r/nursing • u/sagegren • 14h ago
Question Bad experience at NICU clinicals - help?
I’m a nursing student and had my first day of clinicals in the NICU. I asked one of the nurses if I could follow her while she was doing her assessment on one of the babies and she agreed. I was standing by watching what she was doing when she asked me what a good temperature for a baby is. I was really anxious, and I have trouble recalling things when I’m on the spot even though this was very simple. It’s stupid but I just couldn’t remember what we had learned in class and said that I thought 97 degrees F was okay. Even though it’s a little low, I thought that this was still acceptable, just on the low end of the range. When I told her this she immediately said “97 is not a good temperature for a baby. It’s not even a good temperature for an adult. What year of school are you in?” I answered that I was in my third year and she said “well you should definitely know this by now. I don’t know why your instructor didn’t teach you. I’m gonna print out a paper of temperatures for you.” If she said this in a nicer way like she wanted to help, I would’ve had no issue. However, just the way she said it was really harsh and I was embarrassed. I didn’t interact with her for the rest of clinical and followed around another nurse who was nice, but the first nurse never ended up giving me a paper with temperatures on it. When I google it, I’m seeing a lot of mixed ranges, but from my understanding, 97 F is okay for a baby and an adult? Please tell me if I’m wrong here. I genuinely want to learn and become better; however, I’m just really confused and embarrassed over this interaction. Thank you!
46
u/VetTechG 8h ago
Being an asshole to someone trying to learn should reserve you a spot in the lowest rung of hell. Why would you ever stifle someone seeking knowledge. Ugh
10
u/Goatmama1981 RN - PCU 6h ago
Same goes for people who make fun of someone's laugh or their smile. Mocking someone's expression of joy? Bam! Right to hell with people being an asshole to someone trying to learn!
46
u/flawedstaircase RN - NICU 🍕 14h ago
That NICU nurse is just mean. We use Celsius where I work and anything between 36.5 and 37.6 axillary is acceptable.
2
58
u/HyperSaurus RN - NICU 10h ago
97 is too low for a neonate. Keep in mind that they are much more sensitive to cold stress than adults are and thus have a stricter temperature range. We usually go by 36.5 (97.6) to 37.5 (99.5) in my NICU.
Now regarding the nurse’s attitude, if they’ve been in NICU for a while, they lose perspective of what other specialties are like, and get tunnel visioned onto NICU standards.
13
u/doodynutz RN - OR 🍕 7h ago
I’m just jealous you got a NICU clinical. All I got was a quick tour of the NICU.
4
2
u/nosyNurse Custom Flair 4h ago
We didn’t get NICU, either. We did rounds in PICU.
6
u/EnvironmentalRock827 BSN, RN 🍕 4h ago
My rotations stunk. Peds was nothing but testicular torsion in 18 year olds.....Fortunately I worked as an aide and had some great nurses who showed me lots.
3
u/nosyNurse Custom Flair 4h ago
Looking back, our clinicals could have been a lot better. We wrote so many care plans I now feel a little anger hearing those words. I have never actually written a care plan from scratch in my career. I hated the abstract talk about “nursing dynamics.” Most of the talk should have been replaced with practice. Practice makes perfect, not mandatory group discussion with power point presentations. We didn’t interact with the hospital nurses at all, no shadowing, no chance to ask them questions. I was unprepared for the actual job when i graduated. I am very kind to new nurses for this reason. Most have no clue what the job entails.
2
u/EnvironmentalRock827 BSN, RN 🍕 3h ago
I graduated back in 1998. Yes! About care plans. Nursing diagnosis!. I remember telling my co-students not to waste time on diagnosis crap. That care plans were a joke. They weren't using them where I worked. Writing pages and pages was so ridiculous. Yes! To replacing it with practice. We learned nothing about IVs. Nothing about EKGs.. I wonder what they are doing nowadays?
3
u/nosyNurse Custom Flair 3h ago edited 3h ago
I hope it has improved, but i doubt it has. I graduated 2002. New nurses seem just as bewildered by the job as we were. And omg I deleted “nursing diagnosis” from my vocabulary!!!! What a worthless term! Risk for this and that….but not this one, it’s too close to a medical diagnosis, nurses can’t diagnose real problems. Waste of precious expensive time!!!!
2
u/EnvironmentalRock827 BSN, RN 🍕 2h ago
Lmao. I'm having a bout of Altered Mental Status! Impaired Gas Exchange! Ineffective Coping!!
31
11
u/InevitableDog5338 BSN, RN 🍕 7h ago
That nurse could’ve simply and kindly corrected you without being condescending. Just refresh yourself on the correct vitals 💕
4
u/Past-Quantity7484 7h ago
my baby was admitted at 3 days old for his temp being around 97, they diagnosed that as hypothermia
11
u/Real_Combination_913 7h ago
Eh. Don’t get your feelings hurt. I bet you know temps now don’t you? This is how teaching hospitals work sometimes. Don’t be like her and realize you learned something
2
u/Harlequins-Joker RN - NICU 🍕 7h ago
Sorry you had that experience… it reflects on them poorly how mean they are to those who are trying to learn rather than on you for not “knowing everything” in a new area.
From experience there’s a lot of mean nurses in NICU, just comes with the area unfortunately
2
u/happymomRN RN 🍕 6h ago
Sounds like you just had your first interaction with a mean nurse or nurse bullying, and I’m afraid it won’t be the last.
But you did the right thing by not interacting further with that nurse because that is what other nurses who aren’t masochist do, because we need to focus on doing our very important job and that’s hard to do when some jerk is getting her twisted psychological needs met by poking at the tender underbelly of our human feelings of uncertainty in some situations.
The reality is that nurses frequently seek out the nursing judgment of other nurses. On any unit you work with there will probably be collectively close to at least 50 years of nursing experience you can call on to get some insight or information you need or to validate your own nursing judgment.
Don’t feel bad. Every seasoned nurse was once where you are and feeling what you’re feeling. It just means being a good nurse and serving your patients well means a lot to you.
A compassionate experienced nurse would have taught you something and given you the gift of her years of experience. I share with students little helpful trick for doing things and remember things all the time.
I’m the one with the knowledge and experience so that makes me the teacher.
2
u/inkedslytherim 3h ago edited 3h ago
I teach alot of nursing students in the NICU. We get alot of capstone students (even though most aren't interested in the specialty.)
I think since nurses either forget how little information is taught in school on infants, or they just have a complex. I ask similar questions of my students but then I explain the reasoning so it's not just about memorizing numbers. We talk about weight and thermoregulation.
A consistent temperature below 97.7 in infants and premies usually requires an intervention on my unit. Sometimes it's as simple as turning up the thermostat in the room. If I have a kid with decreasing temps, we start adding hats, double-swaddling. I look at how long they've been out of the isolette, do they need to go back in? Are there other signs of possible illness? Babies often run cold when sick, as opposed to fevers. Do we need a viral panel or perhaps an order to draw a CBC? Neonates often need blood transfusions and an inability to thermoregulation may be a sign they need blood.
Dont take it personally. It sadly won't be the last time someone talks to you like you're stupid. I've gotten attitude from doctors, NPs, radiologists, pharmacists, even our clerk. Healthcare requires a thick skin. I often focus on picking out what I can learn from the interaction, and then letting the rest slide off my back. Unless it becomes a pattern of abuse and I have definitely gone to leadership about that.
Just remember that clinicals are just a stepping stone to graduation. Grit your teeth, say thank you, and get it over with.
2
u/Vegetable-Ideal2908 RN 🍕 2h ago
I don't know about nicu babies, but 97 is perfectly fine for an adult. It must be, since all my adult patients with temps of 98 tell me that's a fever for them. They usually run 97!/s
1
u/HMoney214 RN - NICU 🍕 4h ago
36.5-37.5 in Celsius and 98.6 with a degree on either side in Fahrenheit is an easy way to remember it. Sorry you got such a rude nurse to shadow
1
u/Raebans_00 4h ago
Baby temps that are acceptable is 97.7-100.0 F, or 36.5-37.5 C, I don’t expect my nursing students to know that in the spot in their first clinical. This is a specialty and your course in this specialty is being super rushed, so no, I would not have done the same.
97.0 is totally fine for an adult tho. Don’t let this keep you from asking questions and jumping in on clinical!
1
u/sparklestarshine 3h ago
There’s argument that 98.6 was never a true average temp and that body temps are decreasing over time. This is a brief summary, but it’s a really interesting thing to look into!
1
u/ChaplnGrillSgt DNP, AGACNP - ICU 3h ago
How did she take the temperature? Tympanic? Temporal? Rectal?
Tympanic and Temporal can regularly come back lower. Gold standard is Rectal.
That nurse overreacted. In no world am I getting overly concerned with a temp of 97 unless it's a big change from trend or if there's a substantial clinical change. Nurses trying to flex how much smarter they are than a student is the dumbest shit ever. You SHOULD know more than a nursing student if you are a full fledged nurse with experience.
You're fine. Keep learning.
•
u/George_GeorgeGlass 9m ago
Unmmm, has she only ever worked in a NICU? Because adults read around 97.0 regularly. 97-98 is very much a nonissue
-62
u/bionicfeetgrl BSN, RN (ED) 🤦🏻♀️ 13h ago
To be fair she’s doing you a favor as it is by allowing you to shadow her. Then you stopped interacting because you didn’t think she was nice enough. I probably wouldn’t have bothered printing up education material for you either. Instead of taking the opportunity to ask questions and learn, you didn’t like her tone and questions and decided she was mean.
26
u/ExtensionProduct9929 11h ago
Nah screw that. Why would I follow around someone who is rude? I’m a nurse and I wouldn’t. You’re attitude speaks volumes, and it shows your maturity. If you decide to be rude when you asked the question, why the heck would I want to follow you? And no it’s not a favor, she could just say no, many nurses do that.
7
u/Goatmama1981 RN - PCU 6h ago
Whenever I have students shadow me, I tell them to never waste their time with someone who is being rude to them or acts like they don't want them there. You don't want to learn anything from that kind of nurse anyway!
8
u/ExtensionProduct9929 6h ago
Yep, and the fact most Clinical’s are 12 hours. Such a terrible feeling being shit on for that long.
3
u/Goatmama1981 RN - PCU 3h ago
And have some compassion, ffs! Most of the students are already nervous, try to make them feel more at ease, build their confidence. Granted, I have seen some that definitely are cocky and probably need to be humbled, but to just be a dick because you feel inconvenienced ... really grinds my gears
49
u/Fancy-Improvement703 13h ago
I think it’s unreasonable to expect nursing students to feel comfortable asking questions when the nurse obviously did not create a safe environment to reflect and learn and instead instilled shame
-36
u/bionicfeetgrl BSN, RN (ED) 🤦🏻♀️ 13h ago
Regular nurses are not nursing instructors. At some point grown adults, which is what nursing students are need to be ok with being uncomfortable. It’s one thing to expect professors to create ideal learning environments, but floor nurses are creating ideal environments for their patients. Nursing students and new nurses are along for the ride.
Do I have different expectations for nursing students vs new nurses vs experienced nurses (new hires) absolutely. But I expect all of them to remember they’re adults and have the ability to remember that everyone is different and not everything is about them and their ideal learning environment
33
u/Fancy-Improvement703 13h ago edited 13h ago
I’m not expecting regular nurses to be nursing instructors and the fact you’re suggesting so shows you grossly misinterpreted my main point.
Education is a PART of nursing, you educate your patients on their vitals, medications and illness. Pretty foundational. It is ABSOLUTELY then reasonable to expect the nurse to educate OP properly after she was the one who asked the question in the first place, not make a snarky comment about how she was wrong
You can have whatever expectations you’d like, but I’d like you to think back to when you were a nursing student and didn’t have the experience and expertise you have now. You’re expecting a nursing student, who possibly has never worked in healthcare, whose first day in clinical in an entire new area with new population to be completely comfortable then asking follow-up questions to a nurse who berated her? I wholly disagree with that outlook. People aren’t born with knowledge and skills, it’s based off experience and exposure, which, is this students FIRST DAY, especially when it’s standard practice for nursing students to be ignored and undervalued.
I think many people would be hesitant to ask questions to someone who essentially just called them stupid, but I digress.
3
u/Goatmama1981 RN - PCU 6h ago
Yeah, they need to behave like adults, just like you said. The nurse being shadowed needs to behave like an adult and not be an asshole. Fuck outta here with that bullying, eat your young bullshit. Being a student does not mean you should accept being treated unprofessionally.
22
u/cutebabies0626 RN 🍕 10h ago edited 10h ago
Yeah no there’s no excuse to be mean towards someone who is still learning. Lol I had clinical instructor like that during my nursing school years, she actually got fired.
You said “they are adults” if you are an adult they should know to treat other people nicely. Not sure what’s wrong with your perception about “tough it up” attitude but that’s extremely toxic and it creates toxic environment to work in. That’s literally what creates nurses eat their young and whatnot. There’s no excuse for that.
40
u/GivesMeTrills RN - Pediatrics 🍕 11h ago
Having a student doesn’t give you the privilege of being rude to them.
14
u/sirensinger17 RN 🍕 8h ago
Tone like that nurses have literally been proven to prevent learning. Her attitude is literally impairing learning abilities. I know this cause I was a teacher before I was an RN
15
24
u/snarkcentral124 RN 🍕 8h ago
This is such a mean girl “eat your young” take and exactly why we constantly get accused of “mean girl to nurse pipeline.”
13
u/sagegren 13h ago
I do get where you’re coming from. I appreciate that she was helping me and I did thank her for letting me follow her. I didn’t mention it in my original post, but after that first interaction she was then feeding the baby and told me to follow the other nurse because there wasn’t anything to see. I would’ve stayed with her if she hadn’t though. Thanks for the response
13
u/cutebabies0626 RN 🍕 10h ago
Hey don’t mind people like that. They are just unnecessarily mean people in general. Also NICU is very specific to their environment since it’s specialized, I worked at mother baby before I got a job at NICU and I didn’t know what the hell I was doing even though I worked with babies all day before. 🤷🏻♀️ she can’t expect you to memorize all those.
3
u/HaroldFH RN - Psych/Mental Health 🍕 7h ago
She didn’t “let you follow her”. Students are part of her job. If she is going to be a bitch about it she isn’t meeting the standards set for her position.
7
u/Goatmama1981 RN - PCU 6h ago edited 6h ago
Seriously, it bugs the shit out of me when nurses act like it's such a chore to have a student shadow them! As if we weren't all students once. Edited to add this gem from u/SleeplessTaxidermist ... "I wasn't born with the stick of knowledge rammed elbow deep up my asshole like you" 🤭
0
u/purplepe0pleeater RN - Psych/Mental Health 🍕 5h ago
Students aren’t part of my job. It’s not in my contract. I can say no.
4
105
u/leacheso 14h ago
97F is around 36.1 Celsius (worked in Canada NICU for 13 years so used C). It is low for a NICU baby, our goal was 36.5-37.5. However, it’s not DRASTICALLY low and that nurse really didn’t need to react that way. Don’t stress over it, review your basics before your next shift and move on. You’re still learning and NICU is a high stress environment.