Need opinion from experienced NI nurses, please...

[gypsyatheart]

I had a really bad shift the other night, and can't stop thinking about what could've been done differently.I work in a 50 bed level3 NICU...we are combined with a step down/level2 nursery.

All of the nurses, pretty much, are assigned randomly, sometimes you'll go for mos in the highest acuity/level3 area. Other times you'll spend weeks in the step down nursery w/only grower/feeders. then boom you're back in the ICU w/vented kids w/liones, drips, etc.Usually this is OK, I guess.

I have only been in this unit since last Jan. And part of last yr I was out on maternity leave, then right after Christmas I had surgery, so I was out 3 wks. I have 10 yrs previous experience w/L&D-LDRP, normal newborn and Peds. However, as you know, NICU is a world unto itself! :chuckle

I have been PRN since I came back from maternity leave, so the last 4 mos or so. I try to work 1 to 2 days per week. I am certainly feeling more comfortable in this area, I really like it, but I know I still have a lot to learn...I'm not to the point where this is "old hat" yet. LOL! :)

OK so the other night I come in and have 2 ventilated kids, 1 kind of unstable. And I've been assigned to get the 1st admission. There are a few other nurses w/babies only on cannulas, not as sick as mine. The nurse I was relieving could not believe I was up for an admission.

Of course, I got an admit w/in the 1st hr, a 30wkr....needed a lot of stabilization. No one took over either one of my 2vent babies. I had told the charge that I didn't feel comfortable w/the situation. Went in one ear, out the other. A couple hrs after my admit, the unstable vent kid I had coded!

My night was soooo horrible, I was so behind the whole night, I could not keep up w/all the charting! Plus, there were nurses sitting around reading magazines! :angryfire

Am I just being overly sensitive? Is it just that I'm not as experienced in this area yet that I feel frustrated by all of this?

I guess I just needed to vent....thanks for listening. :)

[gypsyatheart]

What happened in your shift in unacceptable :angryfire . I get burned up when there is no teamwork and you feel like you are sinking while trying to swim. Follow the chain of command until you are heard. That was very dangerous at put all of your patients lives at risk.

Next time you may want to suggest to the nurse reading the magazine that you need him/her to do cares or give meds to your other patients while you tend to your patient that is circling the drain.

Do not forget that event when it is time for peer evaluations.

Thanks for your advice...I'm still relatively "new" to NICU, so I'm still finding my comfort zone, so to speak. I knew this wasn't a safe assignment...unfortuneatly, on a Sat night shift, the only person there is the charge nurse and she leaves a lot to be desired!

Well, hopefully this won't happen again, but if it does, I will be having a hissy fit! :rotfl:

[gypsyatheart]

Sorry you had such a terrible night. Where I work ALL vents are 1:1, except on very very rare occasions you may have a grower feeder, but only until they get another nurse. Seems to me you would have been within your rights to refuse the admit. Never done that myself, but I have never had a vented pt. and been asked to admit. The unit I work on was just cited by one study, to have amoung the best outcomes in the nation..... well DUH! Staffing makes all the difference in outcomes.

Wow...you will have to PM me, when you have time, we are looking at moving to Sacramento, d/t my husband's job and possible transfer, and it would be nice to have an idea of the "good" hospitals there.

Thanks for your comments also! :)

[dawngloves, BSN, RN]

I was talking to a traveler that was just in CA and she told me all the vents are 1:1 there! The place she was at also had anyone

[carriec]

That hospital in California sounds like heaven for a NICU nurse!!

I'm so sorry that you had a night like that....I think one thing I've learned being a nicu nurse is learning to open my already big mouth and tell the charge nurse that she needs to assign one of your babies to someone else....or ask people to get you things...that will get them going...

I remember about 11 years ago when I was in nursing school, and we had a couple of lectures on DELEGATING!!!

Those people sitting on their rumps reading need to unglue themselves from those rocking chairs!!! OH THAT MAKES ME SO MAD!! I'm so sorry for you!!!

DON'T BE AFRAID TO SPEAK UP!!!

[gypsyatheart]

Yes, dawngloves and wjf00, please share the names of those hospitals! Even privately, if you wish! It would help to have a "heads up" especially when I don't know much about the hopsitals out there! Thanks...

And carriec, thanks for the support! :)