Has it really been one year?!! A year ago I never imagined that my little blog would give me the opportunity to do something I have always love. I thought my only supporters would be my parents. In just the last six months, Neonurse has opened many doors for me. I can’t thank all my friends, family, and, supporters enough!!!
That’s me 13 years ago after my nursing graduation and pinning ceremony. Who would have known I would end up traveling the world in search of inspiring people, stories. Thank you! Thank you! Thank you! So humbled ❤
I am super excited to start featuring an amazing group of nurses from around the world. I have always loved to travel and explore. In my own travels, I have met some truly inspiring people. For any adventure seeking nurses out there, this is a post for you. Today’s feature is a nurse that has made her way around the U.S. and is now living and working in the U.K. She proves that anything is possible when you put your mind to it. If you’re contemplating working as a traveler, here is your inspiration.Meet Tonya. She is a neonatal nurse originally from the U.S. She started working as a travel nurse,making her way from Florida to California, and has been since somewhat rooted in London, England. Her next adventure leads her to Belgium.
Where are you from?
I’m originally from Florida. I did my training in Gainesville at Santa Fe College and my first job was at Shand’s Hospital at the University of Florida.
In what area of nursing do you work?
I’m currently working in Neonatal ICU, but have previously worked in PICU (Pediatric ICU) and PCICU (Pediatric Cardiac ICU).
How long have you been a nurse?
What inspired you to become a nurse?
When I was in high school, my grandmother was diagnosed with Lymphoma. I visited her in the hospital and saw the nurses caring for her. I was inspired by their compassionate and caring nature.
What advice would you give a new nurse?
#1 And most important!
Take time to renew and recharge yourself. Our jobs are stressful and heart breaking and no one really prepares you for life as a nurse. Have nursing friends (because they will always understand and be able to commiserate), but have non nursing friends too (because they will keep you sane and stop you from talking about work so much).
Don’t let old tired nurses get you down or pick on you, tell them where to shove it! We eat our young in this profession and I don’t know why. Find experienced nurses that you trust and feel comfortable asking for advice and guidance. They are there in your unit and are more than happy to pass on their knowledge. And just ignore the grumpy bitches that are always complaining.
What advice would you give a tired nurse?
Take a break because you’re not doing anyone any good by hanging around and possibly making mistakes. Back to my advice for new nurses, take time to renew and recharge. Patient safety is always our priority and we make mistakes when we are tired and run down.
How did you end up in London?
So England happened by chance. I met my friend Kate in Boston. She had done her registration for Australia and I had been looking into going to the UK. I kind of talked her into traveling over with me. So we did all the paperwork to get registered in the UK and found the travel company to sponsor us, and the rest is history.
What are some big differences between working in the U.S. and England?
I can’t really remember the differences, it’s been a long time since I’ve worked in the US. As far as NICU is concerned I think taking care of the babies is the same. The nurse responsibilities and doctors responsibilities are different. The doctors draw blood and start all the IVs and Picc/Long lines. It’s a different kind of work load. They do weird things like hourly feeds and nurses are responsible for cleaning. It is just all a little different from home. It’s the equipment and processes that are different. The most annoying thing is working within a public system. At home we are used to efficiency and organization. It just seems to take so much time to get anything done here. I do have to say that the follow up care here is excellent. Our unit has an outreach team that follows the babies home which sometimes allows them to go home earlier. There are also Health Visitors that follow a newborn from birth to 5 years old, so the hospital system is frustrating but the community services are great.
Where to Next?
My next move is to Belgium, for my fiancé’s new job. I have to learn the language first, but may eventually look into working there.
Thank you so much, Tonya, for contributing!! Looking forward to sharing our next feature, a nurse on a mission in the Philippines. Thanks for taking the time to read!! Now for some wine ❤
I’ve worked in the NICU (neonatal intensive care unit) for some years now-long enough to witness the struggle a sick or premature baby’s parents face in the roller coaster ride of neonatal intensive care. It can look something like shock, followed by hope, denial , hope, sadness, hope, anger, hope, hope, and more hope. It’s hard to know what to say sometimes. Honestly, this is the hardest part of the job most days.
How do nurses cope when faced with the loss of a tiny patient? I can only speak for myself. I’ve lost babies, sometimes without any indication. It’s tough. We have to keep going and care for the next patient, support the next family. It gets heavy sometimes. I find a combination of time, talking about the loss, and writing helps.
October is Pregnancy and Infant Loss Awareness Month. The following is my tribute to a premature baby I cared for in the neonatal intensive care unit. It is my hope that it will give his parents and (and all NICU parents) some comfort in knowing that the loss of their baby is felt by many. It is hard to work in the NICU and not grieve the loss of a baby on some level.
Dearest baby boy,
It’s been 6 months since you left us suddenly, brave little bright-eyed boy. You were close to being discharged home to your family. Things were looking up as you grew stronger with each passing day. It was a shock to all of us in the NICU that cared for you when you lost your courageous fight as a baby born too soon.
Your parents (like all NICU parents) stood watch by your side day in and day out. They gave you and themselves normalcy in the otherwise frightening and unfamiliar environment that is the intensive care unit. They changed you, bathed you, dressed you, talked to you. They loved you so much!!
You endured painful sticks, surgeries, and were dependent on oxygen your entire life. You were stuck, prodded, and probed all in effort to sustain your little life. You fought an amazing fight. You were stronger than most.
I was your nurse sporadically though I wish I had known you a little bit longer. The thing is, while there is always something special about all the sweet babies I care for, I have to maintain a little distance. It’s called self preservation and it’s part of survival for those of us who care for babies like you. You broke me though. You got through and touched my heart. Maybe it was the collage of pictures that hung over your bed. Your mom, dad, grandparents, aunts, uncles, and puppy all watching over you day and night.
There were nights where you were restless and awake most of the night. I would tease your parents in passing that they had to stay all night because you wanted to be held. Karin and I would hold you, reposition you, rub your back gently to help you sleep. Do you remember when one of your doctors, Karin, sang you to sleep? You were loved by so many.
I was on vacation when Mary told me you passed. It was shocking, unexpected. Those of us that have worked long enough in the NICU see things that most people can’t imagine. Babies die. We learn to try to take it in stride. Self preservation.
I’m not sure how you did it, but you stole a little piece of my heart in the time I was privileged to know you and care for you. I will always have a little space for you there, sweet boy. You were a joy to know. I will remember you in the photographs. I will remember you in our brief moments together. I will remember you through all the babies that follow in your footsteps. I will remember you 💗
It feels like ages since I last wrote. Have missed you all ❤ Between shock, loss, grief, more loss, jet lag, and trying to get back to some kind of a routine, I have slacked off a bit. At the same time, it also requires some outside inspiration to write. Today that inspiration is Edith.
When I visited The Florence Nightingale Museum in London last June, I had the pleasure of learning about Edith Cavell-yet another inspiring and amazing nurse that went above and beyond. She gave her life protecting her patients, allied soldiers in WWI.
Wow, she gave her life protecting her patients! It is said that “during WWI, she treated all soldiers regardless of nationality.” According to Edith, “each man is a father, husband or son” and that “the profession of nursing knows no frontiers.” Before she was executed, she managed to help over 200 soldiers escape an otherwise ill fate.
Thank you for your service, Edith. Thank you for putting others before yourself. Thank you for being so brave. It kind of makes me rethink complaining the next time I miss my dinner break at work because we were understaffed and overworked.
Years ago, when I started working in the NICU (neonatal intensive care unit) I was explaining to a group of non-medical people what I do. I explained that I was a neonatal nurse, that I work with babies. With that came the naive question, “what do you do then, just feed babies all day?” The answer is yes and most definitely no. While of course even the tiniest babies need nourishment, this is just a small part of an enormous job that involves a keen eye, constant reassessment, a soft touch, empathetic heart, and super critical thinking skills. We carry a very heavy responsibility. Many of us at one time or another in our career have gone home with insomnia wondering if we did everything we could for our patients. Did we miss any subtle signs of our patient decompensating? NICU nurses have to be experts at reading subtle signs of danger as our patients lack the ability to communicate when they hurt or feel sick. The following is what is expected of a neonatal nurse in a day’s work.
Part Expert Clinician
This skill takes years to hone. A typical day for a NICU nurse starts after report, also called change of shift. Each patient has different problems, needs, requirements. It requires anything from understanding the pathophysiology of a congenital heart defect to knowing that a premature baby that exhibits a large belly and feeding intolerance can be a sign of necrotizing enterocolitis, a life threatening infection. We are expected to interpret a baby’s blood work and know when to react, know if the baby is getting too much or not enough fluid, and give all medications correctly and on time. We have to know that giving certain medications too quickly can cause ototoxicity or hearing loss. We are expected to know that certain IV fluids should never be given together and never given through small veins. We have to trouble shoot IV sites, IV pumps, ventilator settings. We have to interpret a low grade or high grade temperature. We have to quickly (but safely) give blood product after blood product to keep our tiny patients alive. We have to respond quickly to a dropping blood pressure and stimulate a premature baby who has gone apneic. We are expected to be fully aware (even at 5 or 6 am) and prepared to administer CPR to an asphyxiated baby born after being stuck in the birth canal.
Part Mind Reader
This applies only to working in certain areas in the U.S. Depending on where in the country one works, there still exists a very clear hierarchy where nurses are expected to anticipate the needs of the doctors and in a timely manner. I have through the years reluctantly become a sort of mind reader. It is the nurse’s responsibility to know that Dr. So and So gives all his babies a suppository every 12 hours round the clock (premies become easily constipated).
I have worked with doctors that expected the nurse to know that they require a small towel (rolled in a precise manner) to place under the baby’s neck before intubation and who have all but written me up (instead of simply asking) because I had not charted the baby’s weight in the timely manner they required. This adds unneeded stress in an already stressful environment.
Parents of NICU babies are grieving. They are grieving the normal delivery they had hoped for, the healthy baby they dreamed of, and the diagnosis they have been given instead. Though they are usually referred to a support group or therapist early on, it is the nurse that plays the role of therapist most days. They witness the most critical moments in a NICU parent’s life in real time as it happens. They are there the day the baby is born and admitted, the day the baby is diagnosed with a brain bleed or life threatening sepsis and even on the good days when baby starts eating by mouth or gets closer hopefully to going home. Through this roller coaster ride that is the NICU, the nurse is by both the parents’ and baby’s side watching, monitoring, assessing, intervening, and guiding. The parents rely on the information we give them and sometimes that information determines whether or not they have a restful night, so we learn (hopefully) to tread gently and carefully.
In the 8 to 12 hours that a NICU nurse has assumed responsibility of a NICU patient, it is that nurse’s responsibility to protect the baby. It’s called patient advocacy and it’s a little like a female lion protecting not only her own cubs, but all the cubs in the pride. It can be reminding a parent, family member, or coworker the most critical element of hand washing before any contact with the baby. It can be questioning a doctor’s order that may not be in the best interest of that particular patient. Whatever it is, if it is not in the best interest of the patient, it is the nurse’s job to speak up.
I recently heard one of my favorite doctors here in Sweden say something that will be forever engrained in my brain. Toward the end of a tiring night that required admission after admission of unstable patients, she said to me something along the lines of “it’s best to always prepare for the worst, that way there are no surprises.” This is a good summation of working in the NICU, always preparing for the worst while hoping for the best. At the end of a sometimes very long and emotionally trying day, we are expected to show up for the dinner parties with smiles on our faces. This takes the super human ability of separating work from non-work. Some days are easier than others and that is why it is so much more than just feeding babies. Feeding babies is actually a cherished moment for NICU nurses because this means that we have hopefully done our job and done it well.
Most nurses are creatures of habit. We develop routines before going to work, have routines while at work, and have routines when we get home. How many can relate to this?? This week was my first week back on the job. I’m a night shift nurse by heart. I like the pace, people, and pay.
I reluctantly started night shift on my first travel assignment in 2006. It was not by choice, but after a week of nausea and confusion, I was hooked! There isn’t the constant buzz and whir that one experiences on day shift in a hospital. Nights are great for those of us who become easily distracted, as long as you can stay awake.
Working nights is no joke when it comes to the effects it has on the body. More and more research is finding a connection between shift work and increased likelihood of cardiovascular disease, depression, obesity, and insomnia. That’s why it’s so important to try to make sleeping well, eating well, and exercising a part of life. Don’t get me wrong, I eat chips and drink soda sometimes, but it’s all about balance. I try (keyword try) to limit the junk to one day a week.
I thought I’d share some of my routines for surviving night shift. It’s a process that is years in the making, thus time tested.
I usually have one or two cups of tea before work. It gives a little pick me up and has the added advantage of antioxidants. I might have a cup of tea on my first break at work too as well, but I have a rule of no caffeine too late for fear of interfering with my sleep. I also pre hydrate with water before work in case it’s so crazy busy I don’t have time initially to drink. Every chance I get, I drink a glass of water.
It’s so essential to sleep and sleep well. Whatever it takes. I know that my bedroom has to be as dark as possible and cool. If the temperature is off even by a degree or two I can sense it. I use an eye pillow filled with flax seed and lavender (highly recommend). Eye pillows block all light, can relieve headaches and eye tension, and allow for a deep state of relaxation. The weight of the flax seed in the eye pillow is said to add needed acupressure points around the eyes. The added benefit of lavender has a further calming effect.
I eat healthiest actually on the nights I work. I know my body needs the best fuel possible to stay alert. I eat dinner at home before going in. Baked salmon with a garlic yogurt sauce is my favorite. Both are high in protein and hold me almost the entire night. I bring fruit, nuts, and sometimes yogurt as well to snack on all night. The nuts and yogurt give the energy I need and hold me for a while, plus it is easy to eat quickly if needed.
I practice yoga nearly every day, sometimes it is only fifteen minutes with my legs up the wall with my eye pillow and deep breaths, sometimes it is a full invigorating practice that challenges my strength and endurance. It depends on how I am feeling that particular day.
As we all know, this is usually not a problem. We are often faced with an admission or a decline in our patient’s status when we are most tired (right around 5 am). I usually have a routine of cleaning everything around my patient early in the shift. As I get more tired, if I have nothing patient related to do, I clean and stock.