Piper Jeffcoat is a NICU nurse who shares advice to fellow nurses and nursing students on TikTok as NursePips. Full of energy, Piper shares insight into what it's like to work in a NICU as well as nights.
Tell us a little bit about being a NICU nurse.
Piper: I just passed my three-year anniversary of being a nurse and I went straight into the NICU after graduating from nursing school. I currently work at a level two NICU. We generally take cases from 32 weeks gestation and on but we sometimes can take younger ones down to around 28 weeks depending on how stable they are. We take basically any case that's intubated as long as they're not on an oscillator, needing to be cooled, or have any kind of surgical needs. I will say, I get the good side of it because I work right next to a bigger NICU. If a baby starts to go downhill, we send them over to the other NICU. I don't see a lot of really, really bad cases.
How did you end up in NICU?
Piper: I don't know why, but I just really liked it. I didn't know how to change a diaper before I started! I ended up doing some clinicals at the larger NICU. Everyone else in my clinical group was not interested at all in doing babies. When I went the first day, I found it to be really interesting. It's high paced. When NICU nurses hear an alarm go off, they're standing up, running over to the bed, and trying to see what's going on. They handle babies a lot differently than you would expect. I was expecting nurses to very gently pick up a baby, but they turn them over, start rubbing their back, get them to wake up, and get them to start crying. It’s very different from what I expected but I love it.
When I graduated, I knew someone who worked at this hospital and she convinced me to come work at the NICU. I set up an interview for the NICU floor and then for med surge. I was going to be happy either way. They called me an hour after I left my interviews and got the job on both units! I was too excited about the NICU. I figured I could always go to med surge if I didn’t like it. It’s hard to go the other way around. I figured I'd try it in the NICU and I’ve never left.
Do you think you will be a NICU nurse for your whole career?
Piper: I'll probably be there a really long time. I work with a lot of our day shift nurses who have been there for 30 plus years. That’s almost unheard of when it comes to bedside nursing. A lot of bedside nurses end up with bad back problems or knee problems. All of our beds are pretty close together and our patients weigh a max of 12 pounds at their healthiest. I could see myself doing this for a long time but I have not made a concrete decision yet. There is so much to do in nursing.
What are your fellow NICU nurses like?
Piper: I feel like it's a very specialized group. We’ve kind of noticed that we have a wide variety of personalities, but essentially we're all the same. My unit really doesn't have cliques. It's a very small unit. I think we have like 20 people that work on my unit. If we do something where we're all planning on bringing in food, everyone participates. It's not like we just ask a few people to do it.
We have had a few nurses that come in from other units and sometimes they don't have the same kind of personality. Those people sometimes don't last very long mainly because they just have a different way of thinking about things. It can be really hard for people, especially if they come from doing adults, to see how bad a baby can go. Their emotions can get the best of them. Some nurses are just not good fits for the NICU, it just takes a special kind of person.
A lot of NICU nurses tend to have the same kind of personality and a lot of them, I wouldn't say I'm one of them, are OCD. They want their things exactly how they want them. They want the lines, untangled, and everything how it's supposed to be. I feel like I'm a little more go with the flow, we do have both ends of the spectrum. Some are really messy with their babies beds or lines and some can't stand to see a mess anywhere.
What led you to nursing in the first place?
Piper: My mom used to work for a health insurance company. She was always scared of her job being outsourced or not being needed. She actually ended up getting laid off during the pandemic. She has always told me to get a job that is something that can't be outsourced. I thought about going to veterinary school or something like that. In the practicality of it, veterinary school is expensive and it's really competitive to get into. Nursing is not as expensive to go into. I really love to help other people so nursing fits really well. If you ask any nurse, they're going to say they want to help others. It’s our nature.
I also really liked that even if I came out of nursing school and didn’t like nursing at all, I could go into teaching or being a school nurse. Disney World has nurses! There's a broad spectrum of roles available with a nursing degree. Even if you absolutely hated nursing, you could find something else to do with your nursing degree.
What was nursing school like? What advice can you share?
Piper: Nursing school was horrible. I would never ever want to do it again. My sister-in-law is trying to get into nursing school right now. A lot of people have been asking me what kind of college they need to go to. I usually tell them to go to the cheapest one to get their core classes done for the first two years. After that, when you get into nursing school, find a study buddy or a study group. I had two girls that I studied with a majority of the first semester and that helped tremendously because they had different views of disorders. It can help you remember stuff better.
My other tip for people in nursing school is to take it week by week. If you try to look at the grand scheme of things, you're going to get overwhelmed. It is overwhelming enough having a test or two every single week.
Do you do anything for your patients that is unique to the NICU?
Piper: We actually make little handmade name cards for our babies on our unit. We take the generic hospital one that says congratulations, and make it special as well. We write their name and their birth weight and all that stuff on it. But the nurses in my unit, if we have time, we make little handmade cards with stamps of teddy bears, footballs, or flowers. Recently, the nurses on my unit started practicing calligraphy from Pinterest. So now we calligraphy their names on their cards. I think a lot of times nurses kind of forget that for us, the NICU is every day. For our patient’s families, it’s a life changing event. Childbirth is a huge thing. These are mementos families will keep for decades to come.
Has there been a moment where you've kind of stood there and realized that nursing is what you’re supposed to be doing?
Piper: I am not entirely sure. There's a lot of patients that'll say that but I'm not sure that there's ever been a time. There have been times where I'm in the car driving to work and I'm thinking, you know, I don't have any doubt about driving to work. I actually love my job. Right now I am in the middle of having seven days off and I know by the time I go back next week, I'm going to be withdrawing. I need to be able to hold a baby!
What’s it like being a night nurse?
Piper: I am not a morning person at all. I am really good at sleeping so I have no issue with working nights whatsoever. The night shift crew is very different from our day shift crew. The day shift is mostly the ladies that have been here for 30 years and they work more independently. On nights, we have less staff around that can help so we really have to come together as a team. Other floors aren't as heavily staffed at night as well so if something goes down and they need a ton of people, everyone in the different units try to come together. I really like that.
It can take a while on our unit to switch to days because we don't have very much turnover. I considered a while ago putting my name in to switch but decided to wait until my husband and I have kids. I love nights. I like who I work with. I don't think I'll be going to days anytime soon. I actually have a couple of coworkers that just had kids and they stayed on nights. They are available during the day to take their kids out of school. The flexibility within nursing is incredible. A lot of nurses are scared of nights, but they made me go to days like two weeks to train for charge about a year and a half ago and I hated it. I am cranky in the morning and I didn't really retain anything that anyone told me until about 2:00 PM.
How has COVID-19 changed the NICU?
Piper: Initially, there were a lot of really fast changes. Every day we came into new protocols. Mostly what has changed is our visitor policy. Prior to the pandemic, three guests could be at the bedside including a parent and they could come anytime day or night. We had rooms that parents could stay in overnight and feed the babies. Since the pandemic, we haven't offered rooms for parents anymore. It takes special authorization and a special circumstance for them to approve it. In the beginning of the pandemic, parents could only come in for about an hour a day. Now we're allowing them from 8:00 AM to 6:00 PM. On nights, we miss having parents there. We don't ever get to see parents anymore in person at night unless it’s their very first time seeing the baby then we do allow them in to the unit. We did start doing FaceTime too for the parents. So we'll FaceTime parents if they request it. It was a big thing when we were doing the one hour a day visitation policy. It’s really hard for the parents to put your child in someone else's hands and never ever see who it is so FaceTime did help.
What do you like to do on your days off?
Piper: I am a homebody, so I love my decompression time. After I get off of a stretch of shifts, I take a day to do absolutely nothing. I don't do the dishes, I don't do my laundry. I just like to lay on the couch and watch TV. I usually watch some sort of reality TV, something I don't have to concentrate on. I like to play Sims on my computer. Other than that, I'll go for a walk or I'll train my dogs and that makes me feel productive. It's not that productive, but it feels productive.
What gives you moxie?
Piper: My moxie comes from being able to see that I made a difference in a patient. In my unit in particular, we don't have a step-down unit. We can see a baby go from being intubated and on IV fluids and having central lines in an incubator to putting it in the car seat and walking it downstairs with mom and dad to go home. That's really rewarding seeing them get healthy. Especially lately, we've had some parents that are just so thankful and so appreciative. Little things keep me going like parents who thank us on the phone. I love seeing a baby getting ready to go home. Seeing them get better and to make that kind of progress and to know that me and my coworkers contributed to that is an amazing feeling