What do level III RNs think of level II?

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Specializes in NICU.

Hi. I was just wondering what level III RNs think of level II RNs. The NICU I work is a level IIB and we have a big tertiary center 2 miles down the street which is where our neos come from. It seems whenever we have a transfer to go to the level III the transport team comes and acts like we are a bunch of idiots.

Example: I had a baby a couple of months ago that was term, out on mother/baby and at 24 hrs. of age became lethagic, poor feeder. After an ECHO/workup, it was found the kid had major CHDs, ductal dependant. We started prostaglandins, O2 and set up for a transfer to level III. Because of insurance reasons and some other stuff the kid didn't get transferred until like 12 hours later, but was doing fine, was stable. When the transport team came and were doing their assessment, the baby was crying. The one nurse goes "O, it's ok baby. They did ok for you here". OK?!?!? She's still alive and stable!!!! I think she's doing great!! It just hit me hard because I am not stupid nor are any of the nurses I work with.

I was just wondering what other nurses think of this... anyone ever have similar problems?

Thanks!!!

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Specializes in Community, OB, Nursery.

I work in a well-baby-plus that transfers babies to and gets babies from a level IV fairly regularly. We get along ok with most of the NICU nurses....there are a few that kind of look at us like we are ninnies. But I really think it's because they are just like that, and would be no matter where they worked, not because they are NICU nurses. Most nurses have floated to our wellbaby nursery (we admit on average 15-20 babies daily) and cannot stand the constant gogogogogogo action. They respect us, and I respect them, for I cannot do what they do yet.

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Specializes in NICU.

I work for a network that has both a level II and a level III and I am part of a group of us that work at both campuses, and I think it's true that sometimes people think the nurses at the lower level NICUs are idiots. Of course, if it makes you feel better, I sometimes feel a little bit talked down to when a transport team from a larger level III comes in to take one of our babies to their hospital. Apparently, since we are not in the big city, we don't know as much as they do.

Another thing standing in the way of nursing being seen as a professional career...

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I think the nurse who made that statement was complimenting you guys.

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Specializes in NICU.

I totally disagree because,unfortunately, voice fluctuations cannot be heard over internet... she was totally meaning in a "put down" way... even the other nurses I work with said she is always like that when she comes... it's not that we aren't smart enough... it's just that our hospital doesn't have the needed resources

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So then it's her, not "Level III" nurses. Her.

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Specializes in Maternal - Child Health.

There are definitely some attitudinal NICU nurses who do transport, but they are not the rule.

I've worked on both sides of the Level III/Level II transport fence, and can attest that it is much easier being the one who swoops in on the transport ambulance than to be the one in the DR and doing the initial admission on a critically ill baby, often without immediate backup from a physician of any sort, let alone a neonatologist. I did transport for about 2-1/2 years, from 2 different facilities, and never walked into a complete trainwreck. The admitting staff always had the babies reasonably well stabilized, often without the advantage of ventilators (hand bagged), pediatric IV pumps (This was a very small, rural facility that did not do deliveries. A high-risk mom dropped in and delivered a preemie. The nursing supervisor found some manual IV controllers and personally watched over the lines until we arrived so that they could control the volume infused.)

It is much easier to have state-of-the-art equipment than to have to improvise. I was in awe of some of the complex diagnoses made in outlying facilities and the immediate care provided to the babies until we arrived.

I could never be critical of outlying staff. If the referral center has true concerns over care provided pre-transport, then they should offer up some education. Otherwise, they need to button their lips and lose their superiority complex.

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Specializes in NICU.

Amen Sister!!!!!!

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Specializes in NICU.

I guess I just have bad tastes in my mouth because my 1st NICU job was in a level III and I had a terrible experience with the nurses... they basically told me my skills were excellent, but my personality didn't fit. I am such a good nurse and nice person I don't understand how they can say that and then the whole transport nurse thing happens. I came to work my currect level II to get some more experience before I go back to a level III, but many times I am so scared to think of being treated like I have been again... but I love a level III for the thrill, excitement, and opportunity to use my brain!!!

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I guess I just have bad tastes in my mouth because my 1st NICU job was in a level III and I had a terrible experience with the nurses... they basically told me my skills were excellent, but my personality didn't fit. I am such a good nurse and nice person I don't understand how they can say that and then the whole transport nurse thing happens. I came to work my currect level II to get some more experience before I go back to a level III, but many times I am so scared to think of being treated like I have been again... but I love a level III for the thrill, excitement, and opportunity to use my brain!!!

But don't discount how well you used your brain for this baby. You and your team delivered her in good shape to a far better-equipped team.

You guys ROCK.

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Specializes in NICU.

There are rotten people in Level III NICUs, ORs, ERs, Med-Surg, Well Baby Nurseries... and lovely people in all of those places too. I'm very sorry for the bad experiences that people have had, but I promise I don't think badly of nurses at our Level II referral hospitals unless they send us an avoidable trainwreck. I'm sure that when we, a top 5 referral center, can't fix a baby and send them to one of the other big places or to a LTC facility, they say nasty things about us. Some people are just jerks.

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Specializes in Community, OB, Nursery.
There are rotten people in Level III NICUs, ORs, ERs, Med-Surg, Well Baby Nurseries... and lovely people in all of those places too. I'm very sorry for the bad experiences that people have had, but I promise I don't think badly of nurses at our Level II referral hospitals unless they send us an avoidable trainwreck. I'm sure that when we, a top 5 referral center, can't fix a baby and send them to one of the other big places or to a LTC facility, they say nasty things about us. Some people are just jerks.

Thank you, thank you, thank you. :bow:

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