Does your unit train new graduate nurses? The bright eyes and eager faces of our newest NICU nurses remind me of my own journey years ago. This month, I had the privilege of welcoming a fresh cohort of new grads to my team, and my heart is bursting with excitement for the path that lies ahead of them. Each time I see them perform an assessment or carefully prepare feedings, I'm transported back to my own early days as a new grad in the NICU.

These moments are more than just nostalgia – they're a powerful reminder of how crucial proper training and mentorship are in shaping the future of neonatal care. I stand here today because of a NICU team that took a chance on me, providing the foundation that would shape my entire nursing career. They taught me not just the technical skills, but the art of caring for our tiniest patients and supporting their families through their most vulnerable moments. I am forever grateful (Go Lobos!)

Speaking of supporting fellow nurses, I'm thrilled to announce a live training for any nurse (or soon to be nurse) working in neonatal care coming up in March. If you're looking to enhance your neonatal nursing skills or know someone who could benefit from expert-led training, you'll find all the details at the end of this newsletter. Don't miss this opportunity to invest in your professional growth and join our community of passionate NICU nurses.

🎓My tips and tricks for all the New Grads

To all the new graduate NICU RNs, congrats on landing your first NICU job! 🎉 It's totally normal to feel excited, overwhelmed, and even a little terrified—you're not alone! The NICU is a high-stakes, detail-oriented environment, and learning how to manage your time, absorb new skills, and build confidence is key to your success.

The Neonatal Intensive Care Unit is unlike any other nursing environment. You'll be caring for our tiniest, most vulnerable patients while supporting families through what might be the most scary and challenging time of their lives. Remember that every experienced NICU nurse started exactly where you are now. The complexity of NICU care means that learning will be gradual—think of it as a marathon, not a sprint.

Today, I'm sharing my top strategies to help you survive (and thrive!) in your first months as a NICU nurse.

⏳ Strategy #1: Master Your Time & Stay Organized

The NICU is fast-paced, and time management is crucial. Here’s how to stay on top of everything:

✅ Plan Your Shift:

• Arrive a few minutes early to look up your patient assignments.

• Take note of key tasks: feeds, labs, meds, and procedures.

• Prioritize what needs to be done first vs. what can wait.

✅ Use a Brain Sheet:
A NICU-specific report sheet helps you track feeds, ventilator settings, IV fluids, and meds. If your unit doesn’t provide one, create your own! There are some amazing and beautiful ones on Etsy!

✅ Group Tasks When Possible:
Plan out your day so you can cluster your patients care as much as possible. Think about all the tasks that need to be done for your patient, when they need to be done and how you can put them together. For example, if a baby has meds due near the same time as a diaper change and feed, try to bundle these tasks together.

✅ Gather your thoughts and supplies BEFORE touching your patient:
Based on the report your received, anticipate what you might see in your patient. Does your baby have a history of respiratory distress? Feeding intolerance? How might that present in your assessment? Don’t forget to get all the equipment you need (e.g. a flush for your IV, supplies to check feeding tube placement, extra diapers, etc.)! Discuss with your preceptor to help you anticipate these needs.

📚 Strategy #2: Learn Smarter & Retain More

NICU nursing has a steep learning curve, but these tips will help you absorb new information so that it sticks:

📝 Keep a Pocket Notebook – Write down new terms, procedures, or anything you need to look up later. Consider organizing it into sections:

• Equipment settings and normal ranges

• Common medications and calculations

• Assessment pearls for different gestational ages

• Parent teaching points

• Questions for your preceptor

🔍 Develop Your Clinical Eye – Start training yourself to notice subtle changes in your patients:

• What does their color tell you about their perfusion?

• How does their positioning reflect their comfort level?

• What sounds do you hear during lung auscultation?

• How does their tone feel during handling?

👩‍⚕️ Ask ‘Why’ Behind Everything – Understanding why we do something (rather than just memorizing steps) will help you connect the dots faster. Don't expect your preceptor to give you all the "why's", take an active approach in being curious and looking them up.

🎧 Use Downtime Wisely – Listen to NICU podcasts, read unit protocols, or review common NICU medications when you have free moments.

🛑 Don’t Fake It – If you don’t know how to do something, ask! Your preceptor expects you to have questions—that’s how you learn. In fact, preceptors find it a little scary if you don't have questions.

🧠Reflect at the end of the day – Reflecting on what went well and what you will do differently helps you improve your practice every day. Read up on topics you're seeing at work or learn about them from podcasts, instagram, and youtube videos (I love Lisa Houston’s YT channel!). What are all the resources you have at your fingertips?

Check Out Lisa's YouTube Channel!

👩‍👦 Strategy #3: Talking to NICU Parents with Confidence

Parents in the NICU are often scared, emotional, and exhausted. As a new nurse, learning how to communicate with them is just as important as mastering clinical skills.

💖 Keep It Simple: Avoid medical jargon. Instead of saying, "Your baby’s FiO2 is increasing due to oxygen desaturation," try "We turned up the oxygen a little to help his oxygenation." Explain what the numbers on the monitor mean.

💡 Listen More Than You Speak: Sometimes parents just need someone to listen. A simple “I know this is a lot—how are you doing?” can mean the world to them.

🤝 Be Honest (But Reassuring): If you don’t know the answer to a question, don’t guess! Say, "That’s a great question—let’s discuss it with the provider during rounds."

🏥 Strategy #4: Building Your Support Network Success in the NICU isn't just about clinical skills—it's about creating a strong support system:

👥 Find Your NICU Family:

• Connect with other new graduates on your unit

• Identify experienced nurses who love to teach

• Build relationships with respiratory therapists, they're invaluable resources

• Get to know your unit's lactation consultants, occupational & physical therapists, speech language pathologists and social workers

🎯 Set Realistic Expectations: The journey from novice to proficient NICU nurse typically takes 1-2 years. During this time:

• Focus on mastering the basics before taking on complex assignments

• Celebrate small victories and learn from challenging moments

• Remember that asking questions shows wisdom, not weakness

• Take care of your mental health—this work can be emotionally demanding

🚀 You've Got This! Starting in the NICU is tough, but so are you. Each day, you're learning, growing, and becoming the nurse your sweet patients need. Remember that every expert NICU nurse was once a novice, feeling exactly what you're feeling now.

📆 Your First Month Action Items:

1. Find and customize your perfect brain sheet

2. Start your NICU notebook

3. Identify your go-to resource person on each shift

4. Schedule regular check-ins with your preceptor

5. Join a professional NICU nursing organization like NANN or ANN

💡 Quick NICU Tip:

✨ Feeling overwhelmed? Find one small win each shift—whether it’s placing your first IV, successfully calming a fussy baby, or having a good conversation with a parent. Celebrate your progress!

🎯 Special Training Opportunity: Master Your Neonatal Assessment Skills!

I'm thrilled to invite you to join our upcoming live training session: "Neonatal Head-to-Toe Assessment: A Systematic Approach for NICU Nurses." As a new NICU nurse, having a strong foundation in neonatal assessment is absolutely crucial for providing excellent care to our tiny patients.

📅 Live Virtual Workshop

Details:

Date: March 15, 2025 Time: 9:00 AM PST (12:00 PM EST) Duration: 2 hours Platform: Zoom

What makes this workshop special?

You'll learn:

• How to perform systematic assessments across different gestational ages

• Key developmental variations to watch for at each stage

• Critical thinking skills to connect assessment findings with clinical decisions

• Common pitfalls to avoid and red flags that require immediate attention

💝 Your Workshop Package Includes:

• 2 CE credits approved by Amanda's NICU Consulting CE Provider #18033

• Comprehensive digital workbook for note-taking during the session

• Complete slide deck for future reference

• Lifetime access to the workshop recording

Get all of this for only $33, sign up today!

Register Today!

I’d love to hear from you—what’s one thing you have learned this past week? Hit reply and let me know!

👩‍⚕️💖 Supporting you every step of the way,

Amanda