Imafloat 7,107 Views
Joined Sep 24, '04.
Posts: 1,312 (16% Liked)
WeeBabyRN, I know it's scary the first few times you get a baby out. I found if I get all of my lines in position first and get everything set with mom or dad first, then I seem speedier in getting them up. We will usually disconnect them from the vent and inline suction before we move them over to the waiting parent, and in that cast, you can't be very slow. If the baby doesn't like being disconnected or has a high PEEP, then it goes a bit slower .
We encourage kangarooing, stable babies without umbi lines can kangaroo daily. They must be held for an absolute minimum of one hour, we prefer at least 90 mins. They go back when they start exhibiting signs they are getting stressed with their situation (as listed above by Prmenrs). I've had parents kangaroo for four hours. We have recliners and use the nursing stools that Prmenrs posted the picture of. If a parent decides to recline, then they get completely into position before the RT (in the case of an intubated baby) and I place the baby on their chest, and they stay reclined while we put the baby back when the session is over. We clip the vent tubing to the parents' gown or shirt in two places and check on the position of the baby and parent frequently (but quietly) to make sure they are not moving too much. We discourage talking at all during the kangaroo time, the whole point is for it to be very peaceful and I've seen babies get very upset if the parent speaks. I don't know if it is the reverberation or what, but many don't seem to like it. Also when most people talk, they have a tendency to move their arms or hands to express themsleves, it's an unconscious thing and then, whoops! There goes the ETT.
All of these things (parent in place first, clipping tubing in two places, checking on them frequently, discouraging talking) have helped decrease our unplanned extubations during kangarooing
I'm confused by this comment. This statement implies to me that your unit does not kangaroo unless the baby is really really sick? Or are you saying that you've found that when a parent is allowed to hold/kangaroo they have trouble grasping the fact their baby is a sick infant in an ICU and can still get very ill and possibly die. If the latter is the case, I kind of get what you are saying. It's like trying to tell a parent that just because the baby (possibly a 25 weeker) is here doesn't mean it is fine to hold and touch and stroke and give them a bottle right away. But I've found that if you educate the parents correctly about the concepts behind kangaroo care and it's benefits for ill babies, generally they don't seem to have unrealistic expectations. There are always those exceptions who think that no matter what or how sick the baby is, they should be able to hold.
I work NiCU.
...they are coding your patient in 34, don't worry about listening for report, just go to the bedside
...your patient in 12 has a sedated MRI at 0730 (it's 0710) he had a float nurse last night, I don't know if anythings been done, or if there's consent
....they say his abstinence scores are always high, but he was a perfect angel for me last night, he slept all 12 hours!
I am still in my first nursing job, as a NICU nurse. I love the babies and their families. I love that everything I do at work matters. I love that my population is vulnerable. I am detail oriented so NICU nursing is a perfect match. I have issues with poop and other body fluids, but when they come out of a baby, they aren't so bad (most of the time). I love the NICU because some of our families are there for a long time and we are able to develop relationships at work with them. I realize that people think NICU nursing is sad because it is sick babies. We all know there will always be a need for NICU's, there will be sick babies if I work there or not. I am glad that I am there to help parents through this dark time in their life. What an honor to make a parent smile during the most stressful and difficult time in their lives. I love that the families feel a connection with us and bring the kids back to see us for years and send us pictures every Christmas. It's incredibly rewarding to see the progress the kids make year after year.
Right now I'm not loving the hospital side of my job, we have been on a hiring freeze for a year, even though we have lost many staff nurses none have been hired to replace them. With H1N1 our hospital is busy and we are stretched too thin. I don't like being rushed and stressed all day, what if I mess something up? I know that this is a part of nursing. When I get really stressed, I go pick up a warm snuggly baby and rock them for a minute until everything feels a little better.
Black clicky pens so you don't have to worry about the lids. A black Sharpie to cross out patient info on any papers. I bought a nice clipboard that opens with a calculator at Walmart for $2.00. I keep all of my papers in it, it is even big enough to keep my stethoscope and clinical pens in while I am not in clinical. I found some small colored cards on a ring, they are about 2x3 inches, they are the perfect size to put in my scrub pants (carpenter) and I can study stuff when I have a few minutes down time. A good decent lunchbox, eating at the hospital can get expensive and fattening. I have a small 2 year paper calender in my purse, I have to see everything in front of me at once, it actually covers the entire time I am in nursing school, I got it at the one spot at target. I think it will be cool to look back at it when I am done. It is motivating now to look back and see how far I have come.
I've noticed that I have to pee at work but I can hold it. The minute I step in the door at home I practically have pee running down my leg....
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