Night shift nurses are lazy and NICU isn't real nursing! - page 2
Anyone else out there been hearing this crap from other people? I am surprised, I admit, to find out how many people (at least where I work and went to school) look down on neonatal nurses as not... Read More
Jun 2, '02That simply infuriates me about how people think that other people have it easier. Life is simply hard for everyone. My mom is a public school teacher and I hate it when people think she gets paid for nothing during the summer. But when in fact the money she is getting during the summer is money that was withheld during the school year from her paychecks so she would have a paycheck during the summer. I also hate the long hours and expenses out of her pocket she has for her students. But she wants to give her kids all she can and hopefully in the long run will give them a better life.
Jun 2, '02Originally posted by Teshiee
Sounds like a bunch of player hating individuals who do not have a clue about NICU.
I have been lucky enough to never have heard this, because I'd be in jail for socking that person right in the nose!!!
Burping babies eh? Tonight I was on my feet for 12 hours with a baby that would brady and desat if you sneezed near him. Had to hand bag him half the night even after we switched him to an ocillating vent. Then had to start dopa and Pavulon,change his fluids, blood gasses Q 1/2 hour, H&H, C7 Q 6, Tranfuse x 2, start a PICC, get an LP, Amp, Amik.........yeah, I only had one patient. What's it to ya??!!:angryfire
BTW, Kristi, where do they float you guys to?
Jun 2, '02not to be a 'player hater'...
I work3-11's typically... sometimes I do float to nights.(not as much now as I go to school in the AMs... gotta leave my house at 0530 to get there on time)
BUT... I do KNOW that 90% of the nurses are really good, and check their patients...
but, of course, theres that 1 bad apple that we(not nighters) see...
the one setting up a bed, complete with sheets, blankets and pillows over 2 padded chairs, or the recliner chairs in our dayroom, and then complaining-- after taking a 2hour break(fully asleep, after bracing the door closed with a table) that SHE CANT GET HER WORK DONE?!
(admittedly, typically on rehab at night, it tends to get quiet,.. so, tagging a cig break to a 'dinner' break is the norm, extending the breaks to 1hr15 mins...never 2 hours... and the patient load is increased... 1:12-14.... I know its huge... thats why usually I cant knock the nighters... when its bad, its horrible... but, sheesh...)
anyhoo... its always that one or 2 bad apples that gives everyone a bad name...
Jun 3, '02You guys, thanks! I just came home from my fourth twelve hour shift in a row and am exhausted, and I needed a little 'ego massage'! ;>P I know that people can whine and bi*ch about nothing, and I know that they do, but it still irks me a little. I may only be a new nurse, but I take serious pride in what I do. It infuriates me to no end to hear, of all people, other nurses!!! suggesting that what I do bears little to no resemblance to 'real nursing'. What happened to our 'team'? Morale? I may be in the minority, but I would never EVER think that my nursing is superior to someone else's...I mean, Jesus, some people won't step foot on an NICU, just like I would cry if they pulled me to Oncology or even the ER. I mean, I'm in a very strict specialty- I couldn't handle chemo, some nurses can't handle vents. It doesn't make us better or worse than the other! Just a peeve, I guess. Dawn, to answer your question, we get pulled (as of recently) only to Maternal/Child areas, such as the Pedi-ER (Uh, yeah, TOTALLY different than the Level 2/3 Nursery!!), Inpatient Peds, PICU, and, you'd think that they'd limit it to Pediatric Patients, but NOOOO, we also can get pulled to High Risk Antepartum, Post Partum, L&D, and L&D Observation, as well as OBGYN floors. Yikes. Dangerous, dangerous, but that's a whole other conversation!!! (Oh, you want me to take a Mag patient who lost 2000 cc's of blood in delivery? Okay, sure...let me spike my Coca-Cola with Ativan first...)
Jun 3, '02Nick,
I thought since no one else had done it yet, I would try to explain a little bit of that to you. I don't know how much you know about nursing, so forgive me if I oversimplify some of it! Typically, babies that are admittted or transferred to the Neonatal ICU are having problems that need specialized care. While 90% of babies are born and have no trouble transitioning (adjusting) to life outside of their mother's womb, that other ten percent can result in some really sickl ittle babies. Any number of things can go wrong with a pregnancy or birth, including genetic defects and difficulty surviving due to prematurity or immature physical development. Dawn mentioned 'brady'-ing and 'desat'-ing. Brady-ing is when a baby's heart rate drops very low. This can be transient, lasting only a few seconds, or it can be extended for a lengthy bit of time. This is a problem, among other things, because when the heart slows down, it is obviously pumping less blood per minute to the rest of the body. Our blood carries oxygen that our tissues need desperately to function, so if we are getting less oxygen, the body could eventually begin to shut down in various ways. This can happen alone, but typically it occurs along with 'desaturation'. Though our heart may be pumping blood, sometimes it won't reach the tissues and cells of our body, and this is measured by looking at the saturation level of the blood (in other words, how much oxygen is actually present in our blood). Many babies on NICU's are extremely sensitive to the environment (i.e., the noise and atmosphere of the unit or area that surrounds them). This includes people talking around the crib or isolette (incubator), breezes moving over the crib, the sound of alarms going off, papers rustling, doors opening and closing, etc. We call these babies minimal stimulation babies; in order to heal and grow, they need as little stimulation- whether auditory or physical- as possible. When too much stimulation occurs (for example, touching the baby too long or in the wrong way, or if the unit is noisy, or even, in this case, if you are whispering by the crib- any stimulation at ALL), the baby may respond by dropping his/her heart rate and 'desatting', or losing oxygen saturation in the body. These babies are extremely sensitive and need special care. Though they cannot speak to us and tell us, 'Hey, shut up over there!', by watching monitors that are hooked up to various leads and probes, we can see what irritates the baby and keep a close eye on their vital signs. Frequently, preemies have underdeveloped respiratory systems, and are unable to breathe on their own. They may require a combination of therapies until they have had time to develop and grow, which may include certain drugs, oxygen rich environments, or even mechanical ventilation from a ventilator. Occasionally, even a ventilator is not successful in helping them get oxygen into their lungs, and we will have to 'hand bag' the baby; in other words, we will take an oxygen bag and physically squeeze air into their bodies (they show this on TV all the time, I'm sure you've seen these bags before). An 'oscillating vent' is a ventilator that basically allows for better lung inflation, thus increasing the oxygen to the baby. The rest of the things she mentioned, let's see.... drugs to moderate the blood pressure (Dopamine), drugs to paralyze the baby so that they won't fight the tube in their throat that is hooked to the vent and that will paralyze them for special procedures (Pavulon). We may be required to to take blood and test the gases in it to see what's going on with the baby metabolically (i.e., is the baby's blood becoming to acidic? Acid-base balance in the body is crucial and very sensitive and easy to upset, despite natural 'buffers' the body has to try to correct problems. Q 1/2 hour= 'Q' means 'Every' in nursing-lingo, so that means that Dawn was drawing blood for those gas tests every half hour for the whole twelve hours she was there, H&H is a blood test that looks at the Hemoglobin and Hematocrit in the blood, which basically measures oxygen-carrying capabilities of the blood cells in the vascular system. C7, I assume, is a Chem-7 blood test, where blood is drawn to look at 7 basic factors or 'chemicals' in the body and to see how illness is affecting the most basic levels of the baby. Transfuse x2 means that the baby required TWO blood transfusions in one shift. A PICC is kind of like an IV line, but it's bigger and centrally located. Forgive me for not getting into the details, but I'm sure someone else can explain that! An LP is a lumbar puncture, another serious, invasive test where we draw fluid from the baby's spinal column and test it for various things, including bacteria. I'm not sure about Amp and Amik- is that Ampicillin (a drug)? Amik? Dawn, help us out here! ;>) I'm not familiar with 'Amik'. Hope this answered some of your questins, Nick, and I'm sorry it's so damn long. That's what happens when people get tired. They ramble. Although, my husband says I ramble even when I'm not tired, so we know what that means. Time to get a new husband. ;.) Ya'll take care, and thanks for all of the encouragement.
Jun 3, '02That is simply amazing!!!! I could never handle having to do all that to a baby in 3 days, let alone all in the one night. I really wish people would learn more about what all nurses have to do to maintain our health. Do no worry about it being long winded. In my opinion, it was a good length reply. I really appreciate it. Are you also a NICU nurse?
Jun 3, '02What a bunch of ca-ca, poo-poo. It reeketh of dung. I never listen to that crapola. Bull pucks. Cow chips. Fecal matter. Hmpf!!
Jun 3, '02Kristi,
Very good explanation! I probably just would have said: The baby kept trying to die all night.
In our hospital, other departments think that we are prima donnas. Especially Pharmacy - they don't think a few cc's more or less makes any difference. Big deal, so the TPN came up D14 instead of D17, 3% isn't worth re-mixing.....
Also x-ray can't seem to believe anything with a baby could be needed STAT.
Fortunately, we have some really good Lab people on our shift (although one is leaving for greener pastures with a lower cost of living) that understand that you use the LITTLE tubes for babies (I've been places where they pull out thse 3cc jobs for a CBC).
p.s. we only have to float to WBN. We get called to L&D for codes, Jump-starts and baby evals (sometimes the L&D nurse just doesn't want to deal with the baby :angryfire ), and Peds & ER to start IV's. We are not staffed for this extra stuff.Last edit by nell on Jun 3, '02
Jun 3, '02[QUOTE]Originally posted by nell
Very good explanation! I probably just would have said: The baby kept trying to die all night.
ITA! What it boiled down to is the baby kept looking at the light all night! Thanks Kristi! And you are right about Ampicillian and Amk is Amikacin, another abx.
I think I would barf if I was floated to anything but Newborn Nursery!
Nell, count your blessings with your lab. I have had lab techs YELL at me for sending them so little blood! I apologized and I apologized for the 600 gm baby for not being able to spare enough!
Jun 3, '02ARGH!!! those vampires!!!! Little kids aint got much of anything to work with, and smaller bodies are more susceptible to drugs. How ignorant are these people!!!! They should know that many drugs are calculated to a person's body weight!!
Jun 3, '02well gee folks where i work et night we alls sits arownd skratchin owr bellies and eatin vittiles and drinkin joe. iffin de ER kawls and sez we are fixin to git an admission we justs tells em to hold dem on down dere until de break of day.
weuns night nurses dont do nuthin moren we have to. thats why i reckon we works at nights
Jun 7, '02LPNs are not real nurses, rehab nurses are not real nurses, home health nurses are not real nurses, NICU nurses are not real nurses, night shift nurses are lazy. Seems like the only real nurses are daylight medsurg nurses. What have I been doing working nights in ICU all theses years?