RN4 Staff Nurse, Neonatal Intensive Care Unit
When Ellen came to South Shore in 1999, the neonatal intensive care unit (NICU) was just a fraction of the size that it is today. With more than a decade of NICU experience, Ellen was prepared to be instrumental in the immense changes at South Shore Hospital.
As survival rates improve for the earliest and smallest premature babies, NICUs have had to keep abreast of the latest technology and pharmaceutical interventions that help them care for the sickest of babies. In less than nine years, the South Shore NICU has reflected those changes in neonatal medicine – both in its scope and the knowledge base of its nurses. Once simply a Level II special care nursery (SCN), now there is also a Level III NICU able to care for babies needing a high level of intervention, including ventilators.
Over the years, the NICU’s growth has fostered autonomy in the professional practice of nursing. Nurses in the NICU have developed a discharge program, including car seat safety and CPR training. Ellen has helped to develop an orientation program for nurses and now regularly provides staff education. She is nearing completion of her master’s degree in nursing with a concentration in education, and says that because management has encouraged her to provide staff education, she’s already doing many things she might be expected to do with her degree. Even before she was the quality representative on the shared governance council at South Shore Hospital, Ellen’s manager asked her to do chart reviews for quality audits. This resulted in Ellen and her colleagues being the first nursing team at South Shore Hospital to bring a research project before the Institutional Review Board at the hospital. The study – assessing a new pain scale for use with their preemies – is in the final stages, and Ellen and her colleagues hope to publish the results, which could affect NICU practice nationwide.
Ellen has taken advantage of the clinical ladder program at South Shore Hospital also. Clinical ladders are designed to recognize and reward staff nurses who demonstrate advanced levels of practice. In August 2007, Ellen became South Shore’s first RN4, the highest level on the clinical ladder, denoting her as an expert clinician. To achieve this, Ellen had to create an extensive portfolio of her career to demonstrate that she met certain professional criteria. As a graduate student, Ellen had some components of the portfolio, but found the extensive writing to be beneficial. “It makes you sit down and think about what you have done and articulate that to others. I like to write, and I think it is a great skill to develop,” says Ellen.
Aside from the wonderful growth opportunities that working in the NICU has given Ellen, one of the reasons she practices there is because of the collegial atmosphere between the nurses, doctors, therapists and social workers who make up the clinical teams. Nurses present to the physicians during medical rounds and play a role in every aspect of the baby’s care. “In the NICU world, nurses have a strong voice,” says Ellen.
Learn more about the NICU
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