Trying to transfer to Level II Nursery

NICU_Nurse, BSN, RN · Mar 4, 2004

I was speaking with a nurse recruiter recently and discussing the possibility of an opening in the NICU in the next few months. She said, "Well, we don't have any openings in the NICU right now, but we're open in the PICU!" and smiled at me. I said, "Ah, well, I'm only interested in the NICU- I have no desire to work in the PICU. I realize you don't have any openings at the *moment*, but might you in the forseeable future?" and she said, again, "Well, I have nothing in the NICU, but I'd be happy to schedule an appointment for you to speak with our PICU manager." This went on for about five minutes, before I just thanked her and said no, I'd have to look elsewhere. I spoke to a friend later that day, who works on Mother/Baby there, and she said, "What?!? They've got three open positions in the NICU on night shift alone!".

Moral of the story: They're gonna push and pull you every which way to fill the spots that are most desperately empty. That's their job.

I see nothing wrong with contacting the NM directly- this is what I have done in the past. I just call and say, "Hi, I hope you don't mind my contacting you directly, but blahblahblah."

I think your experience in intensive care would be a huge asset to any unit- whether you have experience or not in the nursery, you're able to work effeciently, learn complex tasks and master both the task and the knowledge behind it, understand the urgency of an ICU, know how to communicate with families under duress, etc.

Chances are the recruiter is under pressure to get some bodies in that ICU stat; you don't have to be one of them. :) Good luck.

Mimi2RN, ASN, RN · Mar 5, 2004

I agree, go directly to the NM. You have nothing to lose by this approach.

You would have a lot to learn, going to a level II, but you do have experience with critical patients, which would be very important in our unit. We don't just do grower/feeders. We also attend deliveries of high risk newborns, and have babies on vents and CPAP.

Good luck!

carriec · Mar 5, 2004

:rotfl: I AGREE ALSO!!I also went straight to the NM and spoke with her...It was so much easier, and they DO higher nurses without NICU experience..The fact that you do have nursing experience PERIOD puts you ahead of the game!!! GOOD LUCK!!!

Jolie, BSN · Mar 5, 2004

Seeking Nursery/NICU view on my situation (also posted to management forum):
I'm a BSN CCRN with 10 years ICU experience, started in ICU as a new grad way back when they were not hiring new grads in the ICU. I did not have a formal internship, I had a preceptor for 6 weeks and then I was on my own. I feel like I have accomplished all that I had set out to accomplish in adult ICU and now I'd like to move on and change specialties. I've applied at a fairly small hospital (lots of deliveries though) for their Level II Nursery. The recruiter contacted me and said that I was not a candidate fot the Nursery position since I don't have NICU experience and they do not do internships. Then she all but begged me to interview for her open ICU positions. (UGH!)The Nursery position has been open for weeks and she admits that they are very short staffed ( another reason they are seeking experience, I'm sure). I am thinking about bypassing this recruiter and contacting the Nursery Nurse Manager directly, forwarding my CV, and asking (I'm willing to beg!) for an interview. I am practical, I realize that NICU/Nursery is VERY different from adult ICU. I am an extremely motivated, responsible, and self directed learner. I succeeded (shone!) in ICU as a new grad with an extremely limited amount of clinical training, and really think that I could learn quickly in the Nursery as well. Any comments, opinions, thoughts would be greatly appreciated.

I agree. You have nothing to lose by contacting the nurse manager directly.

As far as the advisability of starting out in a Level II nursery, I would have to say that as a manager, I would not recommend it for everyone. If I were interviewing you, my decision would be based on 2 factors: 1)the census and acuity of patients in the unit, and 2)my impression of your ability to learn in less than ideal circumstances. Let me explain, and please don't think that I'm dissing Level II NICUs. I'm not. But they are very different from more intensive units.

I started out as a new grad in a 45 bed Level III NICU way back before it was fashionable for new grads to do that. The unit was able and willing to accept new RNs because they had a never ending supply of learning experiences in the form of critically ill preemies, cardiac babies, surgical cases, full-term meconium kids, as well as the relatively straight forward r/o sepsis babies and IDMs. We also had over 100 full-time RNs on the unit, about 1/2 of whom were willing and able to precept, so it was no problem to offer a 12 week 1:1 orientation to new grads, as well as a 2 week class on fetal development, normal and high-risk pregnancy, delivery room stabilization, resuscitation, pathophysiology, pharmacology, etc. All the things that were just glossed-over in nursing school. It was an amazingly thorough and well-planned orientation period. In 2-1/2 years of working there, I only saw 1 or 2 RNs "wash out" of the program. After orientation, we were expected to work full-time ffor at least 1 year, in order to hone our skills. Even with a wide variety of patients to care for, and never-ending support from more experienced staff, it took about 2 years before I began to feel like an "expert".

After 3-1/2 years of NICU, I took a job in a Level II nursery. It was in a small community hospital which did about 2500 deliveries per year. Most of the patients had reasonably good prenatal care, so our high-risk population was fairly low. Good for the moms and babies. Not so good for the NICU staff who were trying to learn and maintain critical care skills. Literally months would go by between vent babies. We would see a chest tube twice a year. Despite their best efforts, most of the staff had very limited IV and blood drawing skills. Even for those of us who came from NICU backgrounds, it was hard to keep our skills up. For those who had not previously worked with infants and children, it was virtually impossible to learn the necessary skills.

So, would I hire you? If the unit has an adequate census to allow you access to critically ill babies on a daily basis, then probably yes. I would require that you take NRP (which the hospital should set up and pay for). I would also seek out a NICU theory course at a teaching hospital or referral center, since it is not possible for a small unit to provide that kind of classroom education for you.

You should insist that you not be floated to any other unit, except L&D to do baby care, for at least the first 6 months of your employment. You can not be expected to learn NICU care if you're on med/surg for the day, just because "it's your turn".

Good luck to you, and deep us posted on what you decide.

SICU Queen · Mar 5, 2004

You should go directly to the NM. That's what I did. I've been in adult critical care for 11 years, and started out as you did. I've always wanted to work NICU/Nursery, and when an opening came up at my hospital, I spoke with the manager of the dept, officially interviewed, and accepted a position yesterday morning! I will be getting a VERY extensive orientation. (I guess I'll be needing a new nickname now. :) )

Go for it, and good luck!

Darchild77 · Mar 5, 2004

You need to be NALS certified to work in the Nursery, at least at our hospital.

Gompers, BSN, RN · Mar 5, 2004

You need to be NALS certified to work in the Nursery, at least at our hospital.

Is NALS the same as the NRP? I've never heard of NALS so I'm curious.

At my hospital, you aren't expected to have NRP before you start working. New staff nurses are given the course shortly after orientation. Since nurses can't go do for deliveries by themselves at my hospital until they are in the NICU for 6 months, the NM felt it was better to wait on it a little and then certify them when they were able to start buddying with a high risk nurse.

my2sons - - did you get my other post about the STABLE program? To me that would be a great thing to put on your resume. Many level II nurses who have a program in their area are encouraged to take this seminar, and if there is one coming up in your area go for it! It's not offered publically very often, not sure if it's offered privately to specific units on a request basis, so getting it when it's available would be a good idea. Many units are able to do an NRP class for new nurses whenver they want if they have a nurse on staff who is an instructor, so that might be easier to get later on.

http://www.stableprogram.org

GOOD LUCK!

Mimi2RN, ASN, RN · Mar 5, 2004

Yes, Gompers, NALS and NRP are the same thing.

mimi

Gompers, BSN, RN · Mar 6, 2004

Yes, Gompers, NALS and NRP are the same thing.

Thanks!

:)

my2sons · Mar 7, 2004

Thanks Gompers. Yes I did, and thanks for the info re: the STABLE program, sounds like a good one. Still trying to figure out what to do. There is the option of staying at my current hospital and transferring to their Level III NICU, to get experience, but I really hate it here. Terrible management, poor staffing, no nurse leadership, high stress.The Level II really sounded like a perfect place for me, but I'm still having trouble getting through the recruiter. Can you believe that I let her talk me into interviewing for their adult ICU?! Well, at least I'll give it a look see, who knows.

fergus51 · Mar 7, 2004

Could you use their ICU as a stepping stone to their level 2? I mean is it easier to move within departments at the same hospital?