Understanding the role of a NICU nurse – Part 1

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Duties as an NICU nurse

With a newborn at Iringa Regional Hospital NICU stands for Neonatal Intensive Care Unit. This is essentially an Intensive Care Unit that is equipped to treat newborn babies who are born very premature and have problems inherent with premature births such as under-developed organs or those who are born full term but with life threatening congenital problems. 

A NICU nurse is responsible for providing total nursing care to infants who may be born premature or those who may have experienced complications during delivery or are diagnosed with congenital defects. These highly specialised nurses develop nursing care plans and also implement and assess the effectiveness of treatments in these plans. As part of their everyday tasks they administer medications, work with complicated technology, perform complex procedures and consult with interdisciplinary medical professionals to coordinate all aspects of a patient’s care. In between of all these medical and technical tasks, they make sure they find time to comfort and soothe their patients and educate and reassure their patients’ families.

 

The evolving role of a NICU nurse

Until about 50 years ago, premature or sick newborn infants received care from nurses who worked in the paediatric wards or in the nursery. There was no such thing as NICU nurse. Today however, these specialist nurses can be found at most general care and maternity hospitals and this area of nursing has evolved into a profession that requires highly specialised knowledge and advanced skills.

NICU nurses work together with a multidisciplinary healthcare team to first perform an assessment and diagnosis, after which they initiate the most appropriate medical treatment and perform the necessary procedures. These nurses may also act as consultants and conduct research. In some settings they also educate other health professionals and nurses.

 

Work settings

There are two levels of NICU nurses – Level II NICUs and Level III NICUs

Depending on your qualifications, experience and personal preference you may work in one of the two types:

  • Level II NICU is designed for infants who are less critically ill and who may need help with breathing and feeding or who may require special medication. These units are usually located in a community hospital. A nurse who works in this level may care for about three or four babies at a time.   
  • Level III NICU is designed for critically ill infants who require sophisticated, high-tech care. These units are usually found in larger medical centres and general-care children’s hospitals. At this level, the nurse-to-patient ratio is usually 1:1 or 1:2.

Regardless of the level, all neonatal intensive care units are busy working environments and all professionals working in these units are highly qualified and experienced. Working with newborn infants in general is completely different from working with any other age group and infants who are born with compromised systems require extremely skilled care. Although NICU nurses are usually contracted to work eight or twelve hour shifts depending on the organisation, working overtime, nights, weekends and holidays all come with the NICU territory as babies, especially premature babies have the habit of arriving without any warning. 

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