Life After Nursing School
Life After Nursing School is a podcast for new nurses navigating their first year in healthcare. Hosted by Nurse Coach Caroline, each episode offers practical advice, expert interviews, and real stories to help you build confidence, manage stress, and overcome imposter syndrome. From landing your first new graduate nurse job to battling imposter syndrome on the unit, this podcast will provide the support and guidance you need to succeed beyond nursing school. Tune in to every episode to thrive in your nursing career!
Life After Nursing School
Can New Grad Nurses Work in the NICU? Career Advice from a Neonatal Nurse
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Have you ever wondered what it's really like to work as a NICU nurse or whether new graduate nurses can start their careers in the Neonatal Intensive Care Unit?
In this episode of Life After Nursing School, Caroline sits down with Lisa Houston, MSN, RNC-NIC, C-ELBW, a neonatal nurse, nurse educator, and Business Development Manager at the Vermont Oxford Network (VON). With more than 20 years of NICU experience, Lisa shares how one unexpected opportunity changed the course of her nursing career and why she still loves caring for the tiniest patients.
Together, they discuss what it's really like to work in the NICU, the skills and qualities that help nurses succeed in neonatal nursing, and practical advice for nursing students and new graduates interested in this highly specialized field.
In this episode, you'll learn:
- Can new graduate nurses work in the NICU?
- What it's really like to be a NICU nurse
- How to stand out when applying for neonatal nursing positions
- The importance of mentorship and lifelong learning
- Common misconceptions about NICU nursing
- Why one conversation can completely change your nursing career
Whether you're exploring nursing specialties, preparing for your first nursing job, or dreaming of becoming a neonatal nurse, this episode is full of practical advice, encouragement, and career insights you won't want to miss.
🎧 Be sure to subscribe for weekly conversations designed to help you confidently navigate life after nursing school.
Connect with Nurse Coach Caroline
Instagram: instagram.com/nursecoachcaroline
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Website: www.nursecoachcaroline.com
Connect with Our Guest: Lisa Houston
Instagram: @nicueducator.lisa
Tiktok: @nicueducator.lisa
Website: www.niculearningnest.com
Hey, hey, welcome to Life After Nursing School. I'm your host, Caroline Dana, aka Nurse Coach Caroline. And I'm here to help you, the new nurse, thrive in your career. As a former nurse recruiter, nurse manager, and now your personal new nurse career coach, I'm obsessed with making sure you don't just survive your first couple of years at the bedside. I want you to absolutely rock them. From the challenges to the triumphs, I'll be right here with you, giving you the real-world advice and support that you need to shine. Whether you're in nursing school getting ready for life after, or you're already out there in nurse life feeling overwhelmed or even questioning your confidence, I've got your back. I'll be sharing tips, tricks, resources, and strategies that are just for you. We'll dive into everything from landing that dream nursing job to slaying imposter syndrome, and most importantly, how to keep that spark alive and stay the vibrant and amazing nurse that you are. So if you're ready to tackle the things nursing school did not cover, like how to build a career, trust yourself, and keep your passion strong, then get comfortable because we are about to dive in and make nurse life the best life. If you've ever dreamed of becoming a NICU nurse or wondered if new graduates can actually start their careers in neonatal intensive care unit, this episode is for you. Today's guest is Lisa Houston, a neonatal nurse, nurse educator, and business development manager at the Vermont Oxford Network. With more than 20 years of NICU experience, Lisa has dedicated her career to caring for our tiniest patients while also helping educate and support the next generation of neonatal nurses. She's led simulation-based learning initiatives, developed evidence-based guidelines, championed quality improvement in neonatal care. And despite all of that, she still picks up bedside shifts because, as you'll hear throughout this conversation, caring for babies and their families is where her heart truly is. But what I love most about Lisa's story is that it wasn't perfectly planned. She actually thought she was going to become a pediatric oncology nurse until one conversation during a job interview completely changed the trajectory of her career. It's such a powerful reminder that sometimes the best opportunities come from staying open to unexpected paths and listening when someone sees potential in you before you see it in yourself. In today's episode, we'll dive into what it's really like to work in the NICU, whether new graduates can start in this specialty, what hiring managers look for in NICU candidates, the biggest misconception about neonatal nursing, and why mentorship and lifelong learning have played such a significant role throughout Lisa's career. We also talk about how one nursing degree can open doors you never imagined, and why saying yes to new opportunities can completely change your life. Whether you're a nursing student exploring specialties, a new graduate interested in the NICU, or simply curious about one of nursing's most unique and rewarding career paths, I know you're going to learn so much from this conversation. Lisa, welcome to the Life After Nursing School podcast. Let's dive in. So today I'm going to welcome guest Lisa Houston. I'm so excited to have you on the show, a NICU expert, finally. So welcome, Lisa. Thank you.
SPEAKER_01I'm so happy to be here. I love talking about the NICU. So hopefully you don't, you know, get me to say too much.
SPEAKER_00Talk forever. I was telling Lisa before we hit record here that I have been asked many times NICU-specific questions for new grads. And to be completely frank with you, I don't know if I've ever stepped foot in a NICU. So, and I probably never will. So I am definitely not saying I'm an expert at all, but I'm like, you know what? I do know a couple people that I could reach out to. And Lisa, thank you so much. I know I actually reached out to you a few months ago and you were so gracious to be like, absolutely tell me when and where. So finally, today's the day that you're here.
SPEAKER_01Yeah. I'm excited to be here. It's gonna be great.
SPEAKER_00Now, Lisa, can you give us your story on life after nursing school, what that looked like, and pretty much how you got to where you are today?
SPEAKER_01Yes, absolutely. I think I'm one of those rare people, at least in the whole universe, where I left high school knowing I wanted to be a nurse. So I went to a direct entry nursing program. I did not mess around. I knew what I wanted to do. I think my parents were very grateful because my siblings did not do that. And I did that. I had a friend when I was growing up who died of cancer of osteosarcoma, which I think today he would have survived. But back then, he talked about his nurses all the time. And so that's I knew then and I went to nursing school. I left nursing school. I thought I was gonna be a pediatric oncology nurse because of him. That was my whole trajectory. But I kind of got sent on this uh sideways path at the end. So my nursing school was pretty unique in that we could do what we call capstone now. Um, I believe we called it an extended practicum back in the day, but um, anywhere in the United States that would actually take us as a nursing student. And so my sister lived in Seattle and I was like, well, why not? I'll go to Seattle for three months. So I did. I worked in adult oncology and I was like, this is great. I could do anything really. And I decided to move to Seattle. I live in the Midwest and I just up and moved. I'm like, I'm leaving nursing school. I have no reason not to, let's go. And I started applying. I also did something unique that I don't know if a lot of people do, especially this day and age. And then I took six months off after nursing school because I felt like I was going to start a career that doesn't have a lot of breaks. And so I was a nanny and I traveled and I started, I took my unclex right away because I wanted to get that over with. And then I traveled and did all that and I started applying. And I applied at the time. So I graduated nursing school. I'm a little old here in 2003. And I, you could kind of get a job anywhere. I was in nursing shortage. We I applied maybe to 11 places, interviewed everywhere. And it was during an interview that someone said, Hey, you volunteer in a NICU, you volunteered at a Newborn Crisis Center. Why didn't you apply to the NICU? And I said, Well, they told us in nursing school that you can't start in the NICU. And she was like, Well, that's not true. Why don't we go on a tour? So I was like, Okay, the only exposure I had to the NICU in nursing school was like a level two babies in cribs, nothing exciting. So we walked through, and the person must have been helping a baby, like literally just have a little apnea spell. And I was like, oh my God, this is critical care. Like, I'm in. And I applied that day. They interviewed me on the spot and I got the job. And it was never really, I knew about the NICU, but I thought maybe I would be a midwife or labor and delivery. And that is where my journey began. And it's just taken off from there. I started in 2004. So I took six months off and I started and I just never really slowed down. I started precepting. I became a charge nurse while precepting a student. Her nursing instructor was like, uh, you need to go back to school. You need to be an educator. And I was like, all right. So I did. And I went back and got my master's in nursing education. I became the same title across many things, essentially a nurse educator, a clinical nurse educator, but I've had like five titles that mean the same thing. I became an NRP instructor, I became a stable instructor. And then we my whole family moved back to the Midwest. I had my third child and we moved back. It was time for a change. And I just kept going, was a nurse educator here. And one of the best things about nursing is one degree can send you on many courses. And now my primary job is working for the Vermont Oxford Network, and I work from home, um, working for a neonatal database while still dabbing my toes in occasional shifts at the bedside and running social media. So it's taken me all along a long trajectory, but it all came just from one degree, which is also my favorite thing about nursing. So yeah.
SPEAKER_00I love your story. There are so many things I want to touch upon. First of all, I agree with you. Like there's a, I feel like there's a small group of us that knew we wanted to be nurses. Like I remember sixth grade pretty much was when I was like, this is what I want to do. And that was it. I had tunnel vision for the profession, which you know was so funny. But it it felt right. Obviously, here I am, right? I appreciate in your story that you were open to other people's feedback, like in ideas for you, saying, like, hey, you were a nanny, you volunteered in the NICU. Would you consider NICU? And you were like, oh, and then you were like, yeah. And then, you know, that instructor saying to you, hey, you need to go back to school. And you're like, okay, like it seems like you are so open to other people's encouragement, or I don't know, just sort of like them strategically pushing you. And it's amazing how these things do fall into our lap throughout our life, but we can easily ignore it, or we can lean into these things and uh create the life that really was meant for us. So I I love that that you really, you know, you didn't just brush the instructor off. You were like, Yeah, good idea. Let me look into it.
SPEAKER_01I know. I think that a lot of times as women and we ignore kind of our gut or we don't think we can do more than we're already doing, and to have other people say something that maybe you thought of yourself but didn't feel comfortable, I think always feels encouraging.
SPEAKER_00Yeah, right. Like it wasn't like they just said something random and you're like, okay, let me sign on the on the dotted line. It's like, well, I thought about going back to school, I didn't know, and then someone else saw that in me, which sort of gives you the courage to then actually take the leap. Exactly.
SPEAKER_01Yeah. And I think that's a big part of like what we can do as older nurses to help other nurses, right? It's like to see in them and to say, like, I get this a lot with people when they don't want to precept. They're like, I'm not ready. And it's like, yes, you are. We all have something to teach. Like, you can do it. You nobody expects you to be perfect the first day, but you have this gift. You should be sharing it with others.
SPEAKER_00So for sure. And as much as precepting is helping someone else get on their own feet in the in the career, in the role, it's also a great way to challenge what you know. And it makes you even a better nurse because you know all the reasons why we're doing something. You can anticipate care and you sort of are are learning the next layer of of education as you're teaching it to someone. You know, it just kind of gets the wheels turning again, which I think is a great way to just perfect your your nursing skills.
SPEAKER_01Yeah, for sure. For sure.
SPEAKER_00Now, you uh mentioned something too in your story that um in nursing school you were told that you can't start in the NICU. And I do feel like nursing school tells these nursing students all kinds of things, but they're not actually the reality. Like I remember when I was in nursing school, it was it was not if you get your master's, but when you get your master's. Like it's constantly like you have to go back to school. And it was like they were teaching us that before we even graduated with our nursing degree. It was like, wait, wait a minute. And I don't think it's necessarily malicious or anything like that. I think it's sort of what has been ingrained in them. However, things are very different when you actually get out. And there are there are positions for new grads in the NICU. Are there a ton of them? No. But what's that look like for you from your different NICU work environments? Were they routinely taking new grads?
SPEAKER_01Yes. Everywhere I've ever worked, we hired new grads. So out in Seattle and then in the Midwest, absolutely. And I would say every state has centers that take new grads for sure. I do think in states with lower nurse turnover or vacancy rates, just like anything, the best in, you know, kind of like critical care positions get taken first. So in California, it is near impossible to get a position as a new grad in an ICU because they just people want to work there. I mean, their staffing ratios are so great, their pay is so great, their um PTO, everything is so great that people want to work there, which other states should take note of, by the way. But they do exist. And even in this calendar year, I saw on LinkedIn, this is not like a secret. Like Lucille Packard was hiring new grads in their NICU. That is a California-based hospital. So it does happen. They do exist. It's you might just have to be patient or relocate. And not everybody can relocate. I was lucky. I was 22 years old with no boyfriend, no nothing, right? And I could go anywhere. I was excited to go places, but not everyone can do that. And that is a reality. And so you may have to start somewhere else. But working in the NICU as a new grad is entirely possible and happens. I mean, just at our hospital alone, the last one I worked at as a uh hiring manager, we hired probably, I don't know, I'd say on average 40 new grads a year.
SPEAKER_00Wow, that is pretty good. Yeah. Now, okay. If someone's like, I am dying to get into the to the NICU and they're in nursing school, are there certain things they can do to make their resume look better? You know, like obviously if they can land a capstone in a NICU environment, that'd be great. But again, that's really hard to do. And a lot of nursing schools don't even offer that. So is there I've also heard too, a side kind of a side note here, that being a milk tech is helpful potentially. Like if you could be like, I don't, I think that's a paid position. Yeah. I don't know. Tell me your thoughts on on how do you yourself look like you know, a great NICU candidate.
SPEAKER_01Yes. The number one thing that I think is actually true for any nursing student, but it will help you as a NICU nurse as well, is to be a tech. Any sort of in-hospital based job that you can do is going to build your resume. So when we were hiring and we would look at resumes as the process went for me at both in Seattle and here, is recruiters look first, and maybe today it's AI. So you gotta think about that. Then we get a look. They had things that they looked for for us, and then we looked and decided who we would want to interview. So the number one thing we looked for is do you have in-hospital experience? That was more important than do you have a bachelor's? It was more we never looked at anyone's GPA, never. Don't care about it, don't know why people put on their resumes. And the thing that maybe I'm gonna say, I don't know if I should tell everyone this, but I'm gonna tell you anyway. You don't tell us how many hours you worked as a tech. You can be a peer in tech, and your resume still says nurse tech or milk tech or transporter. Like, I don't care. But what it's showing us is job longevity, teamwork, escalation, all of those things are so important to being a NICU nurse. And so whether you do that 12 hours a week or 36 hours a week, we actually cannot legally ask you that. We cannot say, how many hours have you put in as a nurse tech? Like, no. So do the there's summer programs. There's at the hospital I worked out, we had a summer program where you worked full-time in the summer on your breaks and then a little bit here and there. Great, great, go do it. So being a tech is amazing. Milk techs are a specific thing to the NICU. Well, I don't know, maybe they have them in PEDs, but um, if a place has a centralized milk room where they're mixing up breast milk, we treat breast milk as medicine. So it is not sterile, but a clean procedure, right? They're wearing cap hats, gowns, gloves. They literally weigh all of the milk, all of the formula. It's math. I had to cover in the milk room once. I was like, I can't do this. It's too much. Get me out of here. So there's a lot going on there. At all the NICUs I worked at, we've never had nurse techs. So we did not have techs in there like doing temperatures or diapers. I do know that there are hospitals that do that. We have we hired front desk associates, people that had simply worked our front desk, but they got used to the flow of the NICU. They learned the lingo, they learned how to talk to nurse practitioners to be like, you got to go look at this baby on mom baby, right? So they're still, again, in a hospital, learning time management, learning teamwork. So anything you can do. And of course, if you can get that in a NICU, followed by PEDs, mom baby, labor and delivery, those are gonna look best for a NICU nurse, but we do not limit it to that. We will take a med search check over someone who has no job history and a bachelor's degree any day.
SPEAKER_00Yeah, that's definitely interesting. I've been on the hiring team, and we actually will definitely take bachelors over ADN nurses. Like that would be a priority. But going back to what you said about GPA, that is not like if you got through nursing school, you're smart, right? Like we don't need the smartest of the smart. We need people that are gonna be like reliable, hardworking, patient advocates, you know, like that matters way more than GPA. And I hope nursing students out there hear me that saying that because I know we tend to be like an overachieving group of people because we want to do our best, we want to show up. We really a lot of times we're competing the most with ourselves, but giving yourself some grace, like a B is great. You know what I mean? You don't have to get a 100, you don't have to get a 90. Just do your best in that moment. And I know nursing school too is a lot of combating burnout, so it's like don't kill yourself for the GPA.
SPEAKER_01I also think it's interesting in my experience. I'm still close with a lot of people from nursing school. In fact, my girl, best friend soulmate, is from nursing school, and she wasn't a great test taker. And she is one of the best nurses, she works with those silly adults that y'all do, and literally her bedside manner is the best. She takes care of her patients, she knows every medication. She just was a terrible test taker, and she's phenomenal, like obsessed with her. So it is not all in that. And so I I do I agree, it is just so tricky to you got to get to the interview sometimes to explain that, which I think can be the limiting part.
SPEAKER_00So I do agree with you on that. Okay, so if you can't get a job as a new grad in the NICU, what would you say is the second or third best specialty? I think you kind of mentioned them from like an experience, you know, as a tech standpoint, but would that next be peds and then mother baby? I forget what you kind of just said. Like, what are the other ones that you think would be helpful before getting to the NICU?
SPEAKER_01To be honest, everyone thinks you should go PEADs next, but really mom, baby, and labor and delivery, I would choose over PEADS because in the NICU, yes, there are some units, mine included, that we saw babies up to a year. But in PEADs, you're gonna see up to 18. It's almost like you're learning adult medicine at the same time. Mom baby, you are learning the essential thing, which is taking care of the baby and their family. We do say in the NICU, while your patient assignment may look like three patients, it's actually six because you're taking care of that patient and their family. So on mom baby, you get really used to that. Same with labor and delivery. Some, I know birthing hospitals now are like you're the same person for the whole thing, which would be even more amazing. I've worked both places where it was very divided and then very cohesive. Um, labor and delivery, you're learning resuscitation, you're learning maternal risk factors. So all of that is gonna be really important to NICU. So I would take mom, baby, and labor and delivery, probably followed by PEDs. So it's a little more nuanced. Then probably adult ICU would be next because adult ICU also, you're learning the critical care aspect, escalation, autonomy of being like, okay, we do need to escalate, we don't. Um, I'm pulling back on a little bit of what I went through nursing school a hundred years ago, but I think they still do all these things. I had to go to an adult ICU to help them with a cooling blanket, I don't know, maybe four years ago. And I just want you to know that I referred to the patient as the baby. So you can really not take the NICU nurse out of the NICU because I was helping with two, and I was like, where's the other baby that needs help? And they were like, oh God.
SPEAKER_00Yeah, they're like, that's an adult.
SPEAKER_01Yeah, we brought the NICU nurse up here. I did fix the machine though, so they should be appreciative of that part. But yeah, I was like, this is so embarrassing. But yeah, it's that would probably be the order I would say to look good on your resume.
SPEAKER_00Okay, I love that. What about um if you are like in nursing school and you're preparing to to apply for a NICU position? Is there, and you know, you're in that limbo of just waiting for a job. Is there a certain like certification that you recommend they get ahead of time? People ask me this all the time. Should I get ACLS? You know, and I'm like, it's not gonna make or break your resume. I know, and I'm like, usually your employer will cover it once you're, you know, there and you don't have to pay for it and all these things. But I also feel like sometimes the nursing students, especially once they graduate, have that like restless energy of like, what can I like move forward? Yeah. What are your thoughts, like NRP or anything? Like, is it worth them pursuing that? I know, I agree.
SPEAKER_01It's it is really tricky. I think, similar to how you were saying about like nursing schools were pushing you in this direction. I think recruiters are doing that too, and nursing instructors. I've had people reach out to me and be like, my nursing instructor told me to get stable in NRP. And I was like, We're gonna pay you, we're gonna pay for it and pay you to go.
unknownYeah.
SPEAKER_01So it's like a double whammy.
SPEAKER_00So if you have two good candidates and one has their NRP, have you like I know in my hiring experience, I've never been like, they're both really good, but this one has their ACLS already. No, yeah, no. I would actually say the opposite.
SPEAKER_01We'd probably take the person that's not because untraining people is really hard. And so in NRP, yes, it is a global course. I've taken it in multiple places, right? And you take it and you have to use the equipment at the class you're at. But when you take it on a unit you're going to be working at, you're using their specific equipment. So for instance, everyone's supposed to use a T-piece resuscitator, right? That's what we do in NRP now. At this unit, maybe they use a Neo Puff, and on this unit, maybe they use a Neo T and you learned this, and now I have to unteach you how to use that and use this. It's almost like gonna create more work for me.
SPEAKER_00Yeah.
SPEAKER_01And I have I have a good friend who is a very similar position as me in California because I do think they're the hardest. And I asked her the same. She's like, no, I never recommend anyone to get it because again, we're gonna pay for it and all of that. So absolutely.
SPEAKER_00I totally agree with you. It is, it definitely is.
SPEAKER_01So yeah, it's hard. If anything, I'd be telling people to shadow and volunteer. We actually look very highly on volunteer work. Um, it shows us kind of just who you are as a person, and it doesn't have to be volunteering in a NICU. You can volunteer in an animal shelter. Like, show us that you're dedicated to something, that you've kept busy, those kinds of things, those do go a long way as well.
SPEAKER_00I agree. Sort of those extracurriculars definitely do go a long way. Okay, now for someone that is like preparing for a NICU interview, you have specific questions or tips on how they can prepare, basically, for NICU-specific questions. We know the all the general interview questions and whatnot, but is there something specific, even if the candidate doesn't have experience in a NICU?
SPEAKER_01Yeah, the big thing is for us, everywhere again that I have been a part of a hiring team, both in the West and here, we are required to ask the same questions of every candidate. People, I don't know if people know that, but it's like a legal thing because otherwise it can show favoritism. So we have our same 12 questions that we prepare ahead of time. And sometimes you might jaunt a little bit on something, a follow-up or something. But we do not ask clinical questions to any new grad nurse because that is unfair. If someone's never set foot in a NICU, we cannot expect them to know something that someone a capstone has done. So we ask more of those general questions that you're probably are used to. We will gear them to the NICU. Like one of my favorite ones is what are qualities that you think make an excellent NICU nurse? And so really honing in on what that looks like. I think anyone that's preparing for an interview should prepare stories just like you would for anything else. What's a time you worked with a patient of diversity? What's a time where you disagreed with the treatment plan? And how did you handle that? Because that happens in the NICU. If you're in a teaching hospital, we change doctors all the time. You don't have an attending for four months if the baby's in the hospital. So someone might change it and you're like, wait a second, last week we were on diuretics and now you're saying we shouldn't be on diuretics. Uh, the diuretics were helping. How do you speak up when the treatment plan isn't aligned? So having some stories in your back pocket ready to go is going to be super helpful. Tying it back to the NICU and using words like family-centered care, how the family applies, escalation. We want escalation, advocating. I I think that people like to say, like, oh, babies don't talk, but they do. They actually talk quite a lot. You just have to change your language. And the language is you're looking, are they modeled? Are they breathing harder? Are they more sleepy? Are they more they are talking all the time? So, how have you advocated for someone else and how are you going to translate that to the NICU is going to make your interview very powerful. And people can do that very well, even if they've never set foot in a NICU. It is possible. But we do not, if you are an experienced NICU nurse and you're switching hospitals, we do ask some questions to kind of figure out what you've done. Um, but that's a little bit different than a new grad.
SPEAKER_00I agree with you. And yes, you are right. You know, we've I've always had a set like list of questions. It also helps a hiring team compare candidates. If we're asking everyone different questions, it's like, well, they all answer good, but I don't know what this person's weakness is because we didn't ask them, you know. So yes, there's definitely some standardization, which I love that you highlighted here. Now, if someone says, I want to be a NICU nurse, but they haven't done any type of NICU rotation, they don't look like they have child care experience. Is that a little bit of like, I don't want to say a red flag for you, but like, do you really want NICU? How do you know you want NICU? Because I do feel like these specialties, people glorify them sometimes or think they want something. And then once they get into nursing, they're like, wait, what? What is this? What did I sign up for? So, how can someone validate or show evidence that they actually do want to be a NICU nurse?
SPEAKER_01The hard part is getting through the first stage of the resume being screened by someone else, right? And so if your resume is not strong or have anything that we're looking for, I think that is actually the trickiest part, which is why I love your podcast and your platform and this idea of like building a resume early. And if you don't and you can get in, I think the number one way that people are probably finding us is then through shadow experiences, reaching out to a manager or a recruiter and saying, Can I shadow in your NICU? I'm a nursing student, so that we then know their name. And then they've come in for a shadow, which you can talk about during your interview. But what I like to tell people, I do mock interviews with nurses coming out of nursing school to help them prepare for NICU interviews. And what I say is your resume should never tell your whole story. You that's what your interview is for. The the interview is not a repetition of what happened on your resume. And so that is your time to shine and to really know your why. And if you say to me that I want to work in the NICU because I want to rock babies, I pretty much stop listening because guess how often I rock a baby? Never.
SPEAKER_00I have no idea how often. Sometimes.
SPEAKER_01Well, actually, we don't rock them because rocking's not good for them, but we do hold them. So it's not as much as you would think we would because hopefully their parents are holding them. Right. But it's really having the passion of understanding. So if some if I said to you, why the NICU, why do you want to work here? And people are saying things like, you know, I'm very interested in evidence-based medicine. I love the critical care aspect. I love the idea of being able to be with a family during their happiest moments and their hardest moments. I want to help them through that transition. I love care at many stages of life and watching a baby go through a long stay. Like all of those things are really good wise. I'll tell you a very quick story. And I talked to her before, and she I she knows I tell this story all the time. But we had a nurse interview with us who this was her second career, and her first career was as a school bus driver. So I want you to imagine that resume. It's probably not the most ideal resume, right? And she came in and she told us why she wanted to be a NICU nurse. She told us all about caring for vulnerable infants during a fragile time. She told us about how she loves talking to families, how she loves teaching families. And to this day, I maintain she's the best person I've ever hired. She is the best NICU nurse I have ever hired. Associate's degree, no NICU experience, no in-hospital experience. So you would think all strikes. And the interviews is what did it. She was so passionate about the population and their families. And she talked about the trajectory of a baby through a NICU stay. And to this day, I think she's one of the best nurses I've ever hired.
SPEAKER_00Yeah, I mean, a lot of it really does come to preparing for the interview and being able to speak passionately about why you want a certain specialty or hospital or whatever that may be, because that does transfer to the hiring team. You can tell if someone's really done their due diligence and they know why they want a certain specialty versus someone that maybe they applied to 100 positions. This is the one they got an interview for, and now they're like, Well, I love babies, they're so cute, right? And it's like, well, that's not a great reason. So a lot of it really is preparation and knowing your why. And I do appreciate it.
SPEAKER_01And also, like, I did this one time. I should probably do it again. It's been over a year where I said, like, the worst interview answers I've ever heard. People thought I was making them up, and I'm like, I am not, and I have more in my back pocket. Yeah. People have been like, Oh, I want to work in the NICU because I don't want to lift adults.
SPEAKER_00Like, I don't even know why you're in nursing. Like, I don't know. I'm like, wait, what?
SPEAKER_01Yeah, like no, yeah, no. No, that to me is worse than I want to hold babies all day. You know? Yeah. It's like, or they'll say, I really don't like talking to people and babies don't talk. And then I'm like, okay, well, they have families.
SPEAKER_00Like, yeah. Yeah. Well, I I think a common myth out there, although I hope like between me and you, we're really debunking it and a few other people in our space, is that people think they can literally show up to an interview and get the job because of this nursing shortage. And and literally, I see people all the time like on social media being like, you don't really need to prepare, you just show up, you have a post, they'll hire you. We're so short staffed at the hospital. Not for new grads. And like, I cannot emphasize that enough. And honestly, I had to learn that the hard way myself. So I just feel like that I think sometimes people come in thinking they can literally say whatever on the fly because we have this, you know, supposed shortage. So yeah, no, you do need to prepare for your interview, especially as a new grad, and especially as a new grad wanting the NICU. Yes. Yeah, that is I know for sure. Okay, so you mentioned rocking babies, but you don't actually rock them, you hold them, etc. And I'm like, well, I don't know. What do you do? Can you share with me what does a day look like in the NICU? And can you also maybe touch upon the different NICU levels?
unknownYes.
SPEAKER_00You don't like go crazy, but just so people kind of know what they are.
SPEAKER_01Yes. So I think you know, lots of misconceptions about the NICU. If I had to dispel two big ones, is one, people either think we take care of the smallest babies and they all die, or we're holding babies. And really the work we do is very much in the middle of that, right? Yeah. So a level two NICU, these actually I think go opposite of traumas, right?
SPEAKER_00Yes, yes, because I was very confused when I learned NICU. Like people are like, oh yeah, level four NICU. I'm like, okay, what are those are like healthy babies, right? Or something. And it's like, oh no, no, those are the sickest. I'm like, oh, yeah, it's backwards. Why do we have to make things the opposite in nursing just right?
SPEAKER_01Amen. So there's technically like level ones that are gonna be like newborn nurseries, where maybe a that's like a late preterm infant or something, but typically they're called newborn nurseries and not NICUs. So a level two NICU can provide up to CPAP typically, and maybe a baby with a peripheral IV that's gonna be like a short stay, maybe a late preterm or rule out sepsis, something like that. A level three provides all forms of ventilation, so any size baby and any form of ventilation and may do some surgeries. And they may do something simple, like okay, no surgery simple, but like ROP for the baby's eye surgery or like a PDA clip where they don't have to crack the chest, but they're just uh clipping the ductus arteriosis. And then a level four, it pretty much does everything. You do not have to do ECMO to be considered a level four, though. That is another misconception, is everyone's like, oh, level four is do ECMO. Well, that's not actually true. The AAP changed their designations maybe four years ago, four or five years ago. So you have to be able to transfer to an ECMO center within one hour, um, plus do like all the other things, more surgeries, like you're doing faliceal, gastroscesis, neck, like everything else. And so those level fours that provide ECMO are most likely freestanding children's hospitals. So that's what you kind of picture in your head. Um, they don't typically have births, but some are connected to birthing hospitals.
SPEAKER_02Okay.
SPEAKER_01Whereas a level three that kind of does everything, they tend to be more specialized in micropremies because they're not doing those sick, you know. When you think of a level four, you're thinking of like all the genetic anomalies we see these days, all those cardiac kids. And some of them may end up in the cardiac ICU, but it's really gonna depend. And I've worked in all of those, except I've never worked in an ECMO center. I believe to be transparent about the things we are not good at. And if someone asks me about ECMO, I'm like, I am not your girl. I cannot help you. Not today, not ever. So when you think of that, like my primary work has been in that kind of level three, four, we did surgeries and fallacyal scash cases, saw that. And your day really depends on what your patient care assignment is. Typically, you have two or three babies with outliers on the ends. Like sometimes you only have one and sometimes you have four, but two to three. And if they're intubated, you usually only have two babies, and your care times are gonna be set. We tend to do cares every three hours where we're going in and changing their diaper and taking their temperature and doing their vitals, moving them, and then giving medications. It is 24-hour care. That's my other favorite thing. When people are like, Oh, I just want to work night shift because you don't do anything. I'm like, okay. This is a 24-hour NICU. We are an ICU, we do everything all the time. So it is like that. You're educating families. That's a big other thing that I don't think people know is how much, like, how many parents I have had of a premature baby who have never even changed a diaper. And now they have to change a premature baby's diaper, right? There's a lot going on there. So we're teaching them about the lines, we're teaching them about the medications their baby's getting, or even just how to change a diaper, right? We're doing so much education. And then the other big thing about the NICU is you have to be ready to pivot because your patient or your teammate's patient could get sick so fast, and babies have no reserve. That's the difference between a neonatal ICU, even a PICU, or an adult ICU, is that they usually have some reserve. And so let's say my teammate's patient gets sick. I may not have four patients for a few hours because I needed to pick up one of hers. Right. So we do that a lot. And that is a quality that I think all NICU nurses should have and don't think about when you think about your day. You can have the best leg plan. I'm a girl that likes her plan. I like my chest flapses and my report sheet. I like all of that, but it could change at any moment, and you have to kind of have room and flexibility for that.
SPEAKER_00Okay, when I think of a NICU, I'm thinking of like one big open room with like babies in like little incubators. Is that kind of what it is? Or have we moved on to a different, I don't know, environment where they have their own room for pay for parents and they get comfortable? Like what is it? I mean, I know we can't speak to every hospital in in America, but what does it look like for you and your experience?
SPEAKER_01I would say most NICUs are now private rooms, or they start with kind of the open bay model and then move to private rooms. Um, anytime a NICU is being redone, yeah, just like you know, how the laws change, designations change. And so it is now pretty much you have to have private rooms if you're gonna redo your NICU. If you can't, you're supposed to increase the space between the beds so that you can provide uh privacy for families.
SPEAKER_02Okay.
SPEAKER_01So when I worked in Seattle, we went, I started in Open Bay, you know, where we had the lights on all the time and we talked on the overhead speaker. You know, my last name's Houston. They used to come on the overhead speaker and be like, Houston, we have a problem. Like this used to happen. I love that. No better, do better. We don't do that anymore. And we built a new unit that went to private rooms. It also required changing the nursing education because I do think there is a benefit to open bays in this idea of learning by osmosis, where you're hearing a provider explain something to their family, where you're watching a nurse put in an IV, right? In private rooms, you don't get that anymore. But it is better for the family. So I know we also learned when we went to private rooms in the NICU, baby's speech scores went down because they were not hearing as much talking and sound.
SPEAKER_00Wow.
SPEAKER_01So we had interesting. Yeah, we had to learn that you've got to talk. So if you see me alone in a room with a baby, I am talking. You're probably like, who is she talking? It's the baby. I just tell them all my life story. You know, if the parents aren't there, I just talk to the baby, I tell them what I'm doing. That's how all infants learn is by the language around them. So we learned we had to talk more in the rooms because of the cutting down. So now it's primarily single patient rooms with a nursing station in the middle, centralized monitoring, so you can still see every baby if your doors are closed. The doors usually are glass in some way, so you can see through to your monitor or your ventilator with doors that open and close.
SPEAKER_00So has like outcome changed at all for the like going? I almost feel like being in an open bay. I feel like babies would be safer because just there's more people around to notice something's going on. But I don't know. Is there any no evidence on outcomes changing depending on the environment?
SPEAKER_01Yeah, with technology now, it's like it alerts you. Yeah, it comes to your phone, you can see it. The monitors you pull up your other babies when you're in one room, so you can see what they're doing. Your phones are connected to everyone around you. So if your teammate's baby's alarming, it still comes to your phone. Okay, you can go in there. If anything, the outcomes have probably gotten better, especially for parents. Parents, I mean, when I started solid, we didn't even allow parents to stay at night.
SPEAKER_00I was just gonna ask you, what's the visiting policy now? Is it 24-7? Parents can be around. I mean, in the way, in a way they should be, right? So they're child probably best for the baby. Yep.
SPEAKER_01Yeah, most units are 24 hours, some still close for report so that nurses can do report, but I disagree severely with that because parents should be part of report, just like depletion is on mid surge. So why wouldn't your parent be on the NICU? So where I've worked in the last two units, it's 24 hours a day, seven days a week. We didn't close during COVID.
SPEAKER_00I love that. I really do. Okay, now how involved are the are do you get the parents? Like you mentioned, like changing a diaper, but I also picture this cute little baby that looks like a rodent. I'm not kidding, this is what I'm picturing in my head. And like lines and tubes and drains, and like maybe you have family trying to change a diaper, but is there a point where you're like, sorry, it has to just be done by nursing staff, or are you like, get in there, dad, give it a go?
SPEAKER_01It's a culture. So I think it's a culture based on the unit you work on plus the nurse you're working with. My goal is to do nothing for the baby. So on a shift, I believe that we believe parents should be primary caregivers. They're the ones taking their baby home. They should take home their baby and not a stranger. And so they should know their story from the beginning. Also, not every family can do that. Um, equity is an issue, maternity leave here in the lovely United States is an issue. There's a lot going on. A lot of our moms go back to work at two weeks so that they can take their time off when the baby goes home, right? I know it's crazy. But what are you gonna do?
SPEAKER_00What are you gonna do? That's why Yeah.
SPEAKER_01So we really encourage families to be involved from day one. We try to get babies out to hold on day one. That is a new goal that's really shifted even the last five years. When I again when I started, uh babies would go 30 days without being held. And now we don't do that anymore. I mean, we try not to.
SPEAKER_00I mean, it is amazing how far we've come in nursing. I remember when I first started 14 years ago, patients would have a single knee replacement, and the goal is to get them out of the hospital in a few days and like maybe out of bed in a day or two. And now it's literally can be like same-day surgery. Like it's just like this is wild. So I know it sounds like similar advancements in a way of you know, babies not being whole for the first 30 days to now the goal is day one.
SPEAKER_01Yeah. I think the big thing is the NICU is very young, like it's an important thing to remember. My favorite thing that people don't always know is you know, JFK Jr.'s son died in a NICU and he was born at 34 weeks. He died of hyaline membrane disease, which we call RDS now.
SPEAKER_02Wow.
SPEAKER_01Those babies don't die anymore. And that was it's something that we can like visualize, right? We can all when I say JFK Jr., you all pulled someone up in your head, right? So you know what we're talking about. And it's this idea that we are advancing quickly, that's what it feels like, because we know better, we have to do better. And we know now that we isolated the parents too much. We sent them home with strangers, they didn't know what they were doing, and they were confused. And the baby's long-term outcomes were not good. And now, when the parents are there, babies that are held skin to skin, regardless of the rest of their course, do better, they have better outcomes. So we have to provide a welcoming uh environment. And if you're the one, the parent walks in and you're like, Oh, it's not their care time, they can't be held, you're the problem, not the yeah.
SPEAKER_00Good point. Good point. You also mentioned that one of the other misconceptions about the NICU is that babies all die there. And here you are saying, We've come so far where now there's so many diseases and conditions that babies don't die from anymore, which I think is really, really cool. Do you feel like I'm and I'm sure you do, but do you feel like there are certain patients or families that have like stuck with you, you know, that you just like will think of kind of regularly throughout your career?
SPEAKER_01Oh yeah. I mean, I think you think of like your firsts of everything, and even what it taught you in those moments. I I could tell you the entire story of the first baby that died on my shift. And I it was less than a year into my career, and I'm at year 22 now, and I could tell you her name, her parents' name, what she died of, where we were standing. But the stories like there's a baby I took care of, and his name is Benson. And I don't keep in touch with families, it's kind of a gray line, but on occasion it happens, and more than anything, his mom and I were kind of just like in the same stage of life, and we have become extremely close over the years. And Benson is a teenager now, and that's crazy to me. But he, you know, just his family stole my heart, and he stole my heart. And it, the thing that I learned from them, because surprisingly, they're teaching us just as much as we're teaching them, is this kind of attitude of gratitude. And his family, it did not matter if we were poking him or changing him or doing his diapers. They just said, thank you all the time. Thank you for saving our baby. Thank you for being here. Thank you for teaching me that. And I have taken that with me in so many aspects of my life. They're one of those families that they held him on his first month birthday by me climbing in a windowsill to get that baby out because it was our equipment, it was not flexible at the time. We couldn't do it, but we did, and he was got out to be held. And I will I can put myself completely in my body at that moment of what it felt like to get to be there and witness it. It was a miracle, and he's a miracle, and I'm obsessed with them. And I they uh they live in Seattle, so I don't see them as much as I would like to, but um, they're just such an amazing family and a story of resilience. And Benson, he was a little 24 weaker, you know, he was just a little teeny tyke, and now he's a teenager. It's crazy.
SPEAKER_00I I love that. I'll see that every once in a while, like on social media. A mom posting their baby in the NICU and then posting a picture now and they're 6'2 and a man, and I'm like, oh my gosh. I think there's also this misconception of like if you start in the NICU and you're premature or whatever it may be, you won't grow normally after. And I thank God for social media and people sharing these things, but I think that's really been a great way to be like, wait, no, you know, they got the right care and they were able to get strong and healthy and come home and grow normally.
SPEAKER_01Yeah, there's uh one of the things I was talking about this year in February was there uh is a Seattle Seahawks player that was a 23-weeker. And he's like 6'5, and he plays in the NFL and he's enormous. And I did a whole like social media thing about him because it's true. It's like the resilience of these babies. Yes, babies do die in the NICU. It is another important thing for people to know during an interview and coming out of nursing school. If you cannot handle babies dying the NICU, it's not gonna be the place for you. I don't think we're gonna get somewhere that where you have a hundred percent survival rate, which we're just not there. And it's it can be very disheartening, but you remember the stories of those that did survive, that that kind of what is what gets you through that.
SPEAKER_00Yeah. Do you come across um stories where babies are just kind of left there? Like are there, you know, or they don't, I don't know, their parents, who knows what happened to them, or they're not in the right state of mind when they had the baby. And then the baby's sort of, I don't know, kind of who's the power of attorney? Who's the guardian? Do you do you run into those situations? Well, yes, Caroline. How did I know you were gonna say yes? Just like adults, sometimes they're dropped off and everyone's like, Where's where's the family? Where's the next kid?
SPEAKER_01It's a fun story. This has happened to me, Caroline. My uh son is that exact story, and so I swear I didn't walk you into that.
SPEAKER_00I know like I was just like, oh, I know in in the adult world it happened. No, it's true, you know.
SPEAKER_01So yeah, so just like any, you know, the boxes or anything that's safe haven law, parents can do a safe haven law. So that is what my son is a safe haven baby. Um, his birth parents knew that they were not gonna be able to raise him and they did not have prenatal care or anything, and so she did deliver him in a hospital, which saved his life. He was born with no heart rate. Um, so he's a charm, he was a charm baby, but had a lot of issues at birth and needed a chest tube and was intubated and all of this. And so he, when that happens when you're a safe haven type of baby, you become a foster child.
SPEAKER_00And that when you say safe haven, that's like someone drops off and just gives up their baby, right? Okay, okay.
SPEAKER_01Yep. And so that is what she chose to do. There are other people that, you know, I I've never really had a patient that the family just stopped visiting. But if they don't visit enough, or we will get, you know, use social work is so involved in the next year. Sure.
SPEAKER_02Absolutely.
SPEAKER_01But yeah, then like with Silas, you know, he went into foster care, and then we were foster parents, his foster parents for 19 months. So he came home from the hospital with us um as his parents. Now he's almost 17, and he's a giant and he's the best.
SPEAKER_00Oh now, now tell me, so you were caring for him for quite some time and you had a connection with him, and you're like, I cannot let this child go into the system. Or how did I mean if this is too personal, too. I'm I'm so nosy. I will ask you all the questions. So feel free to be like, yeah, I'm not gonna answer that.
SPEAKER_01No, no, no, it was a little bit different because um I never was his nurse. Oh. So at the time I was a charge nurse, and so I didn't have my own patient care assignment. Okay. And I knew that he so, like on this assignment sheet, his name was Baby Boy Doe. And so, you know, you kind of know that. And so we just learned some of his story. And as a foster provider, you can have a child when you're you're called the reasonable adult. That's what it was in Washington State. I don't know what it is in every state.
SPEAKER_00Okay.
SPEAKER_01So we did not have our foster care license when he was ready to go home. But I this try. I don't know if I can tell this story without crying, but the um at the beginning, I told you about how when I went to my interview, they were like, Why are you interested in NICU? And that moment changed my whole life because if I had not gotten that job in that NICU, would I have ever met my son? And so he, I have a few moments in my life where I can tell you that in my gut, I knew exactly what was happening. And so I went to baby boy Joe's bedside. The nurses called him Alex after Alexander the Great. So his name was we they affectionately called him that his name's Silas now. But and I went up there and as I walked to his bedside, I looked at him. He was intubated, he had a chest tube, he was sedated, and I said, Oh, there you are. I've been looking everywhere for you. And the next one foster parents, yeah.
SPEAKER_00Oh my gosh. Because I mean, I'm sure like there have probably been other opportunities to potentially do that for other children. Obviously, I'm sure it's not like happening all the time, but yeah, but there was just something different about him.
SPEAKER_01Yeah. And the rule, like in Washington State, some of the laws are like if I had met the birth mom or been his nurse, I would not have been able to take him home. Because maybe, let's say Caroline, you're his birth mom, and I would could have been like, you should just leave him. I'll take care of him, right? Like, could I have influenced someone? And so, because that stuff didn't happen, I was eligible to take to adopt him. And so that was the process.
SPEAKER_00I have chills. Like, clearly, this was all divinely orchestrated. You know what I mean? Like, there are certain things in life that you're like, you can't make this up. It's and it's it's so funny because one of my future questions for you is like, what has the nursing profession, you know, provided for your life that you didn't anticipate? Well, a child, like one of your like, you know, clear like mother, son, soul contracts. I know. Oh my gosh.
SPEAKER_01Yeah, it is it is really really wild. And um, and and credit to my husband too, because he never met him for seven weeks. He couldn't go to the hospital or anything, and he was on board too. So, you know.
SPEAKER_00So wait, what so that one day that you went in there and you're like, there you are, the next day you were able to sort of be like in the foster.
SPEAKER_01We called the foster care people, we called the social worker, we did everything, and yeah, he came home before we got our foster license, so that's why he was like uh we were his responsible.
SPEAKER_00Yeah. Oh well, and you know what too? I love I I don't think people talk about that safe haven law enough because I worked in a level one trauma center at in a pediatric ER. And we would have people bring in babies that were left in dumpsters or babies left on the side of the road, like newborn babies, you know. And it's it's I and I can't imagine what the parents' lives were like, what they must have been going through to think that's their only option.
SPEAKER_02Yeah.
SPEAKER_00But you know, those poor babies that they are just such a vulnerable population. And honestly, I only survived the pediatric world like less than two years because it pulled at my heartstrings. Like I would probably wouldn't last a minute in the NICU. Like I baby signing, no. Old people dying, sure. Like, fine, how you know, which is terrible to say, but that is the reality for me. So I feel like that safe haven log almost needs to be, I don't want to say talked about more, but I I wish I hope people hear that or know about it that are in those tough situations and give birth or whatnot. Yeah, oh my gosh, that's literally such an incredible story. Did your coworkers think you were crazy? No, they're like, ah, it's just Lisa, me and Lisa.
unknownNo, yeah.
SPEAKER_01I used to all probably have thought about it at some point. You know, I think that for him, and you know, I remember at the time, because again, like I mentioned, we have changed, but we only held, like if nurses were holding to baby to feed them or something, we wore gowns and glove. Like that, so at that point in his life, he didn't really have any skin touch him. And a nurse was holding him, and I walk, like, walked by or whatever, and she's like, I know I'm supposed to be wearing gloves. I'm like, I don't care what you're doing. Like, she's like, he needs human touch, like that's just how we are. Like, we're willing to kind of like spend the rules for things like now. We don't do that. Now we hold them without gloves, but you know, we'd use gloves for appropriate things, but yeah, yeah, it's human touch, but yeah.
SPEAKER_00Yeah, there is like a fine line with like, okay, I'm gonna be a professional and be a nurse, but there's also like the human component, right? Like this baby has never been touched by human skin. That feels illegal, right? But at the same time, we have policies like wear gloves and infection control. And it's like, okay, of course you want to do right by you know any patient you're taking care of, but there is that human aspect where you're like, oh, we just need this baby to feel love and yeah, you know, not like they're alone. Yeah. Oh my gosh.
SPEAKER_01Yeah, that's why they called him Alex, and people had already brought him clothes and you know, like all these fun things. So when he came home with us, it was kind of like he came home with all of us. Like in the Nikki, as nurses, we become such a family, and he was just like everyone still like loves him, and you know, he's just a little part of us.
SPEAKER_00So I love that so much. I love that story. I think you're going straight to heaven, girl. You have done whatever. Okay. I feel like I could talk to you for like two more hours, but I've got a couple questions before we wrap up. I do want to touch upon the Vermont Oxford Network. What does that role look like for you right now?
SPEAKER_01Yeah, you know, I mentioned earlier that I you never knew what one degree would take you. And I've been talking about this a lot actually, with like, well, my son's gonna be a junior, and so we're looking at colleges, and so some of his friends and their parents, and just how versatile a nursing degree is, and it does not pigeonhole you. And I wish that more people just went to nursing school to have it, and you also have it as a fallback plan. Like, I don't think AI is replacing a bedside nurse anytime soon. So it's just something to think about. So, about two years ago, I had three kids in three schools and we were kind of going through some life changes, and I really just needed to be home more. And so I everyone that works in the NICU knows about the Vermont Oxford Network and you know what it is and kind of who they are, which I can tell you a little bit about. But I saw the job posting, so it was for a business development manager, which I'm gonna tell you to this day, I still don't 100% know what that means because I'm a nurse, but I essentially help spread the word of Vaughn in many different ways. And I get to go to conferences and I run our social media and I talk to centers all day long. I help people interpret their data. So we're our, you know, they centers submit their data and we help them see kind of where they have areas of improvement. So, what Vaughn is in the NICU world, it is a community of NICU professionals who use data to drive change. So it's very multidisciplinary, which I also love about it. And we started in 1988 just people submitting data and realize like data doesn't do anything if it's just looked at alone. You have to benchmark it, you have to see what, hey, what am I doing well? What could I be doing better? Who is doing well? How can we help each other? And so we do our quality improvement is all based on kind of working together to find the best outcomes. And, you know, in the NICU, one of my like favorite things is you can have twins in the same womb with completely different outcomes, right? They're born and for some reason they have different outcomes. So then think about two babies and two different NICUs with different policies, different products. And so NICU A can now be like, okay, I need some help. I'm gonna ask someone in Vaughn, what are they doing? What are they working on? How is that helping? And then maybe they can share something with me, I can share something with them. So we're not just taking data and being like, okay, here's my data, but it's like, no, what are we doing well? Where are we struggling? Who can help us? How can we help each other? Because what I think about the NICU is like we are so intentional and we are advocates, but what Vaughn does, it takes like that intention and puts it into action. Like, use this community to help improve the care of infants and children and their families across the globe, actually. We're international. So it really is just more than just data, it's data in action, which is amazing.
SPEAKER_00Is this something a NICU nurse can join, or is this something like hospitals would have access to, or both?
SPEAKER_01Both. So you join by your hospital. So a hospital joins and pays for the membership. So we have membership structure, right? So you pay for the membership, but anyone at the center can then have access. We don't limit the number of it. So where I previously worked, we had 275 NICU nurses, and every single one of them had access to Vaughn and what we can provide. We also provide some free webinars and all that, that a regular, you know, somebody that's even not connected right now, but that way we can work together as a community to help improve outcomes.
SPEAKER_00I like that because I know, you know, from a business standpoint, I know hospitals are always competing to deliver the best care and to be known. And, you know, they want that gold star. And they, and I get that from a business standpoint. But at the end of the day, the people in the business, right? The nurses, we just want to deliver the best care that we can. We want to be the best nurse that we can. We're not trying to compete against the hospital down the road. So I love things like this where people can come together and actually share their secret sauce in you know, good faith that it is for humanity, right? It is the for the betterment of people. And in your case, NICU people.
SPEAKER_01I also think it's like reassuring because quality improvement should be data driven. But beyond that, for me, a very specific thing, a NICU-related thing, is when you have a case of neck, which is necrotizing and arcolitis, when a baby gets like an infection in their belly, for those of you that are not in the NICU, they it pretty much comes in threes. I don't know if this happens in other nursing worlds, but like that one really seems to come in threes. And when it happens, I assure you, because I've been doing this for 22 years, that we think we are the worst, that we are the only ones with neck, that we have the worst neck rate, that nobody has neck is bad. And then you get to go to Vaughn and be like, no, actually, look, because Vaughn benchmarks you against a network up against your state, against similar size NICU. So you're not comparing yourself to that level four children's hospital we were talking about, right? And then you can be like, oh, it's the data's not here to blame or shame me. It's here to a reassure me that we're doing okay and to say, hey, you could do better. Let Vaughn help you get there with this community of providers that we have that are working together to just improve this, is it's just it's reassuring. Like, I'm like, everybody should have somewhere they can go and be like, oh, I because it, you know, in your EHR, maybe you're seeing your rates, but what's that telling you compared to what? Yeah, my rate's 10%. But is someone else's 30? Is someone else's one and I'm 10? So Vaughn really gives you that benchmark for that. And I love that.
SPEAKER_00I love that. It's a great tool, right? To get better or to or to actually feel good about the work you're doing. Yeah. 100%. Okay, Lisa, where can people find you, connect with you, learn more about you?
SPEAKER_01Yeah, I mean, everywhere. Unfortunately, I had to Google something the other day and my own face came up and I was like, uh-oh. But yes, I'm on all, well, not all. I'm on YouTube, Instagram, TikTok, and Facebook. If you look up NICUEDUCACAR.lisa, you can find me. Um, I have a website which I have like a brand called the Nikki Learning Nest, because I want us to all be together learning together. Um, a big thing for people that, you know, listen to you, Caroline, is I do have an interview guide that people can find. If they email me, I can get it to you. But I'm out there in all the places and I literally will never stop talking. So if you have any questions, anyone can reach out to me and that's something that I can help them with.
SPEAKER_00Love. Okay, your final question that I ask everyone on the show. Okay. If you could go back to new grad nurse Lisa, what would you tell her and why?
SPEAKER_01That's a great question. Oh my God, that new grad nurse is so such a little baby is so long ago. I think that the number one thing I would want her to know, even speaking to what I said at the beginning about how I took that six-month break before I started, I would want Newgrad Lisa to know is you're never stuck. That if this is the job you took, you're not stuck here. If this is the unit you picked and it doesn't feel good, you're not stuck. That a nursing degree is going to take you on a path that you may never have envisioned for yourself. And if you had asked me five years ago if I was gonna be primarily 95% of my income is based on working from home, right? I would have thought you were crazy. And here I am. And it's because you're not stuck. This degree can take you so many places, a new unit within the same hospital system, a different hospital system, a different state, a different kind of profession, a new a second degree. It can take you so many places. I think I was so worried I was like gonna get stuck and never have a vacation, never have Christmas off again, work night shift the rest of my life, which I loved night shift, by the way. I could talk about that forever. I am a night shifter. I loved it, loved it, loved it. But you're not stuck. And if you're not happy, get unstuck. Reach out to someone, reach out to Caroline, reach out to me, find someone. We can help you get unstuck. But there are so many possibilities with this degree. So, so many.
SPEAKER_00I'm literally obsessed with everything you said. And my all my listeners will know that because I'm constantly saying there are options out there. If you are feeling stuck, it's time to pivot, it's time for a change. Change is scary, but let me tell you, it will lead you to a life of alignment and job satisfaction, you know? And we all just want to be happy, right?
SPEAKER_01Right. Yeah. I have people reach out to me, as you can imagine, in the NICU where they're anxious, right? They're they're anxious before their shifts, they're worried they're gonna make a mistake. No one should feel that bad going to work. So if you, you know, if you've done some things, you've reached out to an educator, you've reached out to a manager, you've taken an extra class, you've asked for extra help, and you're still like, I would not want to feel sick to my stomach every time I go to work. And so maybe the NICU isn't for you, and that's okay. You are not stuck, and we can help you.
SPEAKER_00So yeah, and all of nursing is not like that, it's just you haven't found your right little exactly portion of the profession.
SPEAKER_01I have had a few nurses that actually transfer from NICU to mom baby, right? They kind of go down and they're so happy. They're like, Oh, I do love babies and families, I just don't like the ICU part of the 24-week, like this, and it's like, yes, exactly.
SPEAKER_00And a lot of times in nursing school, you think you know what you want, you get into that part of the field, and you're like, wait, I don't this isn't right for me, and that's okay. You have no idea what you want till you actually just get into the profession and to get started. Yeah, and then from there we can pivot. Well, Lisa, I can't thank you enough for being today's guest. I often forget about the teeny tiny patients in our nursing field, and I'm so glad there are Nikki nurses like you to take care of them. And thank you for supporting nursing students and new grad nurses. They have a special place in my heart. So thank you for being on today's show. We are so lucky to have you in our profession. Yeah, thank you. Well, that's it for today's episode of Life After Nursing School. I hope you feel more confident and ready to tackle the challenges that come with starting your nursing career. Remember, the first year or two might not be easy, but with the right mindset, you can overcome anything. If you found value in today's episode, I'd love for you to hit that subscribe button so you never miss a future episode. Also, please consider leaving a review on your favorite podcast platform. It helps so much in reaching other new nurses like you. Thanks for listening, and remember, you've got this. Take care and see you next time.