This is a question that has been nagging me for quite some time.
Why is it so horrible for us to plan out our route? I want to become a NNP and as stated in a previous thread, infants are the only reason I chose nursing instead of completing a tech degree. From what I have seen on this board and a couple of others say, nursing students shouldn't choose their route before clinicals. But many pre-med programs allow students to choose their route beforehand. I even have a close friend who is a pre-med major and they are writing research papers about their route.
We all started nursing school with some specialty in mind, and I applaud your passion for NICU, but bare with me for a second.
I went into nursing school because I ABSOLUTELY wanted to be a NICU nurse. There was absolutely no other specialty that appealed to me, and I worked in a hospital so I was exposed to every unit. In nursing school, I had the unbelievable experience of doing a clinical in a NICU (my OB teacher worked at the hospital). It was a Level IV NICU, with an international draw - we had patients come to us from 3 different continents. It was unreal. I was so excited to work with babies but I quickly realized three things.
1. Premature babies are extremely vulnerable and you cannot make a mistake. Their drugs are basically are all given in micrograms which can be very daunting.
2. You need to have an exceptional foundation in peds to work in a NICU. If you don't have an incredible preceptor as a new grad, I can't even imagine how you would be able to learn everything you needed to work with kids unless you had some experience in a med surg area.
3. However, those were not the reasons I chose another specialty. My biggest problem with NICU was some of the parents. I had no problem with loving parents who cared about their child. Unfortunately, that was not the type of parent I saw frequently. I saw the cocaine mom who never came to visit and I saw the 22 year old mom on her 5th kid or I saw the 2 parents who hated each other so much, we had to assign them different visiting hours with security present. The last draw was getting attacked by a "father" who wanted to see his kid, but he forgot the "mothers" last name and he was not allowed in.
As for pre-med students, they have no more support than a pre-nursing student does about their interests. The vast majority of nursing and med students change their minds about their specialty so nurses are not out-of-line to question your dedication to a specialty you do not yet work in. You may very well end up in NICU, but what I am trying to say is that an open mind will help you more than an attitude of absolutes. An open mind opens a lot of doors. If you haven't worked or practiced in a NICU, you don't know what you don't know.
After nursing school I worked on a cardiac floor for years and absolutely loved it - high intensity, but adults who could make their own decisions. After 20 years as a nurse, I am now am a college professor who guides others to their dreams. I go out of my way to give them experiences in their area of interest, some even more passionate than you, but I am never surprised when they change their mind.
I truly hope you find your dream job some day, your passion will serve you well.
While I applaud your advocating for your students and teaching the next generation of nurses (such a tough and underpaid job), I wanted to point out an inaccuracy for posters here and for yourself, this coming from someone with 8 years in the field of neonatology that currently practices as a neonatal nurse practitioner.
You absolutely do not need (and I personally believe that it hinders the majority of aspiring NICU nurses) pediatric experience, let alone med-surg experience. Babies are so completely different from the big kids & adults that even learning the normative values of vital signs is completely different and your "instincts" are off when you form into your mind those values.
As I mentioned in a previous post, I've had the opportunity to work at or do clinical at 3 children's hospitals, each of their NICUs ranked in the top 10 in the nation and they've all told me that new grads tend to transition better than nurses who are new to NICU but not nursing because of this and don't have any "bad habits."
While your pre-med friend should have some inkling as to what they might like to do should they indeed get into medical school and have the opportunity to apply to residencies, it's perhaps a bit presumptuous or naive for an undergrad chemistry major to say definitively, for example "I am going to become a cardiothoracic surgeon" when there are so many "what-ifs" on the horizon, ie get a competitive MCAT score, get into/complete med school, get accepted to the residency program of their choice, all the step exams in between, applying for fellowship, etc. And it's not too crazy to imagine that somewhere during the course of all that education, one might find that their clinical interests may change. Maybe during their five year stint as a general surgery resident they would realize that they like working on kidney/pancreas transplants better than the open hearts. I personally know two anesthesiology residents who switched residency programs after the intern year of a general surgery program, so interests do change the more you expose yourself to any field.
The same goes for nursing, though it's typically a bit of a shorter road to the loftier goals, FNP, NNP, CRNA, etc etc. I'm sure that based on your level of interest and drive that you will indeed do well working with neonates in an intensive care environment and will eventually be accepted to the graduate program of your choice. But perhaps it's important to maintain some sense of perspective that your interests may change, the more you learn about the field and your own skills. Perhaps, once you're in the thick of immersing yourself in learning critical care nursing, you'll get interested in pursuing anesthesia rather than NNP. Or maybe you'll find that as much as you like babies, working with neonates is not for you. Or maybe you'll follow the exact track you have planned for yourself without a hiccup, it's all possible.
I think I understand the sort of "shaming" you are referring to and while I don't think it's always necessarily nice or appropriate, being many years out of school and now applying to graduate programs, I can sort of see both sides of the story. As an undergrad nursing student and now as a professional nurse, I have always had plans to pursue graduate education. These plans have shifted somewhat as I exposed myself to various fields of nursing, slowly working "up the ladder" in terms of level of acuity. Of course, as is common, the more I learned, the more I realized I previously didn't know.
I'm sure it can be a bit grating for veteran ICU nurses (which I am not) to meet a brand new RN, orienting in the ICU, who says that they are going to become a CRNA before they even really know what propofol or phenylephrine are, or how to use them. I'm sure there are examples like this in every field of nursing. I certainly don't think these more senior nurses should be trying to crush the dreams of new nurses/nursing students just because they are inexperienced. Honestly, in the examples of this sort of "shaming" I have seen, it's usually based on some level of insecurity or jealousy that someone young has the drive and ability to pursue an advanced education that they never had the stones for.
But on the other side of the coin, sometimes new nurses and nursing students can come off as just plain...arrogant and dumb. I'm sure you are not one of these people, but if you are catching flack for airing your career plans publicly, maybe examine how you are doing it and the language you use. As someone who has appeared dumb or naive many, many times in my life, I can certainly speak to this. It's wonderful to have lofty goals so early in your professional career, and nobody should be discouraging you. But like it or not, you still have to "earn your stripes" on some level in order to gain credibility with your peers. So look up to your veteran nurses and show that you understand that they have a lot to teach you, even pretend it with the lazy ones . Help out on the unit as much as you can, look for learning opportunities, learn how to ask for help and delegate. Understand that sometimes you just don't have the experience to know what you don't know. Try to avoid saying naive or arrogant things . Good luck!
You absolutely do not need (and I personally believe that it hinders the majority of aspiring NICU nurses) pediatric experience, let alone med-surg experience. Babies are so completely different from the big kids & adults that even learning the normative values of vital signs is completely different and your "instincts" are off when you form into your mind those values.
Thanks for the kind words. I absolutely love teaching.
To respond to your comment, It depends on the preceptor experience. I run a post baccalaureate nurse residency program through the university I work in. If you do not have trained preceptors and a CCNE accredited residency program, it can be a crap shoot. I have had a number of nursing students try to work in an ER/ICU/NICU/CVICU, etc, and the skills needed are not unlike other floors (critical thinking, assertive communication, ability to recognize change in condition) but those having at least 2 years experience as a nurse tend to have higher ability to drive from past experience and are more advanced in the aforementioned qualities. Many managers I work with also require some sort of peds or OB experience as well. I think it might be regional, but my main message for the OP was her need to remain flexible. She will need to be if she wants to be a nurse. :)
Specializes in Psychiatric RN & Retired Psychiatric CNA.
There's quite a bit of inaccurate information in this thread; I'll do my best to address some of it. Before I do that- OP, there's nothing wrong in wanting what you want and knowing it. May not be judicious in telling everyone in the world that- there are lots of people who will not be supportive and may bring you down. I especially wouldn't talk about it as a new grad working in the NICU to your colleagues.
I knew I wanted to do NICU the moment someone told me that taking care of sick babies was a "thing." Had never stepped foot in a NICU before. Knew I wanted to do NNP shortly before I graduated from nursing school. Never took care of an adult as a RN and don't have any intentions (well...maybe midwifery if I get crazy enough one of these days).
Many hospitals (most?) do not hire PAs into the NICU
2. Many NICUs are full of "infants" that are a few months old and my license is from ages 0-2, so if you want to take care of older infants, I would suggest working at a children's hospital where many NICUs keep them for an extended period of time (my oldest was 14 months old!!)
3. Academic hospitals hire new grads all.the.time. I've had experience with 3 different children's hospitals and they've all told me that they prefer new grads to experienced RNs (in other specialties, obviously an experienced NICU RN is most preferential) because they transition easier and don't have bad habits to break from the adult world. Like the fact that we are coding when the heart rate is
4. You absolutely don't need to do any other kind of nursing job in order to be a successful NNP. I've been told that I needed a year of med-surg first by other nurses and some old professors. Nope.
Best of luck OP. People are right; you could change your mind (I thought I wanted to do trauma and ICU as a nursing student) but maybe not. Have fun in school!
Late to this thread but just came to say many residents are a non-match for what they want, so even if med students declare a "specialty" they still have to rotate all over the hospital as students and as interns. And many *do not* end up with their first choice. There is plenty of in-fighting and sniping between them as the surgical residents fuss with the internal med peeps and they give it right back. Grass isn't greener and I don't think they have it easier than we do. You can hear the weariness in their voice on the phone when they say "I'm just cross covering..."
+1 to everything you said and honestly I cannot imagine how it would be helpful to pigeonhole myself before I had even graduated. It is great to have goals and a passion, however, the job market is tough and it makes no sense to stay unemployed while you wait for a coveted NICU position. I took a job in a specialty I had never thought about before; now 18 months later I will be transitioning into another specialty I had never thought about before.
Specializes in Perinatal, Substance Use Treatment- Outpatient.
Hey OP! If you are willing to relocate, please look at Marshfield, WI. Our St. Joseph's Children Hospital NICU hires new grads. We are a smaller 24 bed level III unit with many interesting cases. I was hired straight out of nursing school and have been there 4 years now. Don't get discouraged. It is possible! Best of luck!
Hey OP! If you are willing to relocate, please look at Marshfield, WI. Our St. Joseph's Children Hospital NICU hires new grads. We are a smaller 24 bed level III unit with many interesting cases. I was hired straight out of nursing school and have been there 4 years now. Don't get discouraged. It is possible! Best of luck!
How is that place doing now? It has had a rough couple of years with all the transitions.
Specializes in Nephrology Home Therapies, Wound Care, Foot Care..
Actually had the opposite situation recently. A lecturer asked everyone what area of nursing they want to go into. We are 3rd semester students. Anyone who said they weren't sure yet hot a dirty look, anyone who named a specialty other than the one the lecturer is in, was making a poor choice! Lol!
Specializes in Perinatal, Substance Use Treatment- Outpatient.
How is that place doing now? It has had a rough couple of years with all the transitions.
Day to day operations haven't seen any changes. We are still doing our jobs, with no shortage of babies! Of course, we tend not to actually know what the future of the organization holds, but that is generally the way of things in any company. As of now, our NICU isn't going anywhere!
. Help out on the unit as much as you can, look for learning opportunities, learn how to ask for help and delegate. Understand that sometimes you just don't have the experience to know what you don't know. Try to avoid saying naive or arrogant things 
babyNP., APRN
1,923 Posts
While I applaud your advocating for your students and teaching the next generation of nurses (such a tough and underpaid job), I wanted to point out an inaccuracy for posters here and for yourself, this coming from someone with 8 years in the field of neonatology that currently practices as a neonatal nurse practitioner.
You absolutely do not need (and I personally believe that it hinders the majority of aspiring NICU nurses) pediatric experience, let alone med-surg experience. Babies are so completely different from the big kids & adults that even learning the normative values of vital signs is completely different and your "instincts" are off when you form into your mind those values.
As I mentioned in a previous post, I've had the opportunity to work at or do clinical at 3 children's hospitals, each of their NICUs ranked in the top 10 in the nation and they've all told me that new grads tend to transition better than nurses who are new to NICU but not nursing because of this and don't have any "bad habits."