NICU Series: Tips for the New NICU Nurse

Welcome to the NICU or Neonatal Intensive Care Unit. It is here we care for the tiniest patients on the planet. Equally fragile as they are small, the patients in the NICU rely on an enormous team of people to keep them alive. It takes years to hone your skill as a NICU nurse and just when you think you have learned it all, you will be humbled to find there is so much more to learn. It reaches far beyond the machines, the drips, and medications. It takes a very critical ear and eye to recognize the often subtle decompensation of these babies.

Come Prepared

Be sure to wake up the few extra minutes you need every day to take care of yourself. If you have 15 minutes, try to exercise a bit. Eat a high protein breakfast or dinner before starting your shift because you never know when you will have the time to eat. Drink plenty of water before as well to start your shift well hydrated. Bring a water bottle and snacks with you.

Breathe 

Take deep breaths before stepping on the unit. Breath in confidence. Breath out doubt. You can do this. 

Read 

Study, study, study. Eat, drink, and sleep theory. It is your job to have a strong grasp on the unique physiological challenges a NICU baby faces, whether a premature infant or an infant with myelomeningocele. While no single patient is the same, there is a standard for stabilizing and caring for each baby.

Take Your Time

Anything when first learned takes more time. Take the time to learn properly. Avoid rushing through things. It is so essential to take the extra time to disinfect any peripheral or central lines before accessing them. It is equally critical to take your time to allow your tiny patient to recover during any procedure. If your patient begins to decompensate, as they tend to do during a procedure, take a pause and allow them to recover. Focus on your patient, not on the task at hand.

Choose Your Words Carefully

Be careful how you speak with the parent of a NICU babe. They will hang on your every word. Talk with your experienced coworkers about what they would say under the same circumstance. Practice in your mind what you plan to say to the parents before you say it. Try to avoid saying “don’t worry” or “everything will be fine” to the parent. It is their job to worry and worry they will. Instead, perhaps as they leave, let them know the baby is in the best care. Encourage them to go home and rest so they can be strong for their baby. Never ever tell a parent that everything is going to be ok because you can not predict the outcome.

Join the Team

Recognize that it takes a team to care for this baby-each team member with his or her job and specialty. While as the nurse, you are at the center of this team, be a team player. No one person’s job is more important than the other. The nurse’s aid, respiratory therapist, dietician, physical therapist, psychologist, and doctor are with you in wanting what is best for the baby. Chances are they have years of experience on you which is a great opportunity for learning.

As you begin your career, begin from an open and humble place. You do not need to know everything when you step on the unit. What you do need is to be teachable, curious, and most of all vigilant. Best of luck to you!!

Lori is an American nurse and yogini living in Gothenburg, Sweden. She contributes regularly to Mighty Nurse, AWHONN, American Nurse Today, and has been featured in The Huffington Post. Follow her adventures through her blog, Neonurse, or on Instagram.

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