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!
I hate it when the lab calls and tells you they never received a sample, even though you placed it in the same sealed bag as the other 4 that already resulted, AND the computer shows someone in the lab scanned it in.
Do you REALIZE that I just took 2% of my baby's blood volume to send those labs???
How about when you have a 380g baby (happened just recently) and the lab thinks you're actually going to send two full tubes for a CRP when you have multiple other labs to draw (and this baby had already had 2 infusions of PRBCs)! You do not need that much! I happen to know because I have sent less for babies weighing 3 times as much as this baby!
I am so new at NICU nursing I have not really developed many. Im not a big fan of when there are no diapers at bedside and you do not realize it until your baby is laying there with a dirty diaper open.
Aren't you supposed to check that out at the beginning of the shift? It's nice to do it for the next shift, but it's also about getting all your supplies BEFORE touching your baby. Something I've also had to learn myself
How about when you have a 380g baby (happened just recently) and the lab thinks you're actually going to send two full tubes for a CRP when you have multiple other labs to draw (and this baby had already had 2 infusions of PRBCs)! You do not need that much! I happen to know because I have sent less for babies weighing 3 times as much as this baby!
Our CRPs are one tube. Weird. However everything that is PT, PTT, Fibro...2.7 CCs. YIKES.
Our CRPs are one tube. Weird. However everything that is PT, PTT, Fibro...2.7 CCs. YIKES.
interesting how its different from place to place. our crp's are 1 tube as well (used to be 2) but the PT,PTT etc (DIC panel) is 1 blue vaccutainer that takes ~1.5
interesting how its different from place to place. our crp's are 1 tube as well (used to be 2) but the PT,PTT etc (DIC panel) is 1 blue vaccutainer that takes ~1.5
Ours is blue, too, but it's adult sized. We HATE them because it's usually the micropreemies that get them.
Or the cardiacs who get a 2.7cc green for genetics/FISH, AND a 2.7 lavender for our heme study, in addition to getting drained for a ABG/lytes & lactate every hour.
We have some nurses who use sucrose as a substitute for just picking up a baby and holding it, or finding some other way to comfort it. Can't help but wonder what the long term effects of getting lots of sugar that young.
Our charge and transport nurses are not counted in staffing and so they float about the unit and offer help. Of course, often they sit at the front desk chatting or being online and then 45 mins to an hour after we start our care round (all our babies are scheduled to have cares at the same time) (another huge pet peeve of mine) they arrive at my row and say, "Do you need anything?" I bite my tongue so I don't say, "Yes, 2 criticals, not three, would you like one for the night?' Or "coulda used you 20 mins ago when I was rushing through my last kiddo". What should I do, give them my last baby to feed, while I sit down for the first time since I walked in the door and put my skates on?? "If you really want to help, show up earlier!!!
Because I want to work in a less toxic environment I'm soon going to have a crucial conversation with the most kindly charge nurse and give her some ideas on a better way to be helpful, such as: You know who has the busiest rows, so go there at the beginning of a round and say," How can I help you?" or "I'm sleepy, put me to work so I'll wake up? or "This is a hard row, what can I do to lend a hand?" We would all appreciate that so much more and feel like visiting with them as they helped us out. :heartbeat
One night shift we struggled all night to stablize a cardiac baby (cannot now remember the defect it's been a long time) Finally, Cards agreed this kid needed surgery NOW! Sent all the pre-op labs STAT.
An hour later, we get a call from lab asking if we'd wanted the labs run because.....THEY WERE IN THE GARBAGE CAN!!!!! Beware the fury of a P.O'ed peds cardiac surgeon!!!
I wish I could say this was a rare occurrance. Alas, I cannot.
Brand new residents. Period. But in particular, when they round the first morning and don't know a clue about the way charting works, what NIPS are, or what's going on with your kid. Were you not oriented at all???
They are BRAND SPANKIN' new, fresh out of med school. They are afraid of you, they are deathly afraid of the babes and they are going to get brutally murdered by their attendings and older residents. You are MUCH better off helping the residents and being nice. You'll see they are willing to learn from you if you are willing to give them two minutes of your time. No, they haven't been oriented at all to the NICU. NICUs are a different planet compared to the rest of any hospital and they do have to learn everything in very little time!
It may be your pet peeve, and it used to be mine....but you were brand spankin' new once upon a time....
And LABS...........OH MAN DO I HATE LAB STAFF....do they NOT get it at all that these are TINY TINY BABIES?
NFB2008
134 Posts
How about when you have a 380g baby (happened just recently) and the lab thinks you're actually going to send two full tubes for a CRP when you have multiple other labs to draw (and this baby had already had 2 infusions of PRBCs)! You do not need that much! I happen to know because I have sent less for babies weighing 3 times as much as this baby!