First Solo Night

Y'all, I had my first solo night as a NICU RN the other night! I survived it!!! But folks, it was frickin' rough.

Even with them knowing I am a brand-new nurse and had been on orientation the night before... they gave me 3 of the "easier" babies, all with things I have not had to deal with yet with a preceptor and HAD NO FUCKING CLUE HOW TO HANDLE ON MY OWN.

I was talking with a girl who was helping me out, and she asked how my night was going, 2 hours into the shift. I told her good, then explained to her I was given an 8:30 feeder and two 9 o'clock feeders. She legit looked at me and said, "get used to getting terrible assignments for awhile, it happens to everyone."

In a joking matter I laughed and asked, "is it like hazing the new kid?" with a smile and a slight look of fear... to which she responded, "yeah, a little."

Now, I get trying to get me new experiences, and giving me easy babies. Okay, I get it. But if you look at the feeding schedule and avoid giving all of the other, experienced nurses babies that all need to feed at the same time, why the fuck would you give a brand-new nurse all babies that need attention at the same time her first night by herself? Seriously.

For those of you who don't know, feeding times in the NICU are important. Those are the times when you do assessments, get labs, bath, and care for the kid, then feed them. The feeding is supposed to start at their designated feeding time and all cares should be completed before then.

My 8:30 was a kid that was needing to room-in with the parents so that if the parents had any issues during that process, they would have help literally across the hall.

One of my 9:00 feeders was brand new that day, and a train-wreck because not all of her admission labs had been done upon admission, then the NP decided later in the day (like 5 hours later) that hey, maybe getting blood cultures and the other normal admission labs should be collected, just in case. So, day-shift nurse left those for me to do... Now, I'm getting better at regular labs where you just do a heal stick an milk their little foot. The blood culture labs require an IV stick, leaving the catheter in the vein, then aspirating blood drop by drop into a 10 mL syringe to ensure that it is not contaminated with the bacteria from the skin. This is a super scary way to draw labs, and mighty tedious. However, baby veins are so little that you can't just use a butterfly needle or draw blood the way one can on adults or even children. Yes, drawing labs this way is as irritating and tedious as it sounds. Add in the fact that I haven't gotten an IV stick since the very first one I placed on day 2 of orientation, and it stresses me out to no end.

My other 9:00 feeder is truly a feeder-grower. His parents know how to do all cares and he eats really fast. He knows what he's doing and, honestly, I'm not entirely certain why he isn't able to go home yet. But hey, I'm new, so they must be keeping him around for something.

On top of normal cares, me freaking out, and work needing to be completed, we have to get baby weights on night shift. In order to do so, all 20-30 babies are weighed using 1 of 2 scales, unless they happen to be so small that they have a bed with a bed scale.

I had just finished my first assessment when ALL of the parents showed up for ALL of my kids. I needed to do a bunch of paperwork and teaching for the parents who needed to room-in, then get them over to their hospital room for the night. One dad came in with his mom to hold his daughter for the first time since her early birth from emergency c-sections (the kid I still needed to draw labs on...), and the other parents for my second 9:00 feeding showed up and started in on cares and feeding for that baby.

Meanwhile, the charge nurse is asking where I'm at, I had time to only poke my head into each baby's room before I got caught up in the new kids room with a very nervous but sweet dad. The parents waiting to be able to room-in were working on feeding their kid, but ended up having to wait 30 minutes after he was done eating in order for me to get back to help them. And, my sweet parents for my last baby's feeding took care of everything except for weighing their baby, which I put off until the last feeding.

The charge nurse found me, and seemed to get mildly upset with the fact that I wasn't able to be in all three rooms at the same time, but started to help me with delegation and getting other nurses to help with the rooming-in training and whatnot.

Looking back on it now, I can see that feeding the newbie kid should have waited a little bit and I should have gotten labs drawn on the kid when I had a little bit of time before parents showed up. However, I have seen the super-experienced nurses have tons of days like that and I think I handled it pretty fuckin' well. I taught the new dad a lot, and answered all of his questions. I let the parents that knew what they were doing get time with their baby and kept checking in on them instead of just disappearing, and I was able to find a time to sneak away from patient's in order to ask for help. Plus, I was given a difficult assignment that even the day nurse, who has been a NICU nurse for like 15 years, changed as soon as she got in and got report. Now I know I can ask to change it.

I survived my first solo night as a NICU RN. I got done everything I needed to get done, though some was a little bit late. I got a kid a bath, who was in desperate need to be bathed, and he gave me good-smelling baby snuggles with each feeding. I offered help when I had the time, and worked my ass off all night. I organized the beds, talked with all of the parents, and did all that I could, while fending for myself. I was a difficult night and some newbie mistakes were made, but people helped me and went to bat for me once they determined I am willing of their time and effort. I thanked people up one side and down the other to make sure they know I am appreciative of their help. I left in the morning feeling tired, and a little bit defeated, but now that I think back on it, I did an amazing job for a brand-new nurse with only 2 weeks of night time orientation and 12 weeks over-all orientation.

There will be many nights where I will feel way worse because of everything getting crazy busy and hectic all at the same time. There will be days I mess up really bad and need someone to bail me out. There will be difficult parents, babies who are not wanting to fight to live anymore, and times where I feel like a complete failure. For me, I have only had one job where I left and didn't care what happened at work: IT. Working IT left me dreading going to work and counting down the minutes until I left. When I was a cashier in high school, I was so invested in my work that I was constantly trying to improve and do better than I was the day before. In being a CNA, both in the Alzheimer's facility and as a patient sitter in the hospital, I left each day either elated and accomplished or feeling sad/defeated/frustrated/upset. Leaving clinicals was a similar experience for me.

My upset/defeated days come from thinking I could have done something vastly different to lead to a much better outcome than what happened. This can be from interactions with patients, their family, nurses, or any number of the medical staff. It might come from a day when I have no help and the full fuckin' moon is up along with every person with some sore of behavioral issue (both temporary and chronic), or it may come from a day where I am perpetually behind because of something happening at the beginning of the shift.

My happy days come from knowing I did as much as I could. Or from a patient/family member telling me how much I helped them that day. Occasionally, it'll come from a nurse or doctor letting me know how much I helped and how much my presence was required and useful that day (did not happen but once in my 3 years of CNA experience and I didn't believe it when the nurses would tell me that during clinicals because I know I slowed them down). It also came when I had just an amazing learning or teaching experience, like getting to scrub in and assist with a surgery on my first OB clinical night!

For me, I could not handle going to a job where I didn't have emotional connection and attachment to my work. Yes, my heart and emotions are constantly on a roller coaster but, let's be real, I'm on a roller coaster all the time anyway with my bipolar episodes *ba-dum-ts* (that was supposed to be the drum and cymbal sound for when people make a joke). Ha, I made a joke.

You know what, it's true though. My whole heart has been in everything I do, even working IT, and I wouldn't have it any other way. People can tell when you're just there for money or if you actually care about what is happening. I pray my heart stays tender, that I never lose my sense of wonder, and that I am able to continually learn how to be better and care more efficiently so that everyone can feel how much I truly care for them. I never want to get a hard and jaded heart. This means I will have to endure many heartaches and a lot of pain, but I cannot imagine working for 30 years and not feeling anything for my patients or caring about people by the time I retire.


Moral of story for this post: I survived. My babies survived (thought one tried to die on me). And, to top it all off, I was one of the first ones to leave even thought I was able to keep up with all of my work and even help others with their work (as much as possible). I figured I would have been one of the last to leave and super behind all night. Woohoo!