Just a few tips for nursing students rotating through a level 3 neonatal intensive care unit. After precepting students for a few semesters, here are my suggestions.
Before the shift:
- Study necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH). What are the risk factors? How do we prevent, diagnose and treat these?
- Understand why infants of diabetic mothers, small for gestational age (SGA) infants and preterm babies are all at risk for hypoglycemia soon after birth.
- Read up on oxygen toxicity in preterm babies. What is retinopathy of prematurity (ROP)? Why are we conservative in cranking up the oxygen on preemies?
During the shift:
- Bring a comfy pair of shoes. Don't fall into the trap of sitting down too much. We're more likely to involve you in potential learning experiences if you look interested and active.
- Ask to read your baby's progress notes (the daily notes from the physician). In particular, computer-generated progress notes often go by systems and are particularly helpful in understanding your baby's treatment priorities.
- Wash or foam your hands frequently - before and after every baby, and any other time that you're thinking about it.
- Focus. Students generally aren't assigned to the sickest babies, and you may not even have the most interesting baby in the unit. Asking to look at the trisomy 18 kiddo in the next pod is okay, but make sure that you don't miss out on a learning experience with your own baby.
Questions? Comment or email me!
Good point E.J. I don't have my nursing students take care of Nicu babies or even special care babies. I do have one of them follow a nurse in the Nicu. They all really seem to like this experience.
ReplyDeleteI like your point about standing up and looking interested. If you look bored, folks probably won't involve you.
Good tips. I would also add hyperbilirubinemia and developmental care.
ReplyDeleteGood call on the bili and development issues, RR.
ReplyDeletePinky, our students only take care of very stable level 2 babies. They can PO feed and take vitals under very close supervision. They're usually room air kids. No kids with CVL's, CPAP, umbilical lines or PICC's.
A 2.5 kilo baby doesn't seem too exciting to most of us, but it's likely the smallest baby a student has ever laid eyes on, so I think it's still a good experience if the bedside staff is on board with providing the necessary supervision.
Hi E.J.
ReplyDeleteI'm in my 3rd semester in nursing school, and I'll be rotating to my hospital's level II NICU in a few weeks. Thanks for the tips -- I'll deffinetly come back and reread this post the night before clinical.
Thanks for the help, and thanks for remembering how scared/excited we are in Clinicals.
~ B.C.
I wish I had of found this as a student!
ReplyDelete