I was wondering if anyone can give me insight on how the NICU that you work in is staffed?
Meaning, do you have NNP's 24hours a day?
Do you have a neo on staff at all times (in the building or on call?)
Does a staff nurse go to high risk deliveries? Do you have an NNP or Neo attend all high risk deliveries?
What protocols do you have if you have an NNP on staff and not a neo- meaning what can't your NNP do that he/she would have to have a neo be either on hand or on phone?
Thnks
any info greatly appreicated.
Level 3 unit with approx 40 beds.
NNP's are not on staff 24 hours/day, only during day hours.
A neo is in house at all times. Usually, another one is on call if needed (but not in house).
We have a dedicated delivery team that attends all deliveries. NNP or neo attends deliveries that are expected to end in admission to the NICU or if the OB requests.
We never have a time when there are NNPs in house but not neos.
Phenobarb is rarely used in our unit, unfortunately. We start with Morphine, then move to methadone to wean. Often, we try to wean with Morphine, but it seems like that fails most of the time and we end up moving to the methadone anyway.
There is a methadone clinic in our area that routinely tells pregnant women there is no withdrawal from methadone and not to worry about taking it. Frustrating.
Another thing that bothers me is some babies do not show active withdrawal until three days or later. By the time they would be treated, they have already been discharged home.
I am sure you can understand that we have based our responses on the information provided by the op, which in our critical opinion, is believable. Obviously, we do not have both sides of the story, but most experienced nurses and managers have fairly accurate BS alarms and can identify "woe-is-me" stories that do not ring true. This isn't one of them. Also,any nurse with any amount of seniority has either experienced or witnessed a co-worker treated badly for reasons having nothing to do with job performance.
Please remember there are two sides to every story. I, too, am familiar with this unit (with ten years experience). Sure, there is a clique there, just as there is in almost every unit. I'm not in said clique, so there is nothing to be gained by my posting this except clearing up some misconceptions.
Occasionally, BS alarms can be way off. I'm sure you know that.
Some facts I can relate here:
This particular NM is very "by the book" and would definitely not do anything that would jepardize that. HR is generally consulted about every move she makes beforehand. I can guarantee it was nothing to do with a "granddaughter" or anything of that nature.
There is no 6-9 week orientation. It is much longer than that (normally 12-16 weeks).
A lot of value is placed on attendance, especially in the orientation period when the new nurse is still on probation. At this point, there is not even enough sick time acrued to compensate for ONE shift off.
As a rule, new nurses are given a lot of leeway in this unit as far as picking up new skills and learning time management (way too much sometimes as far as I'm concerned).
As far as identifying the unit, the OP did that herself at the very beginning of this thread. I noticed it in some of the terminology that was used to describe the unit and then again when she mentioned our sister hospital by name.
Regarding census, we are up and down. When this thread was started, we were bursting at the seams. Now, we are budgeting. Two days from now, we'll probably be up again. Considering there are current openings posted, I do not see that as being an issue in this case.
This unit is in the middle of a major (long overdue) overhaul concerning policies and it can be a rather tense place at moments. However, it's still a very good place to work.
There seems to be more to this story than what's being posted.
NNP's are not on staff 24 hours/day, only during day hours.
A neo is in house at all times. Usually, another one is on call if needed (but not in house).
We have a dedicated delivery team that attends all deliveries. NNP or neo attends deliveries that are expected to end in admission to the NICU or if the OB requests.
We never have a time when there are NNPs in house but not neos.
Phenobarb is rarely used in our unit, unfortunately. We start with Morphine, then move to methadone to wean. Often, we try to wean with Morphine, but it seems like that fails most of the time and we end up moving to the methadone anyway.
There is a methadone clinic in our area that routinely tells pregnant women there is no withdrawal from methadone and not to worry about taking it. Frustrating.
Another thing that bothers me is some babies do not show active withdrawal until three days or later. By the time they would be treated, they have already been discharged home.
Occasionally, BS alarms can be way off. I'm sure you know that.
Some facts I can relate here:
This particular NM is very "by the book" and would definitely not do anything that would jepardize that. HR is generally consulted about every move she makes beforehand. I can guarantee it was nothing to do with a "granddaughter" or anything of that nature.
There is no 6-9 week orientation. It is much longer than that (normally 12-16 weeks).
A lot of value is placed on attendance, especially in the orientation period when the new nurse is still on probation. At this point, there is not even enough sick time acrued to compensate for ONE shift off.
As a rule, new nurses are given a lot of leeway in this unit as far as picking up new skills and learning time management (way too much sometimes as far as I'm concerned).
As far as identifying the unit, the OP did that herself at the very beginning of this thread. I noticed it in some of the terminology that was used to describe the unit and then again when she mentioned our sister hospital by name.
Regarding census, we are up and down. When this thread was started, we were bursting at the seams. Now, we are budgeting. Two days from now, we'll probably be up again. Considering there are current openings posted, I do not see that as being an issue in this case.
This unit is in the middle of a major (long overdue) overhaul concerning policies and it can be a rather tense place at moments. However, it's still a very good place to work.
There seems to be more to this story than what's being posted.