What is it really like to work NICU?

texas2007, BSN, RN · Jun 30, 2008

I think a large part of your experience will be determined by what kind of unit you're in and it's size. I've had 2 different nicu experiences...I externed at a mid size level III nicu (no ecmo, no surgery) and most of the patients were preemies. However it was a big big deal to have a 24 weeker on the unit. Where I work now, a large level III, we do everything...ecmo, surgery, nitric...the works. We get a lot of the sick kids from outlying hospitals (usually hie, pphn, sepsis or nec) and at times it can be very stressful and downright depressing. A 23 weeker is a big deal but not so much since it seems we get at least one every other week or so. We also get a bunch of cardiac babies and they always scare me. Consequently since we see a sicker population, we also have more patient deaths and a bunch of chronics. So ya...depends a lot on your unit!!

Olivereindeer · Jun 30, 2008

I have worked for jsut over 12 months in a Level III NICU (including cardiac, surgical and nitric but no ecmo) Prior to this I worked in adult ICU and anaesthetics/recovery. It is usually pleasant work but precise work..

I think it all depends on the 'feeling' of the unit..if the staff get on well and are cohesive and supportive then even if the work is hard and sad you still feel good about it. I think management set the tone very much to make employees happy resulting in a happy work place.

It is VERY different from adult nursing - babies do EVERYTHING back the front and go from well to close to death in a matter of hours. The work is not physically hard but you have to have good assessment skills and are often fiddling around with other things which take up your time (paperwork, liasing with other services, supporting/counselling parents)

Care of the parents, supporting, envourgaing and educating them is a HUGE part of the job so I dont recommend NICU for someone with poor communication skills or those who come across as cold or 'sharp'. The parents can be highly emotional and also very very trying especially when you feel they have been the cause of their infants problems (eg, no maternal care, drug taking during pregnancy) You have to recognise when you feel judgemental and still just do your best for the babies and their parents.

It is hard to imagine what the parents are going throiugh and they often make decisions whichI would not (continuing or stopping treatment)

I love attending the high risk births, love doing the initial birth resus and love getting things just right for the babies. It is a precise type of job and you have to be systematic in your care and very organised. Little things make big differences to the health of these babies _eg, too much handling etc. There is not much room for error.

HOwever, I love it..I love the tiny neonates, I love seeing them all scrawny at 24 weeks and then seeing them with good outcomes at term. I love seeing them grow from just breastmilk..I love watching the Mums bond with their babes.

I would check out certain things at a unit:

staffing levels

is there an educator present

do they offer ongoing education

would they pay for college NICU training (mine does)

Is there a way to start at a Special Care Nursery then work up to NICU so you can gain knowledge properly rather than being thrown in at the deep end

Can you take up a temp contract there to see if you like it

Goodluck

babyNP., APRN · Jul 2, 2008

Poop cleanup is amazing. Haha. I work as a nurse tech on an adult trauma-surgery floor where our patients can't do anything for themselves and did my senior practicum in a NICU.

But seriously, it's the most amazing thing I've ever done, working in the NICU. Holding babies, watching them struggle to gain weight, teaching parents, and talking to someone who is adorable and won't whine back to you are just some of the things that I love about this patient population.

Sweeper933 · Jul 2, 2008

talking to someone who is adorable and won't whine back to you are just some of the things that I love about this patient population.

Then you've never met a cranky chronic!!! (especially the GI kids!!!)

babyNP., APRN · Jul 2, 2008

Haha, nope.

But anything is better than a 2am changing all of the sheets for a 200 pound lady who was spewing loose stools and told us she was done and five minutes later find it dripping on the floor again...

WildcatFanRN, BSN, RN · Jul 4, 2008

Haha, nope.
But anything is better than a 2am changing all of the sheets for a 200 pound lady who was spewing loose stools and told us she was done and five minutes later find it dripping on the floor again...

OMG, now you know why I want to work with babies. I know they have poopy emergencies to, but at least you won't break your back taking care if it. My Peds clinical had us observing on NICU one day, for the whole day. On the intermediate care side the nurses let us hold and fee the babies. Actually, they said "you girls can pick them up, they aren't going to break". Anyway, I heard one little one fussing, and went to check on her and sure enough she gave me that "look" more like "um, there is somthing squishy here, please help". Well I gowned up, washed my hands, put on gloves, and changed her. She was most appreciative to say the least, and just gurgled and cooed the rest of the time. She had downs, and was the cutest little thing. I knew right then I wanted to work with little ones. After visiting the side with the sicker babies and talking to several nurses, I discovered it was ok to be scared to work there. One went so far as to say, if hired give things at least 6 months to even begin to know what your afraid of. I know I can do it.....IF I can get my foot in for a interview somewhere. Speaking of interview, I did get one...for an adult ICU. Hey, its a start right.

WildcatFanRN, BSN, RN · Jul 4, 2008

Haha, nope.
But anything is better than a 2am changing all of the sheets for a 200 pound lady who was spewing loose stools and told us she was done and five minutes later find it dripping on the floor again...

OMG, now you know why I want to work with babies. Though they do have diapers, theirs is smaller and the messes smaller in proportion. That and you won't break your back changing said diaper.

On another note, is ICU an ok experience to have prior to NICU. I mean if you can't get a job on NICU, but might get one in ICU is that acceptable experience. I know they are very different places and age population. Reason I'm asking is because I have an interview with an ICU next week. Its in the same hospital system with the NICU I keep applying too. Just trying to get my foot in the door, so to speak.

cherubhipster · Jul 18, 2008

I think I might want to do NICU too...I haven't even started school yet but I have dreams about working with newborns.

How does someone prepare themself for a job in an NICU unit while in nursing school? They seem like hard jobs to come by in my area..

babyNP., APRN · Jul 18, 2008

Focus on doing well in school and passing your NCLEX! I interviewed a few months before graduation (in February) and basically called up managers of NICUs at hospitals and asked if they were taking new grads and then applied. It's very important to keep in contact with the status of your application, I've found in my experience.

When I applied for my nurse tech job, I called nurse recruitment a week after I sent it and asked when I could have an interview, and they gave me one! My other friends waited a month until I told them to call up the recruitor and they got interviews then as well. I figure they're always so laden with apps that they don't have time to sort through them all, but I could be wrong.

Make your interest in the NICU known to your peds clinical prof to see if you can shadow into a NICU or see if you can volunteer to rock babies at a local children's hospital. I got very lucky to do my NICU as my practicum--there are very limited spots, or at least where I'm from.

Good luck!

WildcatFanRN, BSN, RN · Jul 23, 2008

I really wish now I had accepted the NICU Preceptorship during my senior quarter. We had to do a 120 hour preceptorship prior to graduation, one on one with a staff nurse. Well the NICU one was on weekends only and my then manager at my job wouldn't accept my doing that since I worked weekends, I ended up in the Peds ER instead. Granted it was a great experience, but now I wonder if I might have actually gotten in for an interview at least instead of a form letter from nurse recruitment when I applied for a job on said NICU. ESPECIALLY after being asked to resign from my other job due to them supposedly not having any hours to maintain my PRN staus.