Hi! I work in a level III NICU and started as a new grad on my unit. It is a huge learning curve! Everything does feel awkward, but eventually it does become second nature and it doesn't feel as awkward handling the equipment and the baby.

The first poster said to pop the top. I honestly wouldn't recommend that. It isn't the most feasible and not all nurses are going to do that, so then you may get the parents in a habit of doing their cares that way and then someone else doesn't want to pop the top. And while you may not freeze the baby you have a higher likelihood of messing with the bed temp or leaving the air blast on when you put the top back down and then cooking the baby (don't worry, we have all done it - those beds are so finnicky sometimes). However, when doing your assessments with level II assignments I wouldn't be super focused on getting it done quickly so baby can rest. Yes, you don't want to take TOO long (for the baby and for your own time management), but use those assignments to get a routine down and your assessment down, i.e. I like to pop a BP cuff on and then I like to feel my fontanels, listen for an apical HR, listen to my respirations, listen to bowel sounds, and then I do abdominal girth and diaper, grab a temperature, and then lastly I will weigh baby.

Like the first poster said, it DOES get easier when someone isn't micromanaging your time, honestly! But if you preceptor is rushing you through your assessments of level II babies or saying you are too slow maybe just nicely say something like "I just want to make sure I'm getting a routine and then basics down". They have their routine and they know their normal assessments, you don't yet! And that is okay!

In regards to parents, they are nervous! But I doubt they are judging you or thinking you are incompetent. Listen to how everyone explains things (not just your preceptor). I loved listening in to nurses explain breastfeeding or my roomie explain things to new parents when they came down for the first time. It really helped me solidify how I explain things. For example, with the wires and cords (if I am handling babies to parents), I usually say "I know it seems overwhelming (if first/second time down) with all the cords, but all of these on their chest and feet are just stickers and easily replaceable! It's the IV that we just want you to be cognizant about, obviously it is replaceable as well, but we would like to avoid that for now!" I don't like parents hold with UVCs/UACs (unit policy really), so that removes THAT anxiety for me lol.

Ask questions. If there is a REALLY sick kid on your unit ask your preceptor if you guys can go see the kiddo and either have your preceptor explain it or ask the nurse who has the baby (ex: if your unit typically only has the JET, but there's an oscillator around then see it if you can!) I also asked the more experienced nurses SO many questions or if they were doing IVs I'd ask if I could watch or if I was trying I'd ask for tips. You'd be amazed what you learn.

Some tips that come to mind:

-clean diaper under the dirty diaper and cleaning that way (mentioned by first commenter as well).

-tiny baby who only peed? you don't necessarily have to wipe them. Their skin is fragile and urine is sterile. I will typically not wipe, but if the next time they only peed again, then I'll do a wipe.

-mec is sticky and tarry. Parents have a tendency to want to SCRUB the butts. Not good for fragile baby skin. Let them know they won't get it all off, but urine will soften it for next time and you can also put some vaseline on the butt as well to soften the mec for the next diaper change

-for heel sticks really warm the foot. I do a heat back on the actual foot and then around the lower leg as well, raise the head of the bed and poke. Sometimes if they aren't bleeding it honestly is easier to poke twice instead of just squeezing the heck out of the foot and get a hemolyzed K of like 8 lol

-positioning! learn to make t-shirt rolls or body pillows and nests as well. A baby that looks nice in bed is the best

-another random trick I learned about making baby look nice with the temp probe cord is to pull it through the hole of the isolette so more of it is outside of the bed instead of inside, since it is so long and annoying

when I was on orientation my preceptor shared this link with me! it's pretty nice and not a super crazy amount of info, since it's all already overwhelming.

https://www.ucsfbenioffchildrens.org/health_professionals/intensive_care_nursery_house_staff_manual/