Advice from a NICU Nurse - Penn Medicine Lancaster General Health (2024)

Advice from a NICU Nurse - Penn Medicine Lancaster General Health (1)

When you hear the words “Neonatal Intensive Care Unit (NICU),” the first thing you might think of is tiny, premature infants. But the truth is we see a wide variety of babies in the NICU. In fact, we care for premature babies (born as early as 23 weeks gestation), to late preterm babies (born between 35-37 weeks), and even full-term babies (born over 37 weeks gestation). And there’s no “normal” length of time for a little one’s stay in the NICU. We have babies who stay in our NICU for two days, all the way up to six months.

No matter your baby’s age or length of stay, we know that having a baby in the NICU just isn’t part of anyone’s birth plan. We also know that the NICU experience will forever change you as an individual, and as a family. Here are some things I tell every family when their baby is in the NICU:

  • We refer to a baby’s time in the NICU as a “NICU Journey.” Some parents compare this journey to that of a rollercoaster ride. There are many good days when we celebrate big NICU milestones such as baby’s first bath, the first time you’re able to hold your little one, baby’s first bottle, and your first time breastfeeding. But there are also bumpy days along the way. While it can be difficult, it’s normal to have ups and downs.
  • The hardest day for most mamas is if they are discharged from the hospital without their little one. Having a baby is already an emotional time under normal circ*mstances, but the NICU adds an extra amount of stress. Try not to be too hard on yourself, and allow yourself to experience all of the emotions. The staff will be there to support you. Never feel afraid or embarrassed to ask for additional help.
  • Be a parent and do your best to enjoy being a hands-on part of your baby’s care. There is a whole team including doctors, practitioners, nurses, lactation support, occupational and physical therapists, respiratory therapists, and social workers attending to all the little details surrounding your baby’s care. Parents are very much a part of this team, too. We encourage you to attend rounds, and we will keep you updated and informed every day.
  • No question is a silly question. You will hear a lot of new terminology, and learn a lot along the way. Words such as A&Bs, ABGs, CPAP, feeding percent, FIO2, sats, and grams will slowly become part of your new vocabulary, too.
  • We know you want to be here as much as possible, but it is important to take care of yourself too. Once you’re discharged you can call in to speak to your baby’s nurse 24 hours a day for updates on your little one. Most parents tell us it eventually gets easier to go home because they know their babies are so well-loved and cared for by the hospital staff.
  • During your stay, you will hear a lot of monitor alarms from your baby’s monitor and other babies in the same area. Keep in mind an alarm does not always mean something bad is happening. The nurses know what the alarms mean and when they need to act. You may even hear alarms in your sleep for the next several months.

There are also a few common questions parents ask when their baby is in NICU:

“When will my baby go home?”

This is the first question every parent asks, but it’s also a very hard question to answer. I tell parents that now, and for the next 18 years, the baby is in charge. We base all of our care on signs of readiness, or cues, that your baby shows us. Every baby progresses at their own pace and there is no rushing them. The earliest a baby can go home is 35 weeks gestation, but I usually advise parents to expect to go home close to their due date. If they get to go home earlier, it’s a bonus.

“When can I hold my baby?”

This depends on the medical condition and age of the baby. We know this is a huge highlight for parents, so we want to make this happen as soon as possible too. Skin-to-skin or “Kangaroo Care” has great benefits for both mom and baby. Dads can Kangaroo too! Until you are able to hold your baby, your gentle touch and soft voice are still comforting to your little one.

“When can I feed my baby?”

This also very much depends on the age of the baby. We typically start feedings on the second day of life. Babies don’t have the skills to breast or bottle feed until they are at least 33 weeks old. Before that time, they are fed through a tiny feeding tube. When your baby is ready to start breast or bottle feeding, we will help you. But be patient, mama. Getting the hang of nursing or taking a bottle is a learning process for both mom and baby and can take several weeks to figure out.

“What can I do to help care for my baby?”

No matter how small your baby is, you can participate in your little one’s care right from the beginning. You can help take temperatures and change diapers. As your baby gets older and bigger, the nurse will guide you with the next steps. By the time you are ready to go home, you will know exactly what to do to care for your baby.

When the time comes to bring your sweet baby home, you’ll feel so thankful and excited. But don’t be surprised if you feel a bit anxious, too. It’s totally normal to experience a mix of emotions when your baby leaves the NICU. Don’t hesitate to ask as many questions as you need to feel comfortable with baby’s care before you go home to make new memories together.

Advice from a NICU Nurse - Penn Medicine Lancaster General Health (2024)

FAQs

Why is it so hard to be a NICU nurse? ›

Becoming a NICU nurse can be challenging as it requires extensive training, an advanced skill set and the ability to work in stressful environments. In addition to a nursing degree, nurses must gain around two years of clinical experience to begin working as NICU nurses.

What is the hardest part of being a NICU nurse? ›

Very Demanding

Caring for neonates requires a great deal of precision, and any mistake made could have a drastic, negative effect on the baby in question. NICU care also requires making difficult decisions, since it's not always clear what treatment is best for the babies, especially in a crisis situation.

What level of NICU is Penn Medicine? ›

Newborns who come into the world early (premature birth) or have health problems receive specialized care at Penn Medicine. Our hospitals have Level 3 neonatal intensive care units (NICUs).

Does a baby born at 35 weeks have to stay in the NICU? ›

Although every baby is different, in most cases babies born before 36 weeks of gestation require a minimum of one day of observation in the NICU before they are transferred to the postpartum floor to stay with you. All babies born before 35 weeks gestation will need a longer observation period in the NICU.

What is the top salary for a NICU nurse? ›

Nicu Rn Salary. $100,000 is the 25th percentile. Salaries below this are outliers. $151,000 is the 75th percentile.

What makes a good NICU nurse? ›

The truth is that this nursing specialty necessitates a caring and highly skillful nurse. Becoming a neonatal nurse is a selfless act of empathy and compassion. It requires self-assurance, dedication, and advanced nursing skills. It can also provide a meaningful and rewarding job for the right individuals.

What is the lowest level of NICU? ›

NICUs are classified based on their capabilities into levels by the American Academy of Pediatrics (AAP). Level IV (four) is the highest level of distinction, and Level I (one) is the lowest.

What level NICU is Hershey? ›

As a Level IV NICU (the highest level NICU) and the only one between Philadelphia and Pittsburgh, our team provides complete and comprehensive, lifesaving care to the most complex and critically ill newborns and serves as a regional referral center.

What is the difference between Level 3 and Level 4 NICU? ›

Level IV units include the capabilities of level III with additional capabilities and considerable experience in the care of the most complex and critically ill newborn infants and should have pediatric medical and pediatric surgical specialty consultants continuously available 24 hours a day.

What week should I avoid NICU? ›

Babies born before 34 weeks go to the Neonatal Intensive Care Unit (NICU). Babies born between 34 and 37 weeks who weigh more than 1,800 grams (about 4 pounds) may be able to go to the Progressive Care Nursery (PCN).

What is a good weight for a premature baby? ›

Infants born between 32 and 34 weeks are called moderately preterm and weigh between 3 and 5 pounds and those who arrive between 28 and 32 weeks (very preterm babies) can range in weight from 2 pounds, 7 ounces at 28 weeks to 3 pounds, 15 ounces at 32 weeks, depending on the sex.

Can I hold my NICU baby? ›

Talk with the nurses about touching and talking to your baby. At first, you may only be able to touch your baby's skin through the openings of the incubator. As your baby grows and improves, you will be able to hold them and help with bathing them. You can also talk and sing to your baby.

What challenges do NICU nurses face? ›

Common Challenges in Neonatal Nursing
  • Managing Premature Birth Challenges. ...
  • Handling Respiratory Distress. ...
  • Adapting to Evolving Medical Technologies. ...
  • Nurturing Developmentally Supportive Care. ...
  • Balancing Emotional Strain. ...
  • Supporting Neurodevelopmental Care. ...
  • Enhancing Family-Centered Care. ...
  • Coping with Staffing Challenges.

Is it worth it being a NICU nurse? ›

Some of the top neonatal nurse benefits include:

Supporting families during the most difficult time in their lives. Teaching parents how to care for their infant both in and out of the NICU. Advancement opportunities within the hospital. One of the most competitive nursing salaries.

Why is neonatology so difficult? ›

Working as a neonatologist in a neonatal intensive care unit (NICU) is stressful and involves ethically challenging situations. These situations may cause neonatologists to experience high levels of moral distress, especially in the context of caring for extremely premature infants (EPIs).

How competitive is NICU nursing? ›

A: It is very competitive to get a job as a nurse in the NICU. My advice to people interested in working in the NICU is to be proactive in seeking opportunities that will assist them later when they are ready to begin their nursing career. There are several ways to accomplish this.

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