One of the most intense, yet most rewarding experiences in the field of nursing can be found in a place you may not expect: the neonatal intensive care unit (NICU). A day in the life of a neonatal nurse is never the same day twice, with patients ranging from babies who are born mostly healthy to those born with complications. It’s a profession with struggles, but the little victories that make them worthwhile.
In this article, we’ll take a look into the lives of neonatal nurses to find out what exactly their job entails, what it takes to get there, and how you can get started on the path to working in the NICU should you decide it’s the right career path for you. If you’ve ever wondered, “What is a neonatal nurse, and what do they actually do,” then read on.
THE DAY TO DAY JOB OF A NEONATAL NURSE
There are four different levels of care in a hospital’s neonatal unit, and a neonatal nurse could be assigned to any one of them, or work multiple levels. The first is the nursery, where healthy, full-term babies go until their parents can take them home from the hospital. Levels two through four are organized in escalating order of severity, with level four housing the most serious cases.
Level two is for babies who were full term but have fallen ill, infants born on the latter end of preterm but still early, and those with more minor health issues. Three is where infants born very prematurely, with major respiratory issues, or with defects. Level four is where babies born with major chronic issues requiring sustained care are placed. Some smaller hospitals will only have levels one and two, and then transfer more serious cases to larger and better-equipped facilities, while some can house all levels of care. In all cases, the duty of the NICU nurse encompasses both care for their infant patients and assisting the parents emotionally coping with the situation.
Kathleen Colduvell, a NICU nurse with a decade of experience under her belt, described the highs and lows of the job — the emotional toll it takes and the reward of seeing a patient make it through — on a blog entry for a nursing website:
“Even though there has been more heartache than I care to remember, the success stories make every single minute of my shifts worthwhile. We fight to help our patients breathe on their own, take bottles independently, and achieve their developmental milestones, and that is such a reward.”
A neonatal nurse’s shifts are often 12 hours long, and at variable times, as their tiny patients often need round the clock care. The babies are fed every three hours, and the nurse will often conduct any testing or procedures like blood draws during feedings to make sure the infant can spend the majority of their time on rest and recovery. The amount each baby can eat needs to be monitored and adjusted according to their condition, vitals need to be checked, and a plethora of other variables need attending to for each patient. In addition to these duties, a NICU nurse will often end up helping the babies’ families, explaining care and procedures to them to keep them informed.
A common saying in the nursing world, and to which the NICU is no exception, is that “there is no typical day.” Neonatal nurses have to be close by their patients to lend them the best possible care, especially since babies can’t articulate what may be happening with them. Anyone who describes the job will tell you it can be challenging, but also that they love it and wouldn’t want to be doing anything else. One nurse described helping parents care for their child for the first time as especially rewarding:
“…there are a thousand amazing great things about being a NICU nurse. You can be the first person to help a mom see, touch, or even hold her fragile little preemie. You get to help people become parents for the first time and do ‘normal’ parent things like change diapers for the 1st [sic] time while working alongside an oscillator and IV pumps. We facilitate all those early and important bonding tasks, regardless of the baby’s acuity, there’s always something the parents can do and we get to show them that.”
JOB OUTLOOK AND REQUIREMENTS FOR NEONATAL NURSES
In order to specialize in neonatal nursing, you need to already have completed a Bachelor of Science in Nursing (BSN) degree. After that, two or more years of experience working with neonatal patients and a passing score on the certification exam for neonatal nursing must be completed. Areas of care recommended for gaining those years of clinical experience include:
- Labor and delivery nursing
- Maternal-child nursing
- Pediatric nursing
- Well baby nursing
There are two main routes candidates for a neonatal nursing job usually take to become certified: a critical care neonatal nursing certification (CCRN) via the American Association of Critical Care Nursing, or an RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC) via the National Certification Corporation. If you wish to further certify to gain a leg up on the competition and increase your job prospects, you can choose to get one of the following certifications:
- Advanced Cardiovascular Life Support (ACLS) certification
- Basic Life Support (BLS) certification
- Neonatal Resuscitation Program (NRP) certification
Nurses can pursue some or all of the above to reinforce their professional tool kit. Continuing education programs through accredited providers like the National Association of Neonatal Nurses (NANN) are also necessary to remain at the top of your game as you progress along a career path in the NICU.
The Bureau of Labor Statistics (BLS) predicts a rise in demand and a healthy job outlook for the nursing field as a whole over the next decade, and that demand will be even higher for nursing professionals in specialized fields. As a large portion of the nursing workforce nears retirement, more will need to be recruited to replace them. The median salary for a registered nurse is around $73,500 according to the BLS, but respondents on Payscale report an average salary of $97,306.
HOW YOU CAN TAKE THE NEXT STEP
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Our program is CCNE accredited and taught by passionate, highly-educated professionals actively working in the field of nursing. A rolling admissions policy means you can sign up when you want, and the program can be completed in as little as two years. If you’re ready to advance yourself and your career visit our website for a detailed breakdown of courses and credit hours required.
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Our Nurse of the Week is Allison Squires, a professor in the NYU Rory Meyers College of Nursing, who has been selected as the National Academy of Medicine (NAM) Distinguished Nurse Scholar-in-Residence for the Future of Nursing 2020-2030 Study.
The Distinguished Nurse Scholar-in-Residence program is supported by the American Academy of Nursing, the American Nurses Association, and the American Nurses Foundation. It is a year-long opportunity for a fellow of the Academy to engage with nurse leaders and other scholars at the National Academy of Medicine while helping to develop health policy at the federal level.
Squires is a global health workforce capacity-building researcher with a special interest in improving immigrant and refugee health outcomes. As the NAM Distinguished Nurse Scholar-in-Residence, Squires will examine methods for increasing interprofessional collaboration and maximizing the skills of nurses through sustainable development perspectives.
Squires stated in a press release: “I am honored to be selected for this opportunity to represent the American Academy of Nursing, the American Nurses Association, and the American Nurses Foundation while undertaking this important work at the National Academy of Medicine, in collaboration with the Robert Wood Johnson Foundation. This is an excellent chance for me to utilize my international focus to advance NAM’s research on health equity and the sustainability of our nation’s nursing workforce.”
Squires was selected as the NAM Distinguished Nurse Scholar-in-Residence for her strong policy background and stated focus to examine and address sustainability of the workforce from the perspective of integrating social determinants of health. Her study comes at a critical time and will be vital to determining nursing’s course in the coming decades.
To learn more about NYU Professor Allison Squires who was selected as the National Academy of Medicine Distinguished Nurse Scholar-in-Residence for the Future of Nursing 2020-2030 Study, visit here.
Two nurse researchers from the Columbia University School of Nursing have received a combined $3.73 million in grants from the Agency for Healthcare Research and Quality, a unit of the US Department of Health and Human Services. Amanda Hessels, PhD, assistant professor at Columbia Nursing, will receive $1.86 million in funding through a five-year R18 Research Demonstration and Dissemination grant. Lusine Poghosyan, PhD, associate professor at Columbia Nursing, will receive a $1.87 million five-year R01 grant.
Hessels’ study is titled “Simulation to Improve Infection Prevention and Patient Safety: The SIPPS Trial.” The study will test a simulation intervention designed to improve provider performance of standard precautions and prevent healthcare associated infections (HAIs) and occupational blood-borne pathogen exposures.
Hessels tells Newswise.com, “Despite well-established guidelines and training, standard precautions are not reliably practiced, with self-reported adherence among nurses, who have the most direct patient contact in acute care, at less than 50 percent. HAIs are a substantial public health problem affecting approximately two million patients annually, and every year one in 25 registered nurses are exposed to blood-borne pathogens. We think simulation training may improve standard precaution adherence and ultimately improve healthcare quality and safety for patients and providers.”
Poghosyan’s mixed methods study is entitled “Social Networks in Medical Homes and Impact on Patient Care and Outcomes.” The study will combine analysis of team configurations and social networks in Patient Centered Medical Homes (PCMH) to assess quality of care and patient outcomes and identify team best practices.
Poghosyan tells Nursing.Columbia.edu, “The PCMH model aims to address such primary care challenges as poor access and quality and rising costs by delivering team-based care. Yet little is known about the composition of effective teams to achieve best patient outcomes. How team members communicate, share advice or help to deliver care, or how social networks affect quality and outcomes have not been studied. Our innovative mixed-methods study will fill this gap to assure the best quality of care and outcomes, particularly for patients with chronic diseases.”
To learn more about Columbia University nurse researchers Amanda Hessels and Lusine Poghosyan who received a combined $3.73 million in grants from the US Department of Health and Human Services, visit here.
According to NYU Nursing, new nurses work overtime, long shifts, and sometimes a second job. More specifically, most new nurses work 12-hour shifts, 13 percent hold a second job, and nearly half of new nurses work overtime.
This data comes from a new study by researchers from the NYU Rory Meyers College of Nursing which found that nearly half of newly licensed nurses work overtime, while more than one in 10 have a side job, and these trends have remained stable over the past decade. Recent changes in health policy have had implications for nurses and the hours they work like the Affordable Care Act and the recession which has delayed retirement for some nurses. Researchers at NYU set out to understand what these changes have meant for the newest generation of nurses.
The study analyzed surveys from more than 4,500 newly licensed nurses in 13 states and Washington, DC, collecting information on nurse demographics, education, work attributes, and attitudes. Nurses were asked about their work schedule, daily shift length, weekly work hours, overtime, and whether they worked a second job. Four cohorts of nurses were surveyed and compared to observe changes over time.
Amy Witkoski Stimpfel, PhD, RN, assistant professor at NYU Meyers and the study’s lead author, tells NYU.edu, “On the positive side, we observed that new nurses appear to be working a similar proportion of 12-hour shifts as more experienced nurses based on other studies, and the majority of nurses were working the shift and schedule that they preferred. We also did not find meaningful increases in overall weekly work hours or overtime hours compared to previous studies. At the same time, our study did not reveal major changes in when or how long new nurses are working that could enhance patient safety and well-being among nurses.”
To learn more about NYU Nursing’s recently published study which found that nearly half of newly licensed nurses work overtime and more than one in 10 have a side job, visit here.
A new citywide nurse residency program being implemented in New York hospitals is expected to help retention efforts and curb burnout among nurses. The program will support participating hospitals with a year-long residency that bridges the gap between education and practice for recent graduates.
The Citywide Nurse Residency program will be implemented in 24 participating hospitals and 500 newly-hired nurses will be provided with specialized training that promotes job retention in first year nurses. The program is being offered in partnership with the Greater New York Hospital Association, NYU Langone Health, and New York-Presbyterian Hospital.
The program will provide newly-hired, first-time nurses with on-the-job training, focusing on ethics, decision making, clinical leadership, and the incorporation of research-based evidence into practice. Nurses in the program will also receive support and mentoring to enhance job satisfaction, performance, and retention.
New York City’s public hospital system is the largest in the nation. Adopting a citywide nurse residency program will help hospitals save on the financial cost of losing employees and provide a proven way to help retain nursing staff.
Mayor Bill de Blasio tells healthcarefinancenews.com, “We’re exploring every possible avenue to create new pipelines of opportunity for New Yorkers who deserve good paying jobs as we continue to make strides toward being the fairest big city in America. This Citywide Nurse Residency program will help expand opportunities and retain skilled professionals at public hospitals that deliver quality health care to countless New Yorkers.”
To find out more about the new citywide nurse residency program being implemented in New York hospitals, visit here.
This past October, the Columbia University School of Nursing hosted its first annual Innovations in Simulation Summit where they brought together 14 simulation specialists to exchange and discuss best practices in the field of clinical simulation education, examining its future, research trends, and how it can be used to improve patient safety.
Participants attended from around the world, representing a range of nursing and medical disciplines, including deans, directors of simulation centers, and researchers. The participants were grouped into three panels by topic: the future of simulation-based education, latest trends in simulation research, and patient safety outcomes. Four of five experts then presented on each topic.
Stephen Ferrara, DNP, assistant professor and associate dean of clinical affairs, tells Nursing.Columbia.edu, “This interprofessional summit is like a brain trust of simulation. Every one of you has helped advance the frontiers of healthcare simulation, which continues to enhance how we train future and current practitioners to provide the best care.”
The goal of simulation is to give students and healthcare professionals opportunities to practice skills without risking harm to patients and to hone their ability to think critically on their feet. Participants agreed that simulation has gone beyond its original purpose of just teaching basic skills to nursing and medical students. They observed that simulation is now used in healthcare systems as part of staff development, entailing scenarios designed to promote skills maintenance, harm reduction, and better staff integration.
A highlight of the summit was a tour of Columbia Nursing’s Helene Fuld Health Trust Simulation Center. Opened in the autumn of 2017, the center consists of multiple rooms on two floors of the school including a simulated labor and delivery suite, an operating room, and beds equipped as they would be in typical hospital rooms, with vital sign displays and electronic medical records.
To learn more about Columbia Nursing’s first annual Innovations in Simulation Summit hosted this past October, visit here.