Hi! I was reading these threads and just wondering about everyone's different NICU's- how they're set up, usual census, capacity, unique features...let's share info about our respective units! No need to say where you're located, if that makes you uncomfortable! What things do you have or do that makes your unit special? What things would you do if you could to make it a better place for your babies? I'll go first. ;>) I work in what is considered the largest Level III facility in my area, in a large (very large!) teaching hospital. We have three nurseries in our hospital- Levels I, II, and III. I am currently floated between the II and III, but spend most of my time working in the LIII unit. Occasionally, I am pulled to the Level I which is attached to our transitional nursery by a central office space. Our unit is very bare-bones; no frills, small budget. Our turnover rate is very high!! Our level III can hold 24 babies easily, up to 32 if we cram them in. We don't have the O2 lines to hold any more than that, and usually have no more than 20 babies in the LIII at a time. Our transitional nursery is smaller, and can hold up to 26 babies before we have to start moving them out. Both nurseries are rectangular, with the babies lined up to either side. We are a sister hospital to the larger, community hospital down the block, and our units were originally located down there. They moved about 10 years ago, and a patient wing of the floor was remodeled (badly!) to accommodate the nurseries. We are adjacent to L&D, but it's a nice long walk through winding hallways to get there. Honestly, whoever designed this unit must have been truly thoughtless, because it is the most inconvenient design I've ever seen- supply closet and equipment room are off-nursery, way down the hall. We have a tiny lactation room with one rocking chair that is used for all three nurseries but can only fit one person. Our unit supplies are spread out all over the place- the T-connecters are on one side of the nursery, and the PRN adapters are on the other...that kind of thing. We have no facility for teaching parents- no conference room to speak of, and though we desperately need more patient education, if it doesn't take place at the bedside, it won't be done. We have a waiting room in ANOTHER WING of the hospital for parents and family, and it is pretty sparse. Our hospital, due to the demographic it serves (someone else's words, not mine!), offers no classes, etc. on anything related to babies other than Infant CPR, which is a requirement. We do not have the ability to care for ECMO patients, and certain cardiac defects, nor do we have the ability to house infants that need specialized surgery, plastic surgery, etc. We do take chronic vent babies, trachs, long-termers, etc. We are known for getting the babies with rare and serious infections that no one else sees, and we also have a great deal of drug-exposed babies. Our hospital has the only high risk antepartum unit in the state that has prenatal detox, so we get pretty much ALL of those kids. We also serve the underserved so almost all of our babies come with no prenatal care at all. I'd say about a third of these are the sixth or tenth in a string of children, and most of them come from moms who claim they didn't know they were pregnant, sat on the toilet, and pop! out came the baby. We have one lactation consultant who works M-F with only those moms who are having serious problems breastfeeding, but overall, our breastfeeding rate is horrendous. There is no unified education for the nurses, and knowledge ranges from extensive to nonexistent. This is not a criticism of the other nurses, but many of them don't even know how to work a manual breast pump. (This could be due to the lack of interest we get from moms...they are truly excellent nurses in many other respects.) Our unit looks very run-down and is probably no assurance at all to the parents who come to see their children. Our nurses, however, are top-notch, and come from all over the world with various levels of experience. Our unit is known for the place to learn the most, which also helps to explain the high turnover rate- people come, learn, and go! ;>) Sometimes, I wish I worked in a nicer place- certainly one that is more patient/family-friendly, but most of the time I feel lucky to be working with these particular babies, because their futures are so unsure because of poverty or family issues. The nurses on our unit are definately in charge, and are frequently responsible for 'policing' the many residents, students, and interns, as well as the respiratory team. We are in a constant battle with the RT's, as there is very little team communication, however, and we often fight over what is best for the baby. The RT's are responsible for ALL vent changes, drawing and running gases, etc., and we are not given an opportunity to learn these things at all here. (This makes me feel at a great disadvantage, and also has me worrying that I will not survive at another hospital, should I choose to move...) Ultimately, the RN's are in charge of the baby's care, but some of these decisions are made with little knowledge, which can be scary to a new nurse like myself. If you want to learn something, you are on your own, and I have spent a great deal of time studying this year (I graduated in December). More than I studied in school, and I'd thought that was absolutely impossible!! The best part about my unit is being able to reach out to willing parents who are lost and need guidance and actually see them try to make a difference in the life of their child. So what about you guys?