HELP - need vent advice

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I'm an 'old' level I & II nurse who did short-term vents (30weeks+) many years ago, but never felt totally comfortable with them even then. Now the hospital where I work is starting to keep the same type vent patients. We're not just stabilizing and transporting anymore. I need to brush up on this stuff and fast! Mgmt. is dragging their feet about training us.

When I hear our level III expert of a contract nurse talk about the downtown NICU, I realize how much I DON'T know.

My question is...

Can you recommend a good book, course, whatever, to aid me in recovering lost skills and learning new stuff as it realtes to caring for the vent baby?

I have taken STABLE, but without the frequent use of some of the skills, I have had trouble retaining all of it. I have a neo intensive care handbook, but it is ooooold.

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Specializes in Maternal - Child Health.

Your unit management needs to do one of two things:

Send each and every staff nurse to a Level III NICU for vent training. This needs to be AT LEAST a week in length, during which you would receive both classroom and clinical training (1:1) with a preceptor doing hands-on care of vented babies of all types (preemies, surfactant administration, full-term meconium and pneumonia babies, whose care differs greatly from that of preemies).

OR

Hire a large number of experienced per diem nurses who have gained vent experience at other jobs, and have one on call 24/7 for the first year. Those nurses would be required to come in and precept your staff whenever a vent baby is present in your unit.

Frankly, the first option is preferable because you stand a better chance of getting a thorough orientation and a significant amount of hands-on care in a relatively short period of time.

It is admirable that you are trying to update yourself, but as you know, that is difficult to do without access to actual patients. It is your hospital's responsibility to provide your staff with the proper training. Otherwise, your unit will be a Level II in name only, which is terribly dangerous to your patients and your licenses, and fraudulent to the parents who think they can rely on you to provide the necessary care for their sick babies.

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We are a level II nursery and have been. They are trying to up our status to a level II 'B' (or 'C' ?) -- NOT level III by any means. We don't keep babies below about 30 weeks.

We do keep vents occasionally now. I had two last night. They were stable and did ok. The respiratory support here is not as good as it was at the other hospital where we kept vents. We don't have a large enough unit to have a resp. tech just for us - we share them with other units.

I am fairly comfortable with stabilizing a vent for transport - the neo & resp. therapist are at the BS, and the baby is gone within a few hours. It is the patients who stay and must be managed without constant neo support for several days that make me nervous.

We are all asking to go downtown to the level III unit and saying over and over that we need proper training. Mgmt. talked about starting by having a few key nurses going downtown for training and then expanding that to include all the level II nurses over time. The problem is, they are getting the cart before the horse. We are starting to keep babies we used to ship, and they have not sent any of us for training yet.

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Specializes in NICU.

I agree about the vent training but if you don't use it, poof, out it goes. I can't offer too much advice. We are a level 3+ and use RT's a WHOLE lot. Maybe you could put together a reference guide after the training that is kept in the unit. (we'd get staff nurse points for a project like that!) in your oh so copious spare time. I see what I can dig up books wise. Babe's crying back later.

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A level III nurse I know told me about a book, Neonatal Core Curriculum. Apparently nurses studying for their RNC use it.

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Specializes in Level III NICU.
A level III nurse I know told me about a book, Neonatal Core Curriculum. Apparently nurses studying for their RNC use it.

That book is good in general for NICU. I had a book awhile ago that was specifically about respiratory stuff, I think it was called The Handbook of Neonatal Respiratory Care or The Manual of Neonatal Respiratory Care. It was something like that, my preceptor had given it to me when I was on orientation, and I just gave it back to him about 6 months ago. If you look for a book that is just about neonatal respiratory care, it should go into vents (and RDS, mec aspiration, surfactant administration, HFV, etc) more in depth than the Core Curriculum does. I'm sure you can find something on Amazon.

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You need to work with vents all the time in order to maintain your skills. My unit cares for 22 weekers and above and we can have 2 or 3 oscillators plus conventional vents going.

I agree with Jolie who stated, "Send each and every staff nurse to a Level III NICU for vent training. This needs to be AT LEAST a week in length, during which you would receive both classroom and clinical training (1:1) with a preceptor doing hands-on care of vented babies of all types (preemies, surfactant administration, full-term meconium and pneumonia babies, whose care differs greatly from that of preemies)". Good Luck.

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The March of Dimes has some great resource material that may be what you need. http://www.marchofdimes.org

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