Caring for the sickest and smallest patients in the hospital not only takes a special level of knowledge and a unique skillset but also requires a great deal of compassion and personal strength. Becoming a NICU nurse is often not something one chooses directly out of college. However, some hospitals do hire new graduates. In most cases, registered nurses transfer to the NICU after working for several years as a floor RN or in the critical care unit or operating room.

Deciding whether or not the NICU is right for you can seem as if it is the most difficult decision of your life. It is also a decision that can change you dramatically, help you feel more content in your career and allow you to make a real difference in the lives of the tiniest patients and their worried family members. Whether you are a new NICU nurse or you are considering making the move into this department, here are some hints and tips to make your transition into caring for these fragile fighters as seamless as possible.

What Is the NICU?

The NICU is the neonatal intensive care unit where doctors and nurses care for the very sickest babies. These babies have often been born prematurely or with life-threatening complications. This unit is closed off from the rest of the hospital to decrease the risk for infections and to control the environment. Babies are monitored extensively and often need specialized therapies.

Understanding NICU Care: What It Is Like to Be a Neonatal Nurse

NICU nursing is an incredibly competitive field. Much like the labor and delivery floor, the neonatal intensive care unit is a popular place to work, and it may initially be quite difficult to get a job here. However, there are some ways to get your foot in the door if your hospital is not currently advertising open positions. The most helpful tip is to get to know a long-time nurse within that unit. Seek some mentor-ship opportunities, and let her know that you would love to get your feet wet on that unit. You may even be able to follow her during one of her shifts to see what your work would be like there.

As a NICU nurse, you will frequently be working in high-pressure situations that require you to think on your feet. When working with the sickest babies, you may only care for one or two babies at a time. In many cases, you will be working with a particular baby for a long period because many infants are in the hospital for several weeks.

NICU nurses need to be able to think critically and quickly. However, they must also have great communication skills not only for sharing important details with doctors but also for talking to the baby’s family members. These nurses must be able to remain calm even in stressful situations while also responding with empathy to families that are under a great deal of stress.

As a NICU nurse, you certainly want to be the most knowledgeable and empathetic health care provider that you can be. The following tips will help you succeed in your daily work, rise to the numerous challenges in your profession and develop improved skills for caring for your fragile fighters.

Work as a Team

Working as a NICU nurse is not always easy, but even on your worst days, you will always have your coworkers to help you get back up when you feel as if you are failing. Even though your patients are tiny, they can still be quite difficult to care for, and you may frequently need to ask for help. When you are able, help your coworkers. When you are having a difficult time, you can know that they will also have your back. By working as a team, you can all benefit from the team’s combined knowledge and experience.

Know the Numbers

There are many numbers to memorize in nursing just so that you can remember the norm for your patients. However, NICU nursing can be particularly difficult because the normal numbers for these tiny patients are often far different from what they would be for adults. Some of the most important numbers to memorize include the following:

-Heart Rate
-Mean Blood Pressure
-Arterial Blood Gases
-APGAR Scores
-Common Laboratory Values

Always Look Past the Numbers

While numbers are certainly important, they are not always the most important measurements of your patient’s health in the NICU. You also need to be constantly looking at your patient’s presentation, such as skin color and signs of distress. If you become too focused on the numbers, you may miss early clues that could be pointing to a patient with worsening health.

Assess Constantly

The health of these fragile fighters can change quickly and frequently. However, because you are almost constantly at your patient’s bedside, you will be able to assess the infant at all times. Watch the numbers, and listen to your gut as you determine whether the infant’s health status is changing for the worse. Even if you do not have a clear, measurable indicator of how your patient is doing, you may be able to predict what could happen just by looking at her.

Stay on Top of Changes in the Field

Neonatal intensive care units were first begun in the 1960s, and changes in the field of neonatology have been nearly constant since that time. While this is great news for parents and loved ones of the sickest children, it can mean a great deal of work for NICU nurses who have to stay on top of the field. Continuing education is one of the best ways to learn about these changes, and nurses should also feel free to ask neonatal doctors questions about patient care.

Regular Touch Is Invaluable

Many NICU patients are covered in wires and tubes and often have to spend a great deal of time in an incubator. However, whenever possible, these infants need to be touched by parents and nurses. Holding a baby can calm distress and normalize vital signs in many cases.

Get Additional Certifications

Because the field is rapidly changing and because working in the NICU requires a high level of knowledge, it is ideal for you to get additional certifications. A BLS certification is typically required before you can work here. An ACLS certification can also help you recognize heart rhythms and respond to codes. In addition, the CCRN (Neonatal) certification is designed specifically for NICU nurses who want to become knowledgeable leaders on their units.

How the Neonatal Resuscitation Program Certification Can Help

For NICU care providers wanting additional training in life support for neonatal patients, the Neonatal Resuscitation Program Certification, or NRP Certification, is an invaluable resource. This training helps care providers respond immediately and accurately to life-threatening health changes while providing the highest quality of neonatal resuscitation for such problems as asphyxia. This program is especially helpful for NICU nurses who assist during high-risk births.

At Project Heartbeat, we provide NRP Certification classes at our locations in Sacramento and Oakland, California. Classes begin with an online training portion that should be completed before attending class and is followed up with a two hour hands-on skills session. Upon successful completion, you will be given an NRP card from the American Academy of Pediatrics that is valid for two years. Contact Project Heartbeat today to learn how you can further advance your NICU practice.