Whats your NICU experience?

NicuGal, MSN, RN · Jan 3, 2014

Well, you will be dealing with their stinky dirty families and all babies aren't peaches and roses.

Have you shadowed in NICU? I only ask because in interviews I have found that people who say they love babies usually have a vision of sitting and rocking babies, not dealing with a sick 22 weeker with a lot of issues or a screaming drug baby with a crazy mom you have to deal with.

jackiei3 · Jan 3, 2014

No, I have not shadowed. I understand I will not be rocking babies..it's a NICU. That's why I am asking what my expectations should be? I currently work with the product of screaming drug babies. (The adult mentally challenged and their parents.) I am asking what the highlights and lowlights of a NICU nurse are?

Luckyyou, BSN, RN · Jan 5, 2014

The recent realities of NICU nursing in my world (details changed to protect privacy):

Admitting a term infant who coded for over an hour at an outside hospital, knowing that he will never be anywhere near neurologically normal. Watching the medical team tell the family it's not in the best interest of the child to continue with aggressive care. Watch parents decline, saying that a miracle will cure their baby, who has no gag or blink reflex, nor any voluntary movements. Watch him get a trach, a g-tube, grow progressively more contracted and develop multiple drug-resistant infections. Send him home to a future filled with nothing more than laying in a bed and waiting to die.

24-week twins, desperately wanted by the parents who go through multiple cycles of IVF without success and finally conceive on their last-ditch attempt paid for by a family member. Watch all involved suffer through a week of life before taking them outside for the first and only time to die together in mom's arms.

Mom's tenth kid, going through severe withdrawal due to multiple opiates and benzos taken throughout pregnancy. Watch mom and dad come in half-awake, walking into walls and falling asleep holding and feeding baby. Watch mom ask genuinely if baby can be put in the trunk for the drive home.

Please, please, please, don't go into the NICU if you're just doing it "because I don't have to work with dirty older patients". There are plenty of other units out there where you can make connections with long-term patients and families (inpatient oncology, BMT, infusion nursing?). If you have your heart set on babies, newborn nursery is a great place for real newborn interaction.

ETA: I love my job despite all the heartbreak, and we do have plenty of happy endings, but I feel like so many people go into nursing thinking "I want to be a NICU nurse and work with babies all day!!" and then get into a level 3 unit and get slapped hard in the face with the true realities of what we do all day.

katierobin23 · Jan 6, 2014

This was a week I experienced not too long ago.

Night one: Decent shift, I don't remember the details...average night. Probably what most nurses think of when they think of working in the NICU. A few feeder/growers, maybe an IV or two.

Night two: I start with two babies, but the second one is given to another nurse two hours into my shift because baby #1 took a nose dive. The rest of the night was spent trying to make sure this 13 ounce baby was comfortable and mentally willing him to produce urine...any urine at all. He is so swollen that his skin is cracking and weeping. He is on 100% and maxed out on the jet, I have the code cart by his bedside. At 0600, he codes. Pulmonary hemorrhage worse than I've ever seen...blood shooting out of ET tube with every chest compression.

We lose him.

Mom says, "it's okay. I have eight more."

Night three (less than twelve hours later): My assignment is fine, but my friend has the baby next to me and needs my help. The baby is super sick (sudden overwhelming sepsis.) Had been doing beautifully the day before, but now is on 100% and maxed out on the jet. We code her five times in 12 hours, we give her just about everything in the book. The fifth time we code her, she doesn't come back, time of death called at 0700. Her mom falls onto the floor, yelling, dry heaving, and crying, "why god why? Why again?"

After that week, I had some time off and I very much needed it. This doesn't happen all the time, but it happens.

In my experience, nurses who come to work in the NICU that aren't passionate about it don't last long. It's not a place to work to avoid working somewhere else, it's a place to work because you can't imagine doing anything else, imho.

Bortaz, MSN, RN · Jan 7, 2014

In my experience, nurses who come to work in the NICU that aren't passionate about it don't last long. It's not a place to work to avoid working somewhere else, it's a place to work because you can't imagine doing anything else, imho.

This. Agreed 1000%. Wish all NICU aspirants would understand this.

uRNmyway, ASN, RN · Jan 7, 2014

I used to think NICU was what I wanted to do. Then the realities of nursing in general, coupled with becoming a mother myself, made me change my aspirations. Could not deal with what you all go through. Seriously, God bless you and all you do.

phlebo2rn · Jan 8, 2014

Most of the NICU nurses at the hospital I work at have had 10+ years working in pediatrics or ICU before they became NICU nurses. On top of that, most of them have their Masters as well. Because their job is so specialized, the requirements are more strict. I would suggest volunteering in a NICU or in General Nursery for awhile and see how you like it. Also keep in mind it's not very likely you will get a NICU position right out of Nursing School (not sure where you are in the program according to your post?) but a thought could be aiming for a step-down unit at a Children's Hospital. Getting lots of experience will help you, whether that be being an RN on an adult ICU floor (yes, even with the "dirty older patients"), volunteering, or shadowing. Good luck!

lee1 · Jan 8, 2014

Please do NOT go into NICU nursing if this is NOT your passion. I have just retired from critical care adult cardiology nursing and have now experienced a close family member who gave birth to a 37 week old baby that unfortunately required "cool cap" therapy. This poor mother did everything right during her pregnancy although she was at high risk due to "short cervix" issues. The baby was born floppy and anoxic during the last few minutes of the labor. Now, the baby has tremendous issues facing him due to HIE.

During the last month while the baby was in the NICU I have witnessed the passion and care of the NICU nurses. These are "sick" babies and require all of your expertise and close monitoring just like in adult critical care to prevent further complications.

judybsn · Jan 8, 2014

If you are trying to escape germs and other "dirty" issues, surgery and labor and delivery are better than most. NICU nursing is very interesting but hard emotionally. I tried it and couldn't take it long term. Too much death, suffering and suboptimal outcomes.

nurselindah, BSN, RN · Jan 8, 2014

"My reasoning for wanting to be this type of nurse is because I don't have to work with dirty older patients" Dirty old patients?

squirtcatt · Jan 9, 2014

I still can not get past dirty old patients!? That is just not right.