unhealthy work environment and the lack of teaching that causes their departure.

Many units have day long staff education sessions a couple times a year that are mandatory for staff to attend. If your unit does this, please post a sheet so staff can list some of the topics that they would like to learn more about. Our topics are always selected by management, and we are left out of the process. Those of us in the trenches do know what we don't know. Also, understand our confusion when we attend a STABLE class taught by unit NNP's and we are told that some of the info we are going to be taught will not be what we see practiced in our unit. Where does that leave us??

Also, I traveled for a year and at each of the 3 units I asked the staff, "What are the current unit goals that you as a staff are working on?" Few staff had an answer, other than we're trying to get Magnet or recert. I believe that to engage staff in following protocols, they should know the outcome we are working towards; Eg; here is where we compare to the Vermont in this area and this is where we want to be. Or, we want to lower our ROP by this amount. Or decrease our head bleeds by this %. Nurses want to feel that the many details they perform at the bedside are part of a greater goal. As progress is made toward the goal we should celebrate it and thank all those who helped us acheive it, esp the bedside nurse.

If you work in a unit where nurses primary patients, please respect their committment to this baby and family and involve them in decisions. I often end up caring for babies that no one wants to take care of because of the challenge of the case or family issues. We really do "step up" when week after week we invest ourselves in this way and it would be great to hear from Neos or NNP's that they recognize our efforts. It can make your job so much easier and the families are much happier.

Please, try to address me by name and look at me when we are talking, and not just at the chart. And if I call you to talk to parents ( they can't all come in on the day shift) please come and not tell me to tell them to call their Neo in the am. I wouldn't ask you to come, unless I felt it couldn't wait till morning.

Best of luck in where you end up working. In my old and hopefully wiser age, I have realized that as unique individuals being happy in your job is about having a passion for it and the right fit for you in the right place, where your values align with those of the institution. May you find a good fit! :yeah:

sweet0176 · Mar 21, 2010

Congrats!!

All i can say is that I no longer work with NNP's in my facility (changed jobs) and i'm SO SAD that we no longer have NNP's!!!! You guys were the best because you could understand from the RN's point of view, yet still have the medical point of view to make decisions and write orders (woo!!). I have to agree with what the writer stated above: I was always so excited when I had a NNP assigned to my baby's care for the day because I knew that the baby would receive what he/she needed. Residents were generally good as well, but those NNP's were just fabulous! The only advice that I can give is just Listen to what we are telling you...we are there at the bedside for most of the shift watching them closely, so our concerns should be taken seriously. Just remember don't lose your 'bedside RN" thinking as well (not sure if you catch what i'm saying!) Anyways, i'm sure you'll be great!

Love_2_Learn · Mar 22, 2010

Like the other nurses have said, I ADORE working with NNPs too. The nursing focus on the "whole" patient including family, developmental care, etc is very important along with the medical diagnosis and treatment plans. Nurses are nurses and doctors are doctors but nurse practitioners are the best of both in my book.

May I suggest that if you periodically offer inservice programs to the nurses. All my co-workers love learning from NNPs because we feel you understand what we need to know to be more effective at the bedside. I've worked places where the unit educator taught what they could but also had so many other projects and responsibilities that the staff education was put on the back burner. Bedside teaching is also much appreciated when you find a teaching moment. Keep your eyes and ears open for the signs that a bedside nurse would like to, or needs to, learn more about something.

As far as waking up a sleeping baby so you can do your assessment goes... If you have several patients to see could you maybe ask the nurses which ones are closer to their feeding time and assess them first? I've had babies be assessed soon after eating and the NNP or MDs physical assessment caused the baby to vomit. It would also be a bit more on the developmentally friendly side to try to wait until a more appropriate time for your assessment when you can. I know this will not always be possible but it's a simple suggestion.

I admire you for doing all you can to be the best NNP you can be. It is very obvious how much you care and I wish for you the most fulfilling, rewarding and heart-warming career you can imagine. Congratulations on your achievement!!!

:yeah: :redbeathe

Humbled_Nurse · Mar 23, 2010

Congrats Steve! This is quite an accomplishment. I would love to go to school for NNP for the knowledge, but the thought of everyone looking to me when the 24 weeker drop in has just delivered and they are waiting for me to intubate just doesn't sound that appealing to me. I would rather be the one handing you the ETT :)

I work with NNP's and I love them. They are less intimidating and more approachable. Although I do work with some great Neo's as well. My best advice is to not be too "cocky" but at the same time show that your are confident so you will get the respect you deserve.

Do you have a blog thatchronicles your life as an NNP? If you do I would love to follow it.

Betsey

SteveNNP, MSN, NP · Mar 24, 2010

Do you have a blog thatchronicles your life as an NNP? If you do I would love to follow it.
Betsey

Haha. Not yet. I started a NICU blog here on Allnurses....but school put the kibosh on that for awhile. I might decide to start one though... its a great idea!

Galore · Mar 25, 2010

I would say, please don't forget what it's like to be a bedside nurse and treat them with respect. Most of the NNPs on my unit are great, but there are a few who talk to me more like an assistant than a colleague and they are generally just grouchy people. I think it is ironic since they started off as RNs and should know how it feels to be patronized. We all hate to call them on night shift after they have gone to bed, and I think for the sake of our patients, it's important for the docs to be approachable. Obviously, we are only going to wake you if we think it's crucial and can't wait til the AM.

karnicurnc, MSN, APRN, CNS · Mar 25, 2010

I agree with all the other posts. Only 1 thing to add: never forget your roots - you were an RN first. Congratulations on your advanced degree! We need more like you!