I don't have a question, but I wanted to give some input on the new grad asking about NICU positions. Here in Anchorage, AK we have a fabulous new grad program where you receive a full year of training in the NICU! They call it an "internship" but you are getting paid like an RN, you are on the unit, and they expect you to continue to work for the unit.
Hey thanks! That’s awesome! Thank you for sharing that with everyone!
Would you provide some NICU specific interview questions? Thank you very much.
So I’m not in the business of hiring in the NICU but here are some things that I would want to know about a future co-worker:
1. anything to do with prioritization of care
2. what is it about the neonatal population that interests you
3. what is it about an icu that interests you
4. what would you do if you saw a well-meaning parent providing inappropriate care for their baby? (i.e. a mother over stimulating her 26-week infant)
5. how do you handle stressful situations
6. give a specific example of how you advocated for a patient who could not speak/do for themselves
You don’t have to know everything about the NICU to be hired into one (trust me, I’m living proof!). Know about the organization - are they big on family centered care? What’s some cool research that’s come out of their unit recently? Maybe they have a really low VAP or CLABSI rate and you admire that…
Know why you want to work in the NICU. “because it seemed cool… like the logical choice… i really love babies…” doesn’t cut it. Be specific, i.e. “I’ve worked with newborns for a year now and want to expand my knowledge base with more critical situations” … or… “I really enjoyed the adult ICU and how it tested my critical thinking and need to be constantly vigilant. I’d love to combine that environment with my love for the neonatal population and learn about their specific needs”.
Have examples of how you used your critical thinking, how you dealt with a bad family, a terrible co-worker, or when you did something wrong. Be prepared to talk about the situation, what you did about it and the result. This shows that you’re able to grasp out farther than just the intervention phase of patient care. Be prepared to talk about good things too! What are you most proud of? When was there a time when you know that your care specifically made a difference to a patient.
I hope this helps! Do a google search too about questions to ask. There’s lots of stuff out there. Good luck!
Thank you so much for your reply regarding new grad friendly hospitals! CA is a great place to work. The major problem is the high volume of applicants. Most hospitals receive 500-1000 applicants. UCSF had around 17000 (that's right 17000!) applicants for their new grad program. Standing out with no previous health care related experience is hard. I have started volunteering though. I highly recommend the American Red cross or local clinics.
Wow. WOW. WOW!I had no idea UCSF was that competitive! Now I know why we had residents from California! I really, really suggest looking at residency programs from all over the US if you don’t have to stay in your current location. I moved over 700 miles for mine!
Best part? I totally fell in love with my hospital and town! Bought a house and am here to stay!
I’m sending good vibes your way! Super glad to hear you’re being smart and proactive by volunteering. It gives back to you and the community and you can’t beat that!
When my older sister was born a little over 5 weeks early with her lungs and other parts not fully developed the doctors told my mom that she may not grow up normally. That was almost 20 years ago, and she has grown up one of the smartest people Ive known. My question is how often do you (as in nurses and doctors) tell parents that there may be a problem in the mental development of a child. Is this often the case with ICU babies?
First off, glad to hear your sister is doing well!
There are a couple of things I wanted to address with your question if that’s okay.
First, your direct question of: “how often do you (as in nurses and doctors) tell parents that there may be a problem in the mental development of a child? Is this often the case with ICU babies?”
Speaking personally, unless I have hard evidence, there is rarely a time when I will out and out say that a child will have concerns with mental development. This conversation only occurs when I’ve seen diagnostic data, seen clinical symptoms manifested by the infant, and built enough of a relationship with a family to have such a hard conversation.
There are always the easy ones to say, “Yes, this baby will definitely have some level of mental acuity issues”. This can include a genetic diagnosis such as cri-du-chat syndrome or holoprocencephalies or even such a diagnosis as Trisomy 21 aka Down Syndrome. Other times, we may see something diagnostically on a head ultrasound or MRI.(Click on bold-typed for links to more information.)
Infants born more than 10 weeks early are at high risk for intraventricular hemorrhage of the brain. This brain bleed (graded 1-4 based on severity) cannot be cured. We do everything we can to prevent it. Often times, the less severe bleeds resolve on their own. Sometimes though, these bleeds can be so severe that there is a shift in brain structure. (i.e. A “Grade 4 with a mid-line shift” would prompt a conference between the health care team and the family about the long term outlook of the baby.)
There are other issues including hypoxic events that can lead to seizures or cerebral palsy. Unfortunately, these cases are often a wait-and-see what the infant will do with occupational, physical, and speech therapy. We often tell the parents that until the first two years of age the infant will most likely be behind. For example, if an infant was born three months early, even though they may be 9 months old chronologically, we’d only be expecting them to meet the milestones of a 6 month old.
The other thing I wanted to address was about your sister’s lungs which leads us to talk about respiratory distress syndrome (RDS) and chronic lung disease (CLD) of the newborn. One percent of the newborn population will have RDS. Which doesn’t sound like a lot, and overall it’s not. But when you start talking about the premature population those numbers jump significantly. “About ten percent of premature babies in the United States develop RDS each year. The risk of RDS rises with increasing prematurity. Babies born before 29 weeks gestation have a 60 percent chance of developing RDS.”
So here is where the concern for your sister may have emerged. NICU medicine is still a relatively young science. The first NICU in the United States was back in the 1960’s! And surfactant therapy, commonly used in the NICU now to prevent RDS, was only widely recognized as legitimate therapy in 1980!
If a 35-weeker like your sister came into my NICU I would not be nearly as concerned about her as the staff was 20 years ago. That’s because we’ve come so far in a relatively short amount of time. We’d help her lungs develop if needed, give her rest and medicine to ward off infections and provide nutrition until she was able to feed well on her own.
I hope this helps to give you a peek into why those things might have been told to your family as well as that NICU care has many things to balance out for the neonate. I could go into much further detail but I don’t want anyone to go to sleep out there and start drooling on their keyboard.
Thanks for the question! I hope I helped!
Trying to convince nurse residents to choose our unit…
"But in a good way! I swear! Hey… why are you running away? Come baaaaccccckkkkkk!"
A good reminder for any of us, but especially nurses. We are our own worst critics. It’s always good to be introspective and learn from our experiences. But when we hold onto every mistake… every skill we didn’t preform quickly enough… every conversation with patients (or their families) where we didn’t convey exactly what we meant to… it can become paralyzing; and frankly… detrimental to the care we provide.
So for you out there… yes, you… you who are doubting yourself and not giving yourself credit where you deserve. Put the glass down today. Shake off the fears and doubts and go be awesome. Because I’ll bet you’re about 10x more awesome than you’ve been giving yourself credit for.
I would love to know the name and artist of the song that plays in this video. I just loved it!
Hi there! The Ward Miles video? It’s “Happiness” by The Fray.
Hi Ben, This video is amazing and broke my heart. I am a Development Manager in the Orange Coutny Division of March of Dimes and would love to have your permission in using this video to show our corporate teams on why it is so vitally important why they all fundraise. Thank you so much! Shauna Bradley
This video was shared from the original poster’s vimeo site. I am not Ben; just hugely appreciative of the beautiful message he created. If you’d like to try to get in contact with him, it looks like you can message him through his vimeo account here.
(PLEASE everyone, while the internet is an awesome place to connect and see awesome things like this video, please don’t spam the heck out of this guy. I feel weird enough posting a link to his profile. But since it’s public, I can only assume he’s okay with receiving messages.)