After over 10 years of working bedside, I realized there were few places to go to really understand the nuances of the NICU nurse world. Most sites lack personal perspective and only really scratch the surface. This is a BIG piece of why I started my blog and have focused on curating this space just for you. Here are the BASICS for becoming a NICU nurse: ATTEND NURSING SCHOOL (ADN or BSN programs — BSN is preferred for most NICU RN new grad positions) PASS NCLEX EXAM (nursing boards) APPLY FOR NICU NURSE JOBS (these can include new graduate positions, fellowships, or general RN positions)

To work bedside (as a NICU nurse) you need your Associates Degree in Nursing (ADN) or Bachelors of Science in Nursing (BSN). Bachelors degrees (BSNs) are becoming preferred for most positions. This is the same degree that’s required for all other RN positions. While additional specialty certification isn’t always necessary to get a NICU job, it does make you more marketable and versatile — and sometimes comes with an extra pay differential. After getting a certain number of clinical hours in your NICU specialty as a bedside RN, you can sit for your RNC or CCRN certification. This involves sitting down and taking an online examination, much like the NCLEX. You can decide which certification is best for you and your facility by asking unit leadership or experienced coworkers about which certification they hold. The most common NICU certification is RNC-NIC (this is the certification I obtained).

I took my RNC-NIC after 3 years of working as a bedside nurse. If you know me, you understand how much I worried throughout the certification experience. I’m a horrible student and test taker, and feared I wouldn’t pass the examination after hours of studying. I made it through, however, and I’m so glad I took the time and effort required to get it done! You can find out more about the RNC-NIC Certification via the National Certification Corporation (NCC) here, or in the exclusive nurse content included in my blog!

YES, I did! I was hired as a NICU New Grad Nurse and NO, I did not have prior NICU nursing experience. However, I interviewed for several different Nurse Residency Programs all over California & Arizona. It took me 8+ months and multiple interviews to land my first job out of nursing school. This is why I am so passionate about helping you all through the interview process. We don’t really learn interview skills in nursing school, despite them being a key factor in getting a job offer. If you are in the process of interviewing or want to know what to expect and how to prepare, I highly recommend our E-book and Podcast episode to help you in your process! SHOP MY NEW GRAD NURSE E-BOOK & RESOURCES! THINK LIKE AN ATHLETE! INTERVIEW PREP PODCAST EPISODE

Too many to count! I have compiled 10+ years of NICU nurse experience, crowd sourced from NICU colleagues, and combined it all here for you in this blog. Starting a new job can be challenging, and our very unique patient population can make the whole experience more nervewracking! Whether you’ve just landed your dream job in the NICU, are thinking about applying to nursing school, are studying for the NCLEX, or are a new grad considering where to apply - here’s some hot tips for you if you’re considering starting out your career in the NICU!

Any time someone is PAYING you to learn, I say DO IT! Nurse residencies, sometimes called “New Grad Programs”, are paid programs created to help nursing students transition to the professional nursing world. These often include a year of paid instructional time, either in a classroom or clinical setting, to help new clinicians find success and happiness in their new roles. Each facility or organizaiton structures their nurse residency program in a different way, and some are more competetive to get into than others. Research shows that nurses who start out in a residency program have higher retention and job satisfaciton rates. I personally loved my program, made great friends, and felt confident and competent when providing clinical care. I highly recommend starting in a nurse residency!

Everyone will give you a different answer to this question, so it can be tough to know who to believe! In my experience, the NICU is a great place to start! I began my nursing career in a NICU nurse residency program and have never felt like I needed any other experience to be happy and successful. However, I know plenty of amazing NICU nurses who started elsewhere and transitioned from other units like adult ICUs, L&D, postpartum units, PACU, or OR. In fact, when I was applying for jobs, I truly thought I wanted to be a CVICU/CTICU Cardiothoracic Pediatric Nurse. That was my passion and I felt so drawn to that population and their families! However, due to application process & job strategy, I opted to apply to NICU! At the time, the NICU was hiring more new grads and I thought I had a better chance of landing one of those jobs. I did get the job, and it was then that I discovered my love for preemies. Not only that, but I also have the opportunity to work with cardiothoracic patients within my level IV NICU! I’ve gotten the best of both worlds.

NO. You no not NEED to work med surg first. Many nursing students hear this type of guidance from professors and clinical instructors. In my opinion, however, you do NOT need to work in med surg prior to getting a job in your desired specialty. This is a relatively old school train of thought. My belief is that if you want to start in a specialized area, do it! With this having been said, it can be a bit more challenging to get a job in the NICU if you don’t have any previous nursing experience. It took me 8+ months and multiple interviews to land my first job, and at times I was frustrated and doubtful that things would work out how I wanted them to. If you find yourself having a challenging time getting a job offer, I have two pieces of advice: A FEW TIPS: ​​​​​​​ 1. 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 to your professional life. It’s never too late to change your mind. 3. You may have to move cities or consider a life change but the career you want is achievable. Be patient :)

Every facility and unit has different processes for hiring RNs looking to transition to the NICU. The best thing you can do for yourself is to immerse yourself in the NICU world as much as you can prior to applying for the job. Reach out to the NICU unit manager and ask them to shadow or volunteer on the unit for a day to see how the team works. This shows them that you’re seriously interested in the opportunity to work there. Becoming NRP (neonatal resuscitation program) and PALS (pediatric advanced life support) certified can help your resume stand out and show your dedication to becoming a safe NICU nurse. Enrolling in a NICU-specific educational course can also prepare you for the transition and can refamiliarize you with infant-specific care guidelines you might not remember from nursing school.

First things first: prepare to feel like a new grad again. It’s totally okay to feel like you’re starting all over — NICU is truly its own world. Vital signs, medications, care plans, priorities, emotions, treatments, and diagnoses are all so different. I have been a NICU nurse for over 10 years and STILL feel like I’m learning new things every shift. That’s why I LOVE our patient population. A few key NICU-specific things to remember: Heart Rate: 100-200 (anything below 60 makes you break out in sweats) Respirations: 10-100 (apnea is normal in preemies and is expected) FiO2 Sats: 85-100 (but sats of 50s are ok in some situations, as long as you have a heart rate!!) Temp: 36.5-37.5 C (anything outside of these are a big NO NO and require immediate intervention) NPASS: Pain Score 0-4 IV Med Volumes: we usually measure these per 0.01 ml (YES- you read that correctly. Every 0.01 mL flush behind the med is also technically a bolus: we take our decimal points seriously here when doing med calcs!!) Care Plan Considerations: these are all based on gestsational age & weight Skin to Skin: this is an essential part of your plan of care Caffeine is your best friend (in coffee form for yourself and medication form for your patients) Poop is something you will celebrate (trust me, this is easier in the NICU than most other units LOL) Just know you are in the right place and you’ve got plenty of support to help you in your journey! xo

GREAT question. Frankly: yes. The skills you need for working in the NICU are so specific and unique that most of the skills you learned in your other unit are no longer relevant. However, some of the most important skills you need to be a good nurse transcend all specialties and unit types: Compassion and empathy towards patients and families Medication calculation Efficient and timely charting Prioritization, delegation, and communication Staying calm and collected in stressful and critical situations Every unit, clinic, hospital, community setting you go into will be unique in its own way. There is no way to keep up with every skill you were introduced to in nursing school or your previous units. However, the beauty of nursing is you can always try something else! I have worked as a travel nurse & pediatric critical care float nurse (CVICU, PICU, NICU, & Oncology)! It’s exciting to relearn about patient populations and update your 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 relearn it. Nursing is like riding a bike; you just get back on and try it again — it’ll all come back so much quicker than you think! GET ALL THE DEETS HERE: THE CELLFIE SHOW - LIFE OF A NICU NURSE

Yes I do! TOO MANY TO COUNT! After working for over 10 years in the nursing field and spending an incredible amount of time applying for jobs (new grad positions, travel nurse positions, per diem & staff nurse jobs, you name it) I have loads of experience with the nurse interview process. Filling out the online applications can be overwhelming, but landing that interview is so exhilarating and all of my jobs have been worth every ounce of anxiety and fear! Here are some of my top “Nurse Interview Tips and Tricks” I have learned along the way. Head over to my blog to check out all of our pearls of wisdom, resources, Nurse Report sheets, SBAR printables, interview prep tips, resume writing, tips & tricks as well.

I love so many things about being a NICU nurse. I have a true passion for the neonatal patient population & helping families through some of the toughest times of their lives. Some babies have no parental presence at their bedside, and being their advocate and caregiver as they grow bigger and stronger is such a powerful experience. From the adrenaline rushes, emergency procedures, detailed medication calculations, and unpredictable diagnises, I love being on my toes with these babies. Pre-op prep, surgical care, cardiac anomolies, neuro protection, GI/GU diagnoses; everything is so important when caring for such a complex patient population. I love expanding my knowledge by attending classes and conferences, earning new certifications, and challenging myself at the beside by taking on new leadership roles. I also love the flexibility that comes with working in the NICU. I have worked full time nights, part-time, per diem, travel nurse contracts, and even worked as a pediatric float nurse for a year (NICU, PICU, CVICU, oncology, etc). Being a nurse offers a variety of different opportunities, schedules, specialties, and educational growth — it’s a career unlike any other. My love for the NICU doesn’t stop at the bedside. After much time learning, soul searching, and networking, I decided to start a podcast! I realized I had this huge network of providers, innovators, and people of interest to bring to you! In addition, I also value education & am working to advance my degree. I decided to take a big leap and chose the MSN route. I’m currently an MSN Capella University sponsored student. This is the beauty of nursing; there are so many opportunities out there! xo

There are many reasons why a baby would end up in a NICU. The reason could be as simple as dehydration from breastfeeding difficulties and could be as complex as a life threatening diagnosis or congenital disease. The type and complexity of the diagnoses you may see depends on the level of NICU you work at. Acuity levels range from I-IV, with level IV facilities providing the most comprehensive and complex care. Diagnosis Include: Prematurity (babies born before 37 weeks of pregnancy) Early term infants (babies born between 37-39 weeks of pregnancy) Low birth weight (babies that weigh less than 5.5 pounds) Micro-preemies, Sepsis (serious infections) Respiratory Distress Syndrome (RDS) Heart Defects Congenital anomalies Respiratory failure Birth defects Trauma Seizures Gastroschisis Hypoglycemia Intrauterine Growth Restriction (IUGR) Intraventricular Hemorrhage (IVH) Jaundice Necrotizing Enterocolitis (NEC) Multiples (Twins, Triplets) Neonatal Abstinence Syndrome (NAS, drug addicted mothers) Unknown pregnancies Precipitous birth Placental Abruption, etc. Learn more here....NICU 101

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, and it can be draining. Patients coming to us at their best & worst is our everyday job. We work with life & death, tending to those new to the world and those on life support. Every day, we are witness to the happiest & saddest of the human experiences. To be frank, it is a lot, both mentally & physically. I do find ways to grow as a nurse. For example; I participate in committees, attend conferences, take classes, precept, and take on projects. However, I have also learned to set boundaries and tell managers and coworkers "No”. No to overtime, no to working extra weekend shifts, no to writing research papers when I already feel bogged down. It’s taken me my entire career to learn this, and trust me: I’m still practicing! I went through a heavy "burnout" period early on in my bedside career. 3 years into NICU I was very "burned out," and I decided to make a change; this is when I took on my first travel assignment. That helped me rekindle my love for bedside and reminded me why I love my job. Now, I prioritize balance. That is my biggest pearl of wisdom. I juggle bedside care, studying to become a Family Nurse Practitioner, instagramming, blogging, developing my new business, spending time with my husband, exercising, riding horses, and relaxing at the beach.

NO! I know plenty of nurses who made "nursing" their second or third career. It takes 2-4 years to get through nursing school, with 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, personal ups & downs: that is what will make you relatable and an empathetic nurse. ​​​​​​​CHECK OUT MY BLOG POST ON "NICU NURSE 101" CHECK OUT MY PODCAST FULL OF NICU NURSE HOT TOPICS!!!