I am in orientation for a mother-baby nursing job, and I recently had a grunty/nasal flaring baby admitted from transition and the mother-baby nurse I was shadowing used bulb suction on mouth/nose, then did a sp02, 85%, we called the NICU floater who then did an assessment, determined that baby's right nares was blocked, used wall suction and an attachment tubing to suction, baby pinked up, sats in the 98-100 range. My question: is suctioning in my scope as a mother-baby nurse? What would I be expected to do while waiting on a nicu nurse to eval the infant? I don't even know which tubing type is needed or how far to go, and need to know where to get these skills or do you think this is out of what my role would be, after initially stimulating baby, bulb suction, maybe 02? Please no meanies, I am earnestly trying to learn and don't really know which questions to ask yet or where to get answers from. Will NRP cover this, by the way?
dansamy 672 Posts Specializes in Going to Peds!. Aug 19, 2013 On peds, we use BBG suctioning because it's noninvasive. If they need deep nasal suctioning, we do it prn OR RT does it along with the pt's nebs. We use a small suction catheter. I think it might be 8 or maybe 10.I would bet, with a nicu, that the couplet RN is expected to assess the newborn, provide stimulation & bulb suction. If those are ineffective, I would suspect that you are to then call nicu for anything more invasive. Sent from my HTC One X using allnurses.com
Awhonnwishes 2 Posts Aug 19, 2013 Thank you. That's what I was betting, but being out of the hospital setting for years, I wasn't sure. What is BBG suctioning?
Sun0408, ASN, RN 1,761 Posts Specializes in Trauma Surgical ICU. Has 4 years experience. Aug 19, 2013 One would think that bulb sxning would be in your scope of practice and expected if baby needed it as well as blow by O2. However, this is a great question for you preceptor as facilities do vary and your scope may be less restrictive as others. Your facilities policies and procedure manual may be a good option as well but many times they can be useless.. When in doubt ask your preceptor, NM or unit educator ..
GretchRB 41 Posts Specializes in Women's Services. Aug 20, 2013 NRP covers delee suctioning, it's scary at first not knowing when to stop, but your preceptor should be able to coach you through it. NRP will also cover newborn O2 sats, it's normal not to be sating 100% for a newborn. Things to call the NICU team about are signs of respiratory distress; grunting, flaring, retracting, central cyanosis. Again NRP will cover that too. Don't stress, it gets easier as you go along to know What is going on with your baby, follow your gut. :) good luck!
NicuGal, MSN, RN 2,743 Posts Specializes in NICU, PICU, PACU. Has 30 years experience. Aug 20, 2013 Our nursery nurses use wall suction if they don't clear with bulb. I haven't seen a Delee in ages!
SE_BSN_RN, BSN 805 Posts Specializes in LTC, Agency, HHC. Has 8 years experience. Aug 27, 2013 I just took my NRP, and they didn't go over nasal sxn, just the bulb sxn, which they say they are trying not to do unless they need to.
vandermom 62 Posts Specializes in L&D, NICU, PICU, School, Home care. Has 42 years experience. Aug 27, 2013 Immediately after suctioning is not really the best time to check a O2 sat. Give the babe a minute to recover. You can listen to each nostril to evaluate airflow and use a #10 to suction a blockage. Give the babe time to rest between suction methods.
Bringonthenight 310 Posts Aug 27, 2013 I'm confused, what's the difference between you and a NICU nurse? Your both RNs, can't you both suction? Why is her scope greater then yours? I'm not from US sorry if I'm sounding stupid.
Lanesmama 90 Posts Sep 3, 2013 We can sxn. I typically use delees. Some of our docs still suction on the perineum... I'm the nursery nurse... I don't believe it is out of your scope. If you are unsure of the equipment, ask your preceptor to show you the equipment and allow you to try with the next need for. It is similar to NG suction in that don't occlude on the way in, don't suction for too long. Remember O2 sats aren't expected to be at 90-95 until 10 min post delivery...
NicuGal, MSN, RN 2,743 Posts Specializes in NICU, PICU, PACU. Has 30 years experience. Sep 3, 2013 Please try not to use a 10fr down noses! They cause so much trauma!! An 8 should be fine, we also use neosuckers .
IamSusan 16 Posts Sep 4, 2013 Who does what with babies varies so much from hospital to hospital and unit to unit the answer will vary. What's important is that you have the policy and education to back up the care you give in your facility.
