Cheat Sheets and other weird policies

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    I just transferred from the ER to the NICU about 3 months ago and just got off orientation. I was shocked to learn how many different policies and procedures there are, and in an effort to remember them all and have them at my finger tips I wanted to make a cheat sheet with all the important numbers on it (ex: what age the big isolette covers are removed, when they can go to air temp control, what age to keep midline, humidity, etc...). Well I found out that the medical director of the unit and the nurse manager won't allow "cheat sheets" like this...is this just me or does that seem weird? I guess they want us to look up the policy...which is fine, but the policies are not always easy to sift through and find the answer quickly. I just wondered if you guys had ever heard of anything like this.

    Our unit also has an IV team, so even though I can start IV's when I work in the ER, I can't start them in NICU. What are your policies on this? The rumor I heard is that our medical director wants to kick everyone off the team that doesn't have 100% on IV starts. I wonder when the last time he started an IV was...ugh!!! Do you guys use sterile technique when starting lines? How about when giving IV meds?

    I love NICU but it's a WHOLE lot different than the ER!!
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  4. 0
    I think you could create your own "cheat" book--write down whatever you want/need and keep it in your locker--an "auxilliary" brain. Or @ least write down where to find the p/p required. The last place I worked had everything on the computer, which sounds cumbersome, but wasn't after you did it a few times.

    An IV team sounds like a dream come true-a difficult IV start can chew up your time like nobody's business. Only problem I see is what if no one on the team is working that shift. And if anyone has 100% success on IV starts, they probably can walk on water, too. Don't ever let them go home!! Sterile technique for sure when starting lines, as good as you can get for peripherals and IV meds.

    NICU is a whole lot different than just about anything--sometimes I think the pts are a whole 'nother species!

    Welcome, and best wishes.
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    I agree with you. I feel it would be a wonderful idea to have wallpaper in the Nurses Station & Nursing Lounge with critical info tips on it. New nurses know what would help other new nurses make this crucial transition less stressful.
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    Yes I guess I just don't understand why it is a big deal to have all the most common info in one place for quick reference...just wondering if anyone else thought it was weird that it wasn't allowed!

    I totally understand about using sterile technique for starting IV's and even administering IV meds. I just wondered what you all did as far as who can start IV's in the unit. There are some days I feel so useless not being able to start lines and other days I'm so glad I can't!:-)

    How do you all give Indocin? We needle ours into the closest hub on the IV, tape it down, and let it infuse. It scares me that the needle is going to come untaped and the baby is going to stick him/herself. It seems like there should be a better way to administer it.
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    Not allowing you to keep cheat sheets is ignorant. Expecting 100% success rate in ivs is ignorant. IV team sounds great in theory, but I bet they'll eventually start snipping it away here and then there when they start to feel the IV staff isn't busy enough. I work in probably the worst, most behind-the-times Nicu y'all can imagine, but I still don't think I'd want to transfer to yours. Sounds like policy is being made by people that have never done the work on the floor.
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    That's kind of how I felt about it Bortaz! I get an uneasy feeling that my license is on the line there. I don't always feel like management is behind us, and hearing stuff like "no cheat sheets" kind of confirms it. But like I said, I am still new and come from the ER where pretty much anything goes as long as you don't do any harm to the patient, just so you can keep your head above water. I love the NICU so far and I hope my perception of the unit and management changes the longer I work there...
    Bortaz, RN and Esme12 like this.
  9. 0
    It may seem difficult, but when I was a new LPN then RN I was passionate about my job and found learning rules pertinent to my job easy. F orty years later it is still easy. Most of this should have been done in orientation, or when you had a preceptor. Perhaps you should be doing something less challenging and less critical if you can't recall policies. If you want to keep doing what you are doing, at least learn how to look up policies quickly.


    Quote from JDD1017
    I just transferred from the ER to the NICU about 3 months ago and just got off orientation. I was shocked to learn how many different policies and procedures there are, and in an effort to remember them all and have them at my finger tips I wanted to make a cheat sheet with all the important numbers on it (ex: what age the big isolette covers are removed, when they can go to air temp control, what age to keep midline, humidity, etc...). Well I found out that the medical director of the unit and the nurse manager won't allow "cheat sheets" like this...is this just me or does that seem weird? I guess they want us to look up the policy...which is fine, but the policies are not always easy to sift through and find the answer quickly. I just wondered if you guys had ever heard of anything like this.

    Our unit also has an IV team, so even though I can start IV's when I work in the ER, I can't start them in NICU. What are your policies on this? The rumor I heard is that our medical director wants to kick everyone off the team that doesn't have 100% on IV starts. I wonder when the last time he started an IV was...ugh!!! Do you guys use sterile technique when starting lines? How about when giving IV meds?

    I love NICU but it's a WHOLE lot different than the ER!!
    Last edit by sirI on Feb 22, '13 : Reason: edited by moderator
  10. 3
    I think it's totally unreasonable to not be allowed a cheat sheet? What is the rationale behind it? Is it fear of incorrect info on the sheet? Maybe you can work with them to create a department cheat sheet that other people entering the department/new grads can use.
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    Our unit created a pocket sized guide for all nurses for quick reference for a wide variety of need to know info. Each page has a blank side with space for personal notes. Our educator and 3 staff nurses collated the most common things people of all experience levels needed to look up and that's what they put in the 'book'. Every staff member and all NNPs and our floats have a copy and we will update it every year so the info stays current. Meets people's need for info but keeps the info consistent with guidelines of practice. I think the committee did a great job and so far the feedback is very positive.
    twinkletoes53, Esme12, and prmenrs like this.
  12. 0
    Quote from CarreBarreLPN
    I think it's totally unreasonable to not be allowed a cheat sheet? What is the rationale behind it? Is it fear of incorrect info on the sheet? Maybe you can work with them to create a department cheat sheet that other people entering the department/new grads can use.
    I haven't been able to get an answer as to what the rationale behind it is, but I think you're right about concern of wrong information. We have performance review meetings coming up and I might talk with my manager about trying to create something for them to approve for future new hires


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