Typical day in NICU

elizabells, BSN, RN · Nov 12, 2007

The best part of the NICU is that there IS no typical day, but I'll give it a shot.

Come in.

Get report.

Check orders in the computer.

That's as far as you can plan ahead before you know what you're dealing with on that day.

We do our routine cares, assessments, and feeds q3h on relatively uncomplicated kids. Sicker kids (ECMO, post-op cardiacs) get assessed much more often, more like q15min-q1h depending. If you're lucky, not all of your kids will be q3 nipplers. Nothing like trying to get 3 pokey ex-preemies to take a bottle in under an hour total! Some units rotate their care times, so not all your kids are due, but on my unit if they're eating, they're eating at 8,11,2, and 5. So an NPO kid or one on continuous feeds can make your life a lot easier.

Rounds occur on day shift.

On nights we give baths, change beds, and do the routine labs. On day shift they run the new fluids from the TPN pharmacy.

Again, there IS no typical day in the NICU, it all depends on your assignment. Some people love the q3h rhythm of growing preemies and other not so sick kids. I love the constant assessment and tinkering of an ECMO. I've not been trained to do post-ops yet, but I think I'll like that too.

Other things to do that can't really be put in a chronological list: parent teaching, road trips to radiology, putting in yet another IV because the cranky kid kicked it out, bedside procedures (chest tubes, central line insertions, silo reductions, etc), admissions, deliveries, discharges, transports, different cares for things like ostomies and wounds, family visits, stat labs, intubations, codes, inservices on whatever new product the big boss took a fancy to this month, and the list could go on and on, and I'm sure the others will fill in the many gaps I've left.

Good luck!

MA Nurse · Nov 13, 2007

Great explanation, Elizabells. I am just curious, do you always have to take your babies to Xray?? That would be awful...luckily our radiology dept. comes to us with a portable xray machine, and we also have ultrasounds, etc. at the bedside. The only thing I know that we leave the unit for is surgery or MRI.

bayoubengals · Nov 14, 2007

Thanks! elizabells.I have interviews with 3 differet NICU's in the next week. I am very excited.

SteveNNP, MSN, NP · Nov 14, 2007

We have to take kids to radiology for stuff like swallow studies, upper GI's, VCUGs.... other than that, all are portables.

MA Nurse · Nov 14, 2007

yeah, we do that, too. I wasn't sure if she meant they had to take babies away for just a CXR.

elizabells, BSN, RN · Nov 14, 2007

yeah, we do that, too. I wasn't sure if she meant they had to take babies away for just a CXR.

I've had them try to make me, but I don't do it.

We go out for CT, MRI, swallow, VCUG, barium/various GI, and once in a while for an ECHO or something. Usually ECHOs and ultrasounds are done on the unit, but I did have to take one to the cardiology center once; don't remember why.