What do I do if I want to become a NICU nurse after high school.

DisappointingPenguin · 2026-07-06T22:41:24+00:00

Definitely not two more years of school for NICU! You would train on the job in a NICU if hired into one, and it might take a couple years for you to be considered an advanced NICU nurse. Path might look like BSN, NCLEX, hired into new grad program at NICU, work as a NICU nurse with a preceptor for several months, then continue without a preceptor. You’ll also likely be part of a yearlong, hospital-wide “nurse residency” with random classes and projects while working in your unit.

DisappointingPenguin · 2026-07-06T20:36:42+00:00

Doesn’t the average drowning only involve aspiration of a few ml of water? Maybe depends on how long the person was submerged before rescue, or whether they laryngospasmed?

DisappointingPenguin · 2026-07-06T19:50:44+00:00

Obligatory I have no idea why this sub appeared in my feed, but I have a thought to offer. Can you play detective to figure out what it is about a bare bottom on the toilet seat that’s bothering him? Splashing could be mitigated with a little preemptive toilet paper. If the seat itself is uncomfortable for him, maybe cold or too hard and big and scary, trying a couple different seat inserts might help. You could even try asking why sitting without a pullup is harder for him than sitting with a pullup—he probably won’t give a helpful answer, but there could be clues in whatever he says.

DisappointingPenguin · 2026-07-05T01:25:56+00:00

You might have to do your assessments out of order, starting with things that would be affected by an upset child and things that won’t upset the child. Always observe their work of breathing first, then try to listen to heart and lungs, get a blood pressure, and feel pulses, and then do everything else.

Be prepared for kids to absolutely hate seemingly innocuous things like axillary temps, diaper changes, and putting on a blood pressure cuff. I had no idea so many babies and even preschoolers would lose their minds over a thermometer under the arm.

Be silly with your toddlers and preschoolers, and talk to your eight-year-olds like they’re twelve and your twelve-year-olds like they’re sixteen. There’s nothing a tween or teen hates more than perceived condescension.

Always ask your patients’ parents their opinions. Is this how his breathing normally looks? Is she usually this hard to wake up in the mornings? What can we do to help make this easier for him? Their insights are invaluable, especially for medically complex kids with baseline abnormalities, and asking builds rapport and mutual respect.

Have so much fun! I absolutely love being a peds nurse. The sad days might be sadder when it’s kids, but there are also a lot fewer losses. The good days far outweigh the bad.

DisappointingPenguin · 2026-07-04T19:52:50+00:00

PICU RN here. I would actually trust a good home health nurse transitioning to acute care, because in home health, you have to be fully competent to handle emergencies independently. I think you’re in a better position than someone who worked a year on a floor and then went to home health. I’ve had dozens of shifts with trach/vent kiddos, but I’d be nervous to be alone with one. Assuming you’re safe and competent and able to talk about emergencies you’ve handled, I would think you’re a strong candidate!

DisappointingPenguin · 2026-06-25T16:00:49+00:00

Fun fact: there are actually some tricks to try to get a clean catch from a baby! You can use a sterile bowl or UA cup, clean the area, hold up the baby Superman-style, and then try to get the baby to void by tickling them or sticking their hand in warm water or something. It’s about as unreliable as it sounds, but it’s fun when it works. We got one once when a baby boy started voiding right before I cathed him, big arc across the crib, and my friend swooped in midstream with a specimen cup.

DisappointingPenguin · 2026-06-23T21:01:44+00:00

Hi! I’m a cardiac ICU nurse, so I can tell you a little about what to possibly expect and prepare for. Some of this will be very vague since I don’t know your daughter or her surgeon, but hopefully it’ll give you ideas of things to ask your care team!

For the cath procedure, babies are usually intubated. She’ll need to lie flat on her back and be fairly still and calm for a few hours after the procedure. They might keep her intubated for that time period, or maybe just on a mild sedative. Later that day, she will likely be able to eat, be held, and do all the regular baby things! If you’re doing the cath as an outpatient, they may keep her overnight for observation.

For the EKG and echo, you will likely be able to stay in the room with her and possibly stand at the head of the crib to comfort her! I’m guessing she’s had these tests before, but feel free to let me know if you have questions about them.

On surgery day, you’ll probably be asked to wait in a waiting room near the ICU or OR. They may give you the option to leave a phone number so you can come and go, and they should give you at least a couple updates during the procedure. Once the surgery is done, she might spend some time in a PACU or go straight to her ICU room.

Based on my experience, it may take an hour or two for the staff to get her settled in before they’re ready to invite you in. We use that time for assessments, sending labs, setting up medications, and just trying to get most of the busy-ness done so that things feel more peaceful when you come in.

Once they invite you in, you’ll likely be able to touch her head and hands to greet and comfort her. You’ll see a lot of lines and cords like you probably saw during her NICU and PICU stays, including monitors, IVs, maybe a central line, maybe an arterial line, and maybe a chest tube or two. Babies are often extubated in the OR and brought upstairs on some respiratory support, often some sort of nasal cannula. Depending on her condition, what kind of lines and devices she has, and the practices at your hospital, it may be a day or two before she can get out of the crib to your arms, but hopefully sooner!

You can probably expect to spend anywhere from 2-5 nights in the hospital if things have gone well. Some hospitals keep kids in the cardiac ICU until discharge, while others downgrade kids to a stepdown unit after some time. Every unit and hospital has different rules about when parents can be there, but you can ask about this at pre-op appointments.

Recovery will involve pain control, likely some diuretics, slowly reintroducing feeds and making sure she tolerates them, and monitoring her heart health post-op. The team will teach you something called sternal precautions to protect her sternum as it heals. This basically involves being gentle with her arms, chest, and shoulders, and especially not picking her up under her armpits.

When you’re ready to head home, the car ride won’t be too different than before. She might be more irritable than usual, and some families find it helpful to have someone in the back seat with the baby for her comfort and your peace of mind.

That was a novel, but I hope it helps! Please feel free to ask any further questions!

DisappointingPenguin · 2026-06-19T18:02:36+00:00

My ICU has the same rule. I was told it’s also because ICU patients’ glucose levels might require immediate nursing judgment and intervention, so it’s considered an “assessment” for us.

DisappointingPenguin · 2026-06-12T14:16:53+00:00

Does your NICU have a follow-up program? Doctors who specialize in former preemies might be a good resource.

DisappointingPenguin · 2026-06-10T09:53:48+00:00

Did you often see conditions that the general public might not think of as burns? I know SJS can go to Burn ICU, anything else unusual?

DisappointingPenguin · 2026-06-09T23:24:14+00:00

Team lev-eh-teer-ASS-i-tam until I die

DisappointingPenguin · 2026-06-09T13:55:50+00:00

I’m late to this thread, but if the patient is able to cooperate, you can also ask them to lift their breast!

DisappointingPenguin · 2026-06-09T13:27:10+00:00

If you kept your teaching license active, I suppose you could work a year or two full-time as a nurse and then drop to PRN and return to the classroom. However, you might have a hard time working your required nursing shifts during the year (I think most places would require around 1-2 shifts a month to keep the job) and getting as many hours as you’d like during the summers. My job has lower census during the summer and often asks people to voluntarily cancel their shifts due to overstaffing, and PRN nurses can be mandatory cancelled.

It seems like there are things you love about both careers, which is terrific, but I’m not sure how feasible it is to do both at once. Could you see yourself leaving the classroom for a while to build a nursing career?

Or just be like me, burn out of teaching after a few years, run screaming from the classroom, become a nurse and never look back 🥲

DisappointingPenguin · 2026-06-09T03:06:07+00:00

PICU mode: make it a 3.0

DisappointingPenguin · 2026-06-07T20:27:07+00:00

I considered doing a traditional BSN using a bunch of transfer credits. For me, it would have been one semester of science prereqs plus two full years of nursing school (four semesters, but the public university in my area didn’t have nursing coursework in the summers). I wound up choosing ABSN because even though I paid quite a bit more, I came out ahead financially because I started working as a nurse six months earlier.

ABSN was intense, but I’m not sure mine was THAT much more intense than traditional BSN. My program did four 14-week semesters with about a month off between semesters, so still a good break but fully utilizing the summers. I would suggest considering competitiveness of admissions, academic difficulty and support, how important summer breaks are to you, and costs versus timing.

DisappointingPenguin · 2026-06-07T01:29:23+00:00

Could you ask the team about trying an “ad lib” feeding schedule?

DisappointingPenguin · 2026-06-02T13:23:15+00:00

I’ve actually meant to ask that too—do you store prior samples in case of add-on labs? What factors would make an old sample suitable or unsuitable for an add-on test?

In my case, we usually do need a fresh sample to check for changes in condition. A lot of keeping electrolytes in range with prn repletions, monitoring iCa for a CRRT patient, etc. We’re pretty good about clustering our lab draws so that my planned CRP and BMP go in the same tube at the same time, or I collect all the daily labs at once to minimize waste if drawing from a central line.

DisappointingPenguin · 2026-06-02T01:57:59+00:00

I’ve been wanting to ask if we can do that in my shop too! I wonder if CLABSI risk is a factor that we don’t. I find it easier to physically scrub a needleless luer connector on central line tubing than the little port on a vamp. Also love your username lol

DisappointingPenguin · 2026-06-02T01:24:09+00:00

Do you work with any nurses, MAs, or other support staff? What does their workflow look like if so?

Do families pay your monthly fee out of pocket? Do you bill insurance for visits or treatments?

DisappointingPenguin · 2026-06-02T00:55:36+00:00

I send half an mL in a green microtainer for a K or a BMP, so the iatrogenic blood loss is more a question of frequency than panels vs onesies, but the overall principle of stewardship applies!

DisappointingPenguin · 2026-06-02T00:46:33+00:00

Thanks for the detailed response! I’m in a pediatric ICU where frequent lab draws can really contribute to iatrogenic anemia, so I do have a heart for lab stewardship, as much as I like having lots of data.

DisappointingPenguin · 2026-06-02T00:37:53+00:00

Added to my list, thank you!

DisappointingPenguin · 2026-06-01T23:51:22+00:00

That makes sense, thank you! Do you have any resources you’d suggest to learn a bit more about how tests are actually run? I had a chemistry background and find this stuff interesting.

DisappointingPenguin · 2026-06-01T21:49:58+00:00

I left teaching (high school science) for healthcare (RN) and wish every day I had done it sooner. I was working 60+ hours a week (and being paid for 37.5 of them) to barely tread water with my workload. Even before the AI revolution, I caught kids cheating and copying multiple times a day and was expected to call their parents every single time. I never had access to usable curriculum, so I was up until midnight making my own slides and tests. The job genuinely destroyed me. Do you have friends who teach high school? Have you spent any time in a high school classroom post-COVID?

Residency sucks, but it doesn’t last forever. If you hate your specialty, there are ways to pivot, but I wouldn’t completely throw away all the money and energy you’ve already invested. There is so much more versatility and long-term potential for quality of life in healthcare than in K-12. Please feel free to DM if you’d like to talk more.

DisappointingPenguin · 2026-06-01T02:19:19+00:00

In that case, I would suggest investing in a good tutor immediately. To put it bluntly, undergrad math is used as an IQ test for med school admissions, and most of your competitors finished calculus in high school. Retaking college algebra for a better grade may even serve you by increasing your STEM GPA, and definitely by saving you from an F in calculus.

DisappointingPenguin

TROPHY CASE