The Beginning.

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It’s crazy to believe I’ve been a registered nurse (RN) for almost 4 months now. Let alone a NICU nurse for 3 months! Needless to say it has been a whirlwind of a ride the past 5.5 months for me. Balancing my full-time job as an RN and then my part-time job which have allowed me to embark on a new chapter which I will share when the time is right 🙂

3.5 years ago I was a first year nursing student writing about how I never thought I would make it to the end of first year, let alone getting to the finish line and becoming a registered nurse. The amount of tears, anxiety and stress that was expended to get to this point has definitely transformed me as an individual and now even moreso as a baby nurse.

Since I was about 8 or 9 years old, I’ve had a yearning to be in healthcare, working in a paediatric setting. Moving towards high school I dreamed of working in an either a paediatric hospital (ie. SickKids) or NICU and working downtown Toronto on ‘hospital row’. Inspired by the television infomercial ads that focused primarily on supporting under privileged kids in third world countries needing medical support/intervention and supplies. Who would have thought I would land my dream job in one of my dream hospitals basically straight out of school and just as I was tackling my licensing exam.

In the NICU I work in, we take babies as little as 22 weeks gestation. Generally, the neonate period is usually up to the 28th day of life. However, many babies can stay in the NICU much longer than that (often for weeks or months beyond that period).

I will say though, it has been an adjustment becoming a fully independent nurse after 2.5 months of orientation. I consider myself fortunate to have received 24 shifts of preceptorship (or about 3 months of orientation) compared to my nursing peers who typically receive on average 12 shifts. Nursing is a crazy ride and there are many days where you just want to go home and cry, but you end up sleeping because you’re so tired after a long day of being on your feet, thinking all day, and physically grinding for four 12-13 hour shifts in a row.

Nursing is not easy. How nurses make it look effortless is talent. Often overworked, under paid and under appreciated. Staying later to ensure handoffs are thoroughly completed without claiming overtime, charting through breaks or cutting breaks early to come back to ensure care is delivered in a timely manner, comforting families at the bedside and coming early to get report.

My first three sets of shifts working in a level 3 NICU on my own have been nerve wrecking at times to say the least. Baby’s have no reserves so when things take a turn, they often turn quickly. From your first assessment in the morning/early evening, things can change quickly and i’ve learned that first hand. At times I have had to skip breaks/meals just to keep up with handling two babies, one whom often needs more attention than the other when things start to turn. Having to sort through a quickly mounting list of new orders and yielding phone/verbal orders from physicians to help stabilize a baby. The frenzy that ensues of all ranks of the team coming into your baby’s room and trying to get updates or come up with a new plan. Let alone to end up having to take one baby over to SickKids for more specialized surgical care.

It can be overwhelming, being a new grad working in a highly specialized setting and learning on the go. Whether its interpreting x-rays, eye exams, labs, or ultrasound results. To knowing whether its appropriate to be giving a certain medication (ie. maybe consider not giving tobramycin to a baby who isn’t peeing a lot), ensuring babies are meeting their TFIs (ie fluid intake for the day), to teaching mom how to breastfeed/ pump, or whether all the tests baby needs are ordered by the team and appropriate for baby (ie. make sure 24 hour blood work is ordered and follow up with doctors if its missed). All on top of striving to be your baby’s and their family’s biggest source of comfort or advocate during rounds in ensuring interventions are appropriate since you’re the one at the bedside for the majority of the day. These are your responsibilities as a nurse.

The anxiety and feeling of your heart sinking into your stomach as your baby’s O2 sats drop and them turning dusky, falling to even the single digits at times and the adrenaline kicking into help stabilize them. From boosting the O2 support to often 100% at times, suctioning to clear their airways, adjusting their mask/prongs, having to bag your baby to hopefully get some chest rise, to at the end of it all having to call for a staff assist to get further support from the team (ex. physicians, respiratory therapists, more experienced nurses from the leadership team).

With all the stress, I am so fortunate to be surrounded by so many passionate and well-trained nurses. Many of whom take time out of their day to come check in on me and make sure i’m okay, especially when they’ve noticed i haven’t been able to leave my baby’s room because of all the tasks, assessments, and medications I have to do. It makes a world of a difference working with an amazing team day in and day out.

The inspiration my team gives me is immense. Watching them work day in and day out to help the smallest and most sickest of babies, including those who are only 22-weeks gestation. The amount of passion my coworkers carry for their job (despite how crazy stressful/tiring/sad it can be) is what fuels me to come back after the toughest of shifts. It’s amazing seeing the resuscitation NICU nurses do what they do in helping to attend high risk births and stabilize these babies to bring them up is amazing. Something I hopefully look forward (and will likely be stressed) to learn when i’ve had 2-3 years of experience at the bedside.

With all the stress though comes an infinite amount of joy. There are no words to describe how I feel when walking a parent through a simple task like holding their infant for the first time after being admitted to the NICU, feeding, or even changing their diaper is inexplicable when you see the fright on their face turn into joy. While sometimes it can be overwhelming having a bottle feeder when you’re trying to manage another sick baby, it’s such a joy to be able to help cuddle baby’s when their parents can’t and knowing this is often a big step forward for baby’s to be able to be transferred to a level 2 NICU or head home to begin a new chapter. The love and appreciation from families is so beautiful, especially when many have been there everyday for months and you become essentially a family. It’s often bittersweet to see them go home, knowing their journey with us has led them to a new adventure in which our paths are no longer intertwined. I love getting updates to my e-mail from families who have transitioned home and seeing these little ones grow up.

Despite all the heartwarming milestone, I also have to say it’s been incredibly hard caring for some of these very sick babies who will never go home in the way their parents had hoped or aspired for them to do so.

At the end of the day I do what I can as a nurse and despite all the hurdles i’ve learned the best thing to do is ask ‘stupid’ questions and call for help when you need it!

For now, I am excited to embark on my RN- Perinatal post-graduate certificate course to continue to learn more about how I can continue to support and care for these wee ones to the best of my ability.

I am so fortunate to be able to have an opportunity to do what I love and i’m excited to see where my NICU journey will continue to take me. But to spice all of this up, I’ll have a small hand in being a Corrections RN at a local detention facility in order to not hike myself into a niche for where I hope to end up whether in ethics or policy making 🙂

Despite the crazy journey it has been to finally get to this point I am now so proud to officially call myself a nurse. It’s still so surreal to see RN beside myself name when I’m signing off documents or charting or be referred to as the ‘nurse’.

Hope you all are staying safe,

Megan, MA, RN

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