1. Describe the typical day for a NICU nurse to include rewards and challenges.

Walking on to the unit, the nurse receives her report. Report may be updates if the
patient has been treated in the NICU for several; however, it may also be a full synopsis of the
patient’s history. During the first few hours, the nurses will keep the lights low and maintain a
quiet volume, enabling rest for the neonates. Around 0900, the neonatologist performs their
assessment. Shortly after, the nurses perform their care, clustering tasks together such as
nursing assessment, vital signs, labs, and hygiene, in order to prevent unnecessary stress on
the patient. The main priority of the NICU is to promote a restful, healing environment for new
life.

Challenges in the NICU may include multiple aspect of care, such as monitoring a
NCPAP, the neonates ventilator system. A smaller version compared to the adult world, a nasal
cannula must remain in the nostrils. The nurse must assess if there are any obstructions. In
addition, an OG tube is placed to relieve any excess air in the abdomen produced by the
NCPAP. This tube must be checked, retaped if loose, and further advanced if not placed
correctly. Other challenges may include social situations, such as a baby suffering from
neonatal withdrawal syndrome. It is important for the nurse to keep their attitude free of
judgment and function as the role of a medical care provider.

Rewards include maintaining the neonate at baseline. Receiving a child that is not
functioning at a healthy level, an example would be low oxygen saturation, is a stressful
situation. However, once the child reaches a baseline within normal limits, it is a feeling of
success experienced by the staff. Also, when a neonate receives discharge orders, I imagine
that is also a thrilling feeling for the staff.

-Placed in NICU for premature birth.Infant born at 32 weeks, presented breech and delivered via
c-section. Mother presented in labor with infection, diabetic→ mother has diabetes

-Called to OR for poor strip and meconium.THC, Cocaine, Opioids, O2 Sats 70%, in NICU on
NCPAP, withdrawal symptoms, mother left floor to smoke cigarettes

2. What was your overall impression of this experience.

I was open minded going into the NICU. The floor I work on currently at St. Mary’s is a
step down unit for NICU patient’s, so I could easily say I was optimistic. NICU nursing is a
different type of nursing I had yet to experience, and this day proved to be a learning
experience.

The NICU is a quiet, warm place to get work done. Working being hovering over my
nurse hoping I am not in her way as she described that there was such as thing as stupid
questions while continuing to complain about night shift. Now, this was not a reflection of who
she is as a nurse. She was organized, efficient, and questioned orders that may be
monotonous. However, the welcome committee was not present that day.
 The other nurse I followed was excellent. Happy, hard working, encouraged me to watch
procedures I had yet to experience. She had experience in the pediatric world prior to Women’s
and I was hooked immediately.

While I enjoyed the NICU purely because of patient population, I have to say I would
reconsider a job offer there purely based on teamwork.

3. Select one practicum objective and reflect on how this objective was met or not met by the
nursing staff. How you can integrate what you observed in your own nursing practice. The
practicum objectives can be found in the NUR 4111P Syllabus and include: Communication and
Collaboration; Caring and the Catholic Health Ministry; Servant Leadership and Global Health;
Safe, Quality, Evidence-based Practice; Professionalism and Commitment to Lifelong Learning.

Collaboration: I saw this between the doctors performing circumcisions and the nurses
provided care to the patient while enduring this procedure. Their communication was flawless,
focusing on the needs of the patient entirely. Were there enough blankets, have they been
numbed properly, were they cleaned afterwards: all tasks they collaborated on. It was
comforting to know this aspect of the nursery ran smoothly. Doctors possessed an
approachable attitude, leveling the playing field to all healthcare workers.