Frequently Asked Questions
What is your favorite part of being a NICU Nurse? Would you consider another specialty?
I love being a NICU nurse. I have a true passion for the neonatal patient population & helping families through the hardest time of their lives. (and sometimes babies with NO parents at all). From the addrenaline rush, procedures, attention to detail, and unpredictable patient population I love being on my toes with these babies. Pre-op, Post, op care, Cardiac, Neuro, GI/GU, it is so complex caring for such a complex patient population. In addition, I continue to improve my knowledge with classes, conferences, certifications, challenging myself at the beside & taking on new leadership roles etc. Three years into my career I sat for my national NICU Nurse certification.
After much time soul searching, networking, and seeing so many things happening here in the heatlhcare space, I decided to start a Podcast. I realized I had this huge network of providers, innovators, people of interest to bring to you! And that being said, I also saw an importance to advnace my degree. I decided to make the leap and head back to school! I decided on the MSN route. xo And this is the beauty of Nursing! There are so many opportinities out there!
CHECK OUT MY BLOG POST ON "NICU NURSE 101"
Did you get a NICU nurse position as a New Grad? Did you have prior experience?
YES. I was hired as a NICU New Grad Nurse & NO, I did not have prior nursing experience. I interviewed for several different Nurse Residency Programs all over California & Arizona. It took me 6 months to land my first job out of Nursing school.
(Side note: NICU was my "runner up unit," when I was applying to New Grad Nurse Positions) Initally, I wanted to start in Pediatric CVICU or CTICU (Cardiovascular or Cardiothoracic Units).
However, I applied to NICU out of strategy (they were hiring more new grad nurses). Looks like the big guy had a plan! Sometimes your runner up is Plan A all along!
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Is NICU a good place to start as a new grad? Would you suggest experience elsewhere before applying?
Yes, it is a great place to start as a New Grad Nurse! I loved my Nurse Residency Program and don't feel you need experience elsewhere before applying.
However, I know plenty of amazong NICU nurses who trasnitioned from other units! (Adult ICU, L&D, Mother Baby units, PACU, OR, etc).
In fact, when I was applying for jobs I truly thought I wanted to be a Cardiothoracic Pediatric Nurse. That was my passion! However, due to application process & job strategy. I opted to apply to NICU! (The NICU was hiring more New Grads.) I landed the job, discovered my love for my Preemie population & now, I have the opportunity to work with cardiothoracic patients within my level IV NICU! Best of both worlds.
My point? You never know where you will land! And embrace your journey! You never know!
Work Life Balance. How do you cope with day to day stress?
Working as a Nurse (or in any Healthcare position for that matter) is one of the most rewarding and taxing jobs out there. We are in the business of curing and healing people. Quite honestly, it can be very draining. People are at their Best & Worst in our everyday job. We work with life & death. Life & then life support, the happiest & saddest of the human experiences. To be frank, it is a lot, both mentally & physically.
At this point of my career I have learned boundaries. I do find ways to grow as a nurse. For example; I participate in committees, attend conferences, take classes, precept, take on projects, etc.
However, I do have moments when I say "No." I learned this over time & with experience. (I went through a heavy "burnout" time period early on in my bedside career. 3 years in I was very "burned out," and I decided to make a change; this is when I took on my first travel assignment. That truly helped me rekindle my love for bedside!).
Now, I enjoy my bedside care, studying to become a Family Nurse Practitioner, instagramming, blogging, creating a new business, time with my husband, family & friends, working out, riding horses, beach time, skiing etc.
Find balance. That is my biggest pearl of wisdom.
If I go into the NICU will I lose all my skills?
Well, frankly Yes. Working in the Neonatal population is very different than any other unit. (We don’t do “BIG people”) Our vital signs, medications, priorities of care, etc. all ALL different. Truly any unit, clinic, hospitcal, community setting you go into will be unique in its own way.
There is no way to keep up with every skill (you only kind of learned) in nursing school or your home unit.
But the beauty of nursing is you can always try something else! As of now, I am currently relearning so many things in my Family Nurse Practitioner's program! It is exciting to relearn about patient populations and update skills!
If you decide you want to move on & try something new you can! Just because you "lost" your skill doesn't mean you can't learn it back. Nursing is like riding a bike. You just get back on and try it again.
Do I need to start in Med Surg first & then work in NICU?
NO!! This is another question I get quite often.You DO NOT NEED to work on the floors first! ICU vs Med Surg nursing are very different skill sets.
After venturing the Los Angeles & Orange County CA areas, I can confidently say nursing is becoming more and more boutique, with specialized care. Therefore, if you know you want to go into the Neonatal Population (or any specialty for that matter), “DO IT!”
This being said, it is a very competative market out there. It is often difficult to land your first job in a NICU Nurse Residency program. If you find yourself unable to land your first job there I have two pieces of advice.
A FEW TIPS:
1. First, embrace your journey! Everyone's path is different. Who knows where your personal nurse journey will lead you.
2. If you work for a while & find yourself miserable, take time to spruce up your resume & portfolio; research Nurse Transition programs or Fellowships & make some changes.
3. You may have to move or consider a life change but it is dueable.
HECK OUT OUR PRODUCTS & RESOURCES TO HELP YOU LAND THAT DREAM JOB!
I want to be a NICU nurse but don’t know where to start?!
- Get your Bachelors of Science of Nursing (BSN)
Research Hospitals with New Graduate or Nurse Residency Programs
Volunteer, Network, etc.
Spruce up that Portfolio & Resume
Practice Interviews (over & over & over)
Apply to NICU units in your unit & all over
Be open to new ideas and adventures!
CHECK OUT www.nursesaf.com (Resume Templates, Shift Checklists, etc)
Going from Adult unit into NICU any suggestions?
Prepare to feel like a New Grad again. And it’s OK. NICU is truly its own world. Vital signs, medication, plan of care, priorities, emotions, treatments, diagnosis, etc. are all so different. I have been a NICU nurse for 6 years and STILL feel that way (especially working in a Level IV NICU setting.
When the Norms are:
Heart Rate: 100-200 (anything below 60 makes you break out in sweats)
Respirations 10-100 (apnea is normal and always expected)
FiO2 Sats: 85-100 (but sats of 50s are ok, as long as you have a heart rate lol)
Temp: 36.5-37.5 C (anything outside of these are a big NO NO)
NPASS: Pain Score 0-4
IV meds are in .01 ml (NO seriously. And your flush behind the med is technically a bolus)
ALLL Plan of care is based on Gestsation & Weight
Skin to skin is an essential part of your plan of care.
HFOV (Oscillator) is your best friend
Caffeine is you other best friend
Poop is something you will celebrate.
You know you are in the right place xo
CHECK MY BLOG POST ON "NICU NURSE 101" FOR MORE INSIGHT!!
What type of diagnosis do you see in the NICU setting?
There are many reasons why a baby would end up in a NICU. As simple as dehydration from difficulty breast feeding to life threatening diagnosis or congenital diseases.
This being said, there are 4 types of NICUs. Level I - IV
Level I, Well Newborn Nursery.
1. Babies born on time (at about 40 weeks) who are stable (for example, they can breathe on their own and can maintain their body temperature)
2. Babies born at 35 to 37 weeks who are stable
3. Babies who are sick or born before 35 weeks, but only until they can be moved to a nursery with a higher level of care
Level II, Special Care Nursery. This kind of nursery has a clinical team who takes care of:
1. Babies born at or after 32 weeks who weigh more than 1,500 grams (3.3 pounds). These babies may have some health problems, but they’re not so serious that they need a higher level of care.
2. Babies born before 32 weeks or less than 1,500 grams, but only before being moved to a higher level of care.
3. Babies who have just gotten out of a newborn intensive care unit (also called NICU) and are growing and doing well before being able to go home.
4. Babies who need equipment to help them breathe. These babies should stay in this kind of nursery only for about 24 hours or less; if they need breathing help longer, they should be moved to a higher level of care.
Level III, NICU. This kind of nursery has a clinical team who takes care of:
1. Babies born before 32 weeks who weigh less than 1,500 grams.
2. Babies of any age or weight who are critically ill.
3. Babies who need equipment to help them breathe to stay alive.
4. Ideally, babies with conditions that are known before birth and who need this level of care are born in a Level III hospital and don’t have to be transported (moved) from a lower level nursery after birth. This nursery has a full range of health care providers, including pediatric subspecialists (for example, doctors who specialize in treating children’s heart, lungs or kidneys), specialized nurses and equipment to care for very sick babies.
Level IV, Regional NICU. This is the highest level of care for babies.
1. This kind of nursery has a clinical team who takes care of babies who need special surgery for birth defects and other disorders.
2. This nursery has a full range of health care providers, including pediatric subspecialists, specialized nurses and equipment to care for very sick babies.
Preemies, Micro-preemies, Respiratory Distress Syndrome (RDS),
Heart Defects, Gastroschisis, Sepsis, Hypoglycemia,
Intrauterine Growth Restriction (IUGR), Intraventricular Hemorrhage (IVH),
Jaundice, Necrotizing Enterocolitis (NEC), Sepsis,
Multiples (Twins, Triplets), Neonatal Abstinence Syndrome (NAS, drug addicted mothers), Unknown pregnancies, Precipitous birth, Placental Abruption, etc.
What certification do you need as a NICU Nurse?
To work bedside (as a NICU nurse) you need your Associates Degree in Nursing (ADN) or Bachelors of Science in Nursing (BSN).
Bachelors (BSN) is becoming preferred for most positions.
After two years of working in your specialty you can sit for your “certification.” The most common NICU certification is RNC-NIC (this is the certification I obtained).
Can you explain more about the RNC-NIC process?
I took my RNC-NIC after 3 years of experience. And if you know me, you understand how much I hated this. (I am a horrible student & test taker...but I did it, and so glad I did.)
Nurses can take the RNC-NIC Certification for Neonatal Intensive Care Nursing via the National Certification Corporation (NCC).
RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC)
1. Current licensure as an RN in the U.S. or Canada.
2. 24 months specialty experience as a U.S. or Canadian RN comprised of a minimum of 2000 hours (this must have occurred sometime in your career).
3. Specialty experience can be comprised of direct patient care, education, administration or research.
4. Employment in the specialty sometime in the last 24 months.
5. Both practice time and hours must be met. This is not an either/or criterion.
I took a 3 day course in preparation for the exam. Personally, I think that was the most benefical part for my personal nurse career growth. (Other than having my RNC certification, which has given me more opportunities over other candidates fo sho). xo
BUT WAIT THERE'S MORE!
NCC is pleased to debut two new subspecialty exams for those wishing to demonstrate their expertise in the Care of the Extremely Low Birth Weight Neonate (C-ELBW) and Neonatal Neuro-Intensive Care (C-NNIC). Don’t wait, be the first to earn your C-ELBW or C-NNIC certification.
Certified-Care of the Extremely Low Birth Weight Neonate (C-ELBW)
ELIGIBILITY: Subspecialty Exam leading to C-ELBW Certification
Current licensure in the U.S. or Canada as a physician, registered nurse, advanced practice registered nurse (NNP, CNS), neonatal therapists (PT, OT, SLP), neonatal dietitians, pharm-D, respiratory therapist or paramedic.
The license number, licensing state or province and expiration date will need to be recorded. You will need to upload a verification of current licensure.
No practice experience is required but it is recommended that you have a minimum of one year of experience.
CREDENTIAL: All those who successfully complete the Care of the Extremely Low Birth Weight Neonatal certification examination will be entitled to use the credential C-ELBW.
Certified-Neonatal Neuro-Intensive Care (C-NNIC)
ELIGIBILITY: Subspecialty Exam leading to C-NNIC Certification
Current licensure in the U.S. or Canada as a physician, registered nurse, advanced practice registered nurse, or respiratory therapist.
The license number, licensing state or province and expiration date will need to be recorded. You will need to upload verification of current licensure.
No practice experience is required but it is recommended that you have a minimum of one year of experience.
CREDENTIAL: All those who successfully complete the Neonatal Neuro-Intensive Care certification examination will be entitled to use the credential C-NNIC.
NICU Residency Programs, what is your opinion? Yes or No?
Any time someone is PAYING you to learn, I say DO IT!
Nurse Residencies “New Grad Programs” “Versant Program” are all paid transition programs from nursing school to the professional Nurse world.
They are all slightly different types of programs but all basically the same idea. Get paid to learn your specialty. I loved my program & say YES DO IT.
I am 35+ Am I too old to become a Nurse?
NO! I know plenty of nurses who made Nursing a second or third career!
It takes 2-4 years to get through nursing school. (Pre-rec time included).
If you become a nurse at 40, you still have 25+ years of work potential!
I personally think some of the best nurses come into the industry with seasoned life experience. Life, family, ups & downs, that is what will make you relatable.
I am working in another unit, how do I transition into the NICU setting?
There are a few ways to tackle this!
1. Research transitional programs. "Fellowship" or "Transitional Nurse" Programs. Many teaching hospitals (Children's hospitals, University Hospitals) etc. have programs where you may apply with prior experience.
2. Depending on your background and location you may need to consider a commute or even moving. But embrace your journey! Who knows where it may lead!.
3. Consider a "Float Pool RN position" often times float RNs will work in the NICU setting caring for the less acute patients, (Great exposure and experience!)
4. Research lower level NICU or Mother Baby Units. Example: Nursery units (Level I-II NICU) units may consider a candidate and from that experience you can apply to a (Level II-Level IV) NICU unit.
I want to start Travel Nursing but don't know where to start!?
I loved my Travel Nurse experiences! After 3 years of working bedside I felt ready to spread my wings and learn from other NICUs in the Southern CA area.
I gained experience, strength at the bedside, learned new Evidence Based Practices, met some amazing nurses (and healthcare providers), made new friends, networked, etc!
I was fortunate to work with some amazing companies and have some GREAT rescources for you!
Please email me for
QUESTIONS & HELP TO START YOUR TRAVEL NURSE INQUIRES!
Do you have any interview or job application Tips?
Yes I do!
Check out my Blog post:
"12 NURSE INTERVIEW TIPS AND TRICKS!"
Check out my Blog post:
"51 Nurse Jobs to Consider!"
In addition, my interview "Tips & Tricks" have been compiled in our E-Book!
Head over to check out all of my pearls of wisdom, resources, Nurse Report sheets, SBAR pintables, interview prep tips, resume writing, tips & tricks
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