We've all got them. Those things we find that just get us riled. Perhaps reviewing them will help newer nurses. Perhaps writing about them will just let us vent.
Here's mine:
OGTs that aren't in far enough. The OGT may be in and secured where it has been but the baby has grown. Nurses check placement: push in a little air, hear the sound over the gastric area, aspirate and find no aspirate. They also don't get the air they pushed in back but since they heard the air they think the tubes ok when in reality its just above the sphincter in the esophagus. Put the tube down another 1/2 to 1cm and then you get back the air, and possibly a large amount of residual that was being missed before. If you don't get the air you pushed in back, you have to ask why not!
My pet peeve is babies who are left in a tangle of monitor leads, temp probes. pulse-ox wires, IV tubing, etc., which is usually accompanied by a comment like, "The monitor is not picking up, the pulse-ox is touchy, the temp probe is not working well or the IV keeps occluding." DUH!
It can take forever to straighten these things out and make the baby look like something other than a ball of yarn attacked by a kitten as well as get the equipment working.
No kidding!!! Definitely one of mine!
I also hate when certain things that are a "day shift responsibility" get left for the night shift to do (in addition to all of our shift's stuff). It's usually the same few people who never do the "little things" that they're responsible for. And heaven forbid night shift leave something for days to pick up the slack on...
*It drives me nuts when people put bandaids on after a shot (Vit K, Hep.B)
Usually it doesn't bleed, but if it does just hold pressure for maybe 30 sec. Those bandaids get left on for days and they are very hard to get off and painful for the baby.
*Leaving cord clamps on for several days!
*Messy bedsides and beds!
*Putting tape over the leads (if you have to put tape on them it's probably time for a new set of leads).
No kidding about the band-aids! It drives me nuts when I see band-aids on the heels of my kiddos from lab draws 2, 3 days prior. I think it's done bleeding already!
Not to mention when the previous nurse doesn't check to make sure that a heel stick STOPPED bleeding... nothing like checking your kid out first thing and seeing that it bled right through the band-aid an all over everything else too!
Oh wait can I have 2? When your kid's gasses have been horrible for the last shift, then you come in, suction a huge wad of booger out of their mouth and they miraculously wean on the vent.
Not to mention when the previous nurse doesn't check to make sure that a heel stick STOPPED bleeding... nothing like checking your kid out first thing and seeing that it bled right through the band-aid an all over everything else too!
I don't like using band-aids because of this ( and the three-day-old band-aid problem). I prefer to use a 4x4 folded like a bandana and wrapped around the heel. It apples pressure and comes off quicker!
I don't like using band-aids because of this ( and the three-day-old band-aid problem). I prefer to use a 4x4 folded like a bandana and wrapped around the heel. It apples pressure and comes off quicker!
This is what I do also! No band-aids for me!!
Also, HATE that night shift takes away my containment rolls and leaves the baby prone, NOT on a prone pillow, rolls around them are WAY to small to keep them contained...and then they complain that baby's bili mask "keeps coming off"....maybe b/c the kiddo is moving around constantly and uncomfortable!
Absolutely hate that I restock for the next shift-always, and rarely have supplies for me in the morning.
I hate echo and US techs who take so long and then leave the gel on the kids who now need all new sheets....they don't even try to clean up the kids.
Drives me nuts when parents hyper stimulate kids even after they've been told alllllll about development of the brain....
I am graduating this april and hope to get my first job in the NICU. This isn't a pet peeve but I lOVE how intense and protective you guys are about your little patients. Makes me feel like I will fit right in!!
Also, one other thing. Maybe I am naive or maybe I am too blunt/forward, but is it not possible to speak up and "educate" your co-workers etc. ?Especially if they are repeat offenders and didn't just forget or get to busy to do the right thing.
1. The day shift RN immediately disturbs the infant (even while I'm still giving report) and changes my entire clean, neat, and developmentally appropriate bed "because I just have to do it my way" or "the stripes are in the wrong direction." We're talking even cardiacs with open chests here......
2. Older battle-axe nurses who obviously haven't read a nursing journal or learned (refuse to learn?) anything new in the last 20 years. Old habits never die, and it's hard to improve when people don't want to change. If you're going to lecture me (a grad student) on something, make sure you have some evidence to back it up.
3. Said battle-axes who attempt to chew up and spit out the nurse giving report, about things that are personal nursing judgement, NOT poor practice. Don't sit there and make me feel like I am a bad nurse just because I didn't go about it the way you did.....Especially overnight, when we have less resources/staff, less experience, and the meconium hits the fan. Maybe one of my babies didn't get a bath, but we did get 4 cardiac transports, two sets of twins, and had to intubate and balloon someone last night.....Sometimes we need to make judgment calls and give the best care we can. It may not be pretty, but night nurses do the best they can. And we do a pretty darn good job, too. We're not second class citizens, even if you day-shifters make us feel that way all the time. (DISCLAIMER: I've worked both shifts, so I know how it is)
4. Wrappers, tape, used suction catheters, gauze, syringes lying around the bedside. Clean up your patient's bedspaces before report. Only takes a few minutes.
5. Just because the baby isn't actively crying doesn't mean she isn't in pain. I'm pretty sure that pacifier you just jammed in her mouth does nothing for the chest tube pain she feels every time that vent delivers a breath. Opioids are NOT the Devil. They exist for a reason.
6. Please make sure there's at least enough thawed breastmilk for my 2000 feed. It's hard to make a baby understand why dinner's taking so long.
7. If the baby's getting 1cc/hr of EBM, don't thaw out 3 full bottles, only for me to throw most of them out later. Try and figure out how much he needs and only use that amount.
8. Stop taking the sensor off your baby's vent circuit just because it keeps alarming. Fix the problem. Your baby needs that synchronized ventilation, rather than getting a breath banged in regardless of what he's doing on his own.
9. Take a minute to wipe the blood/feces/vomit/betadine/formula/lord knows what off the isolette walls. Please.
10. Be sure to remember to change the position of the temp probe when you flip your baby. I get too many cold babies lying on their ISC probes.
Sweeper933
409 Posts
No kidding!!! Definitely one of mine!
I also hate when certain things that are a "day shift responsibility" get left for the night shift to do (in addition to all of our shift's stuff). It's usually the same few people who never do the "little things" that they're responsible for. And heaven forbid night shift leave something for days to pick up the slack on...
I really could go on and on...!!!!!