How can such small kids take so much energy???

  1. i have officially had a night from h*ll. i am thoroughly exhausted, and was after only about 4 hours of my 12 hour shift. we were miserably short to begin with, so that just set the scene. oh, and i was in the feeders/growers room. :uhoh21:

    all night long all i heard was monitor after monitor after monitor alarming loudly. all 12 hours of my shift. we had kids playing bradycardia bingo...."let's see who can get the lowest hr for the longest time and repeat it most often" seemed to be the theme of the night. and of course, along with the bradying came apnea, followed by o2 sats that should have been incompatable with life. and let's not forget babies pulling o2 off, ng tubes out, wailing at the top of their lungs, etc. and of course, we still have kids that are ng fed, and their pumps are constantly going off while others are trying to die/eat/both at the same time.

    everybody had more babies than they should have. how can you possibly po feed 4-5 babies in one hour??? and still save the babies that are trying to die on you? what about assessments, what about ng feeds, what about anything else that might need to be done?? :angryfire and let's not even think about the charting!! ha!!! recording o2 sats and fluids q1h?? so not a priority last night. when did we get to chart??? i think it started around 0645 this morning. by the end of the shift, i think we all needed a stiff drink and an extended vacation. thank god we all work as a team to get everything done, but it is still overwhelming.

    how can neonates need so much attention??? i mean, what is up with them constantly violating their monitors??? and why does it seem like if one is having a bad night, all the kids are having a bad night???


    i like the nicu, but i sure will be glad to go to l&d. at least i shouldn't have more than 2 people working hard to die at a time (but i won't hold my breath on that one!) i need a therapeutic rest!!

    thanks for letting me vent a little.
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  2. 13 Comments

  3. by   Mimi2RN
    Sorry you had a horrible night. They may be little, but all it takes is one tiny finger in the right place....and then they gag, and brady, and desat.

    Do you schedule all your feedings at the same time? I've never figured out how you make the babies agree to that. I had a term r/o sepsis babe the other night...feed ad lib....ate 3 times on days, SIX times for me. He didn't care if it was someone elses turn. I hope his mom doesn't plan on sleeping.
  4. by   Gompers
    I understand exactly how you feel. There are nights when I might only have 3 babies and I'm still running my butt off. And the kids are all in the same room!!! I wonder how floor nurses do it, having all those patients in different rooms. It's like, between taking care of the kids and their families, cleaning their bedspaces, stocking their supplies, and doing my charting - I am busy all night long!
  5. by   BlueYYsRN
    I know exactly what it is!! You haven't figured it out?? Ha Ha Hahaa!!! Its a CONSPIRACY!!! What you had on your hands dear friend wasn't sweet little innocent neonates...they were really aliens...I haven't figured out who sent them or where they come from...but I know they know how to do their job...I think its working...Last night I actually heard one (who was trying to pass himself off as a 27 weeker) say "try to stop me, stupid girl!", as he pulled at his ETT, thus kinking it and setting off his alarms. Now I ask you, how did this "neonate" speak while intubated? I bet he has parallel vocal cords...yeah thats it and why did he sound just like Dexter from Dexter's Laboratory?

    Do you think we should clue in the government or the press or the National Enquirer?
  6. by   dawngloves
    You're right. Neonates do require a lot of attention. Your ratio is dangerous on such unstable babies. That really stinks!
  7. by   iceNICUnurse
    I understand you so well
    We are having horrible staffing at the moment and that means that I had one HFV baby, one Vented Cronic on 70-100% oxygen and a Cpap kid on top of that, all weekend.
    I think I need a brake!

    Love from the land of Ice and snow (with no snow at the moment...and no ice either)
  8. by   dawngloves
    OMGosh! You guys are kidding with these assignments, right? Our Director would flip if she saw an assignment like that. But when she's not around on the weekend we sometimes do get two stable vents together. I think the worst is the days I get 4 feeder growers.
  9. by   nekhismom
    Quote from Mimi2RN
    Sorry you had a horrible night. They may be little, but all it takes is one tiny finger in the right place....and then they gag, and brady, and desat.

    Do you schedule all your feedings at the same time? I've never figured out how you make the babies agree to that. I had a term r/o sepsis babe the other night...feed ad lib....ate 3 times on days, SIX times for me. He didn't care if it was someone elses turn. I hope his mom doesn't plan on sleeping.
    All of the babies are scheduled to eat at certain times. I don't know who does it, probably day shift, because we are always told in report what time they are due again. Most eat q3h, some q4. Of course, our assignments are never given based on acuity or feeding times or anything else that makes sense. I used to think you got kids that were close in proximity to one another, but after having kids spread throughout the room, I know that is not true anymore. I can't figure out how they are assigned. But many of the nurses had 2 or more babies that are scheduled to eat during the same time. Feeds are either on the hour or half past. Each kid is supposed to get 30 mins. to PO feed, but it doesn't work that way most times. For example, I had two kids due to PO at 2100, then 2 for PO at 2130 and 1 NG at 2130. Just how exactly is that supposed to happen??? It just doesn't work well, and it's very difficult to get the feeding schedule changed.

    For us, feed ad lib means that they eat at scheduled times, but can eat as much as they please.
  10. by   nekhismom
    Quote from BlueYYsRN
    I know exactly what it is!! You haven't figured it out?? Ha Ha Hahaa!!! Its a CONSPIRACY!!! What you had on your hands dear friend wasn't sweet little innocent neonates...they were really aliens...I haven't figured out who sent them or where they come from...but I know they know how to do their job...I think its working...Last night I actually heard one (who was trying to pass himself off as a 27 weeker) say "try to stop me, stupid girl!", as he pulled at his ETT, thus kinking it and setting off his alarms. Now I ask you, how did this "neonate" speak while intubated? I bet he has parallel vocal cords...yeah thats it and why did he sound just like Dexter from Dexter's Laboratory?

    Do you think we should clue in the government or the press or the National Enquirer?

    Conspiracy was actually one of the first words that came to my mind when I got the assignment!! LOL I think we might have better success with the Enquirer.

    And 4 feeders/growers is a TOTAL handful. No break at all! BUt then again, 2 vents isn't exactly a walk in the park either.

    And dawngloves, nope, we have 4 or more regularly. We get 5 a lot, but this is the first time I've seen more nurses with 6 than 5. We simply don't have enough staff. We have TONS of PRN nurses, but they don't work nights for thte most part, so we are always short. Then we get dumped on. Lots of people are leaving d/t the high stress. Lots won't leave because they only want to work NICU and the next closest one is hours away. We just need more staff. Even unlicensed people would work. Just more hands to feed and change would be a huge help. *sigh* I feel guilty for leaving them, but I have to move on. I couldn't continue to work in those conditions. As a new RN, I'm scared I could kill one of those babies under conditions like that. I can't do it all. So I'm leaving. I do hope to work part time or PRN in a NICU when I move, though, because I love NICU nursing.
  11. by   dawngloves
    Honey, don't feel bad. I left a job for the same reason. The staffing was so bad I was afraid I would kill someone. And no one would have my back. The hospital would point the finger at me alone. Do what ya gotta do and maybe that hospital'll catch on.
  12. by   nekhismom
    Thanks, dawngloves. I know I'm not the first one to leave for that reason, but it sure makes me feel crappy about leaving all of my hard working co-workers in that mess, ya know? But after all, it is MY license. I appreciate the support!
  13. by   MEL101
    [QUOTE=dawngloves]Honey, don't feel bad. I left a job for the same reason. The staffing was so bad I was afraid I would kill someone. And no one would have my back. The hospital would point the finger at me alone. Do what ya gotta do and maybe that hospital'll catch on.[/QUOT "and"

    Goodness! Such memories ya'all are bringing back! I worked NICU, Madison, WI early 70's and guess what...I experienced the same situations that you still describe today!! Unfortunately nurses do not stand up as a "group", that demand improved working conditions not only for themselves but for the patient...My impression...nurses will continue to "leave" one "area" for another to maintain a level of sanity and retain licensure... no one in their right mind wants to retake "boards" or lose their license because admin screams "shortage"!! Shortage was an excuse 30+ years ago....there is no nurse shortage..there are those of us that refuse to continually put ourselves and the patient in jeopardy, at least in the hospital setting. Fortunately (bless their hearts) there are those nurses that will not give up hospital work...yet...
    I do wish nurses would band together and demand major changes...perhaps nurse/patient ratios and a number of other issues could be rectified...

    Mel101
  14. by   TiffyRN
    I remember many nights in our "chronic" room where the kids constantly set off their alarms, mostly for desats but really for everything. We try not to "chase them with O's" so silencing the alarms and waiting them out is general practice. They generally desat and recover quickly. I had an assignment of 2 severe BPD kids that were side by side. It was convenient because I could sit between them with their alarms silenced and watch them. I would joke with the other nurses they were competing to see who could go lowest and stay longest. Fortunately they weren't the type to brady just desat. Usually after a three night run in the chronic room I will hear alarms in my sleep or have nightmares about kids extubating.
    Last edit by TiffyRN on Mar 25, '04

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