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Career Story: Neonatal ICU Nurse At An Inner City Hospital

Neonatal ICU Nurse At An Inner City Hospital

Education: Associates degree Nursing, Goldenwest College •• Huntington Beach, CA

Previous Experience: Jobs as an RN in order (29 years total) Pediatric ICU Pediatric Floor Newborn ICU Pediatric Home Care Pediatric Neuro Rehabilition (developed & managed Pediatric section) Allergy specialist in Ear, Nose & Throat office Visiting Nurse (travelling intermittent home visits 100 mile radius) Telemetry (step down from ICU) Home care with AIDS patients Oncology (cancer) floor NICU Pediatrician office-Triage nurse NICU for the last 12 years

Job Tasks: My hospital is an inner city facility with outlying clinics, providing all venues of health care needs including a multi-state burn unit, pediatric & adult trauma center. It provides top medical care to the poor & needy uninsured, including a large undocumented immigrant population as well as those with payer sources. It is a teaching facility for the state medical school.

My 12 hour day consists of working with extremely sick and/or fragile infants, most born prematurely. The average birth weight is 1 1/2 - 3 lbs. at birth, often due to mothers' drinking & drug use during pregnancy and no prenatal care. Close sophisticated monitoring, life support machines, medications & procedures. The nurses attend deliveries of high risk babies and mothers. The "team" of nurses, doctors, nurse practitioners, respiratory therapists, social worker & discharge planners work closely. I participate in daily rounds of my assigned patients. The nurses help each other with procedures & feedings. I am required to perform thorough, detailed charting.

I use ventilators, special feeding & drainage tubes, start & maintain IV's, give & draw blood, resuscitate babies who (for a few weeks) stop breathing frequently, part of their recovery of prematurity. I also do new nurse training, parent teaching (including coaching & comforting) and even teach my co-workers, after attending nursing conferences. I am frequently the voice of the parents/families to the doctors because of language problems & family fears. We meet to promote current and improving nursing practice. There are many interuptions, so planning, organizing & documenting properly are a must!

Best and Worst Parts of the Job: Best: Best survival & quality success rate in a region hosting five NICU's. Experiencing the miracles of the survival struggle of our babies, my nursing autonomy & personal value is beyond rewarding. Good pay.

Worst: Long hours, personality conflict ("me doctor, you not"), difficult parents (under the influence of alcohol or drugs, misunderstandings, denial).

Job Tips:
1. Self awareness: Purpose of hands-on health care is helping others, not money.

2. Focus on prerequtisites & nursing courses. You will find your boring &/or hard courses will serve you. Special training comes after graduation.

3. Investigate and proactively deal with burnout, which affects everyone because we give much of ourselves to others.

Additional Thoughts: Nursing has many rewards that comes with dedication and hard work. Essentially you get what you give. While I have an two year degree, it is wise to plan to acheive a bachelor's degree (BSN). Most hospitals (at least in large cities) are paying for those with two year degrees to get their higher degrees.

Nursing is also about cost effectiveness, due to insurance having as much influence as the doctors.

There are frequent changes in scope of practice (what you are expected and allowed to do having a nursing license), so flexibility is a good characteristic to have.

Developing a professional demeanor while staying true to yourself is important. Because there are a lot of grey areas in decision making, make sure you have a scientific rationale or a hospital policy & procedure, a doctor's order to back up your decisions & nursing practice. This is where good organizational skills are important. You may find yourself spending job time looking up references (drugs, procedures, safety issues) before or between your patient contacts.

You will have to confront doctors on some of their orders & behaviors. They may not like it and try to pull rank. Always have charge nurse awareness and/or backup before confrontation. Do not follow orders blindly.

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