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!
Our lab is great at calling and saying that your CBC clotted, you didn't send enough. Most of the time I would love to send a very full diaper though the tube system.
Speaking of ID bands, when my twins were in the NICU one of them had a label from the chart with the name, barcode, etc, stuck to his back and covered with a tegaderm!!!! it actually worked fine until i had to peel it off at home three weeks later:wink2:. but hey no one mixed them up!!!! i did think it was weird my baby had a barcode though.
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
This is true but in my experience there are times when a parent or doc is the first to touch a child and that is not when you want to be out of diapers. I think if you use the last of something you should replace it.
Some of this might come down to the customs of the unit however. Some units might customarily stock at the beginning of a shift where as others might at the end, or as needed. There have been times I've been blessed to work with techs who do a great job stocking.
Which brings me to another pet peeve: overstocking. A micropreemie who's almost graduated out of teeny diapers doesn't need a whole package stuck in their drawer. A baby who's only going to need one IV doesn't need 5 catheters at his bedside. etc. etc.
Speaking of ID bands, when my twins were in the NICU one of them had a label from the chart with the name, barcode, etc, stuck to his back and covered with a tegaderm!!!! it actually worked fine until i had to peel it off at home three weeks later:wink2:. but hey no one mixed them up!!!! i did think it was weird my baby had a barcode though.
We did that when multiples were co-bedding--sometimes ID bands get lost.
My pet peeve is when the nurses leave their chairs out in the middle of the floor. Its like dancing through a maze to get from one end of the unit to another. I constantly push them in and make sure I make eye contact with the nurse who has been using it. Heaven forbid there is a crazy emergency.... it would take extra time just to clear the stinking path!
OMG, last night I walked into a TORNADO...flowsheets all over the place, leftover meds at the bedside, one kid wasn't even hooked up to a functioning monitor, one kid laying in a TON of pee, NO fluids were changed, yet they were all sitting at the bedside, open syringes on the counter...
And we were 2 RNs short .. assignment was so heavy: I had four kids - an unstable CPAPer who'd desat to 20-30s VERY quickly if the prongs came out, 1 NC w/ IVFs, 1 NC that I dc'ed with IVFs and glucoses q2 and a 14 y/o mom, and one very dirty NPO kid with just IVFs and abx.. LKFJLKFJLKJ DJ BAD NIGHT.
It was my last night at this facilty - the last time I had an assignment that was actually worse than that, I started interviewing elsewhere....and this is WHY!
I know that our patient population is extremely unique - especially compared to the rest of the "normal" hospital population. However - I really thing that people in lab (and the blood bank too sometimes) should really come to the NICU and see that how tiny and fragile our patients really are. That we really do have a reason to get upset when lab "loses" a blood specimen totaling 2 cc.
I had a "fun" conversation with the blood bank the other day. I was taking care of a 300g baby who was pretty much getting constantly transfused with various blood products. So 10/kg for a PRBC transfusion would only be 3cc. The person I was on the phone with at the blood bank was evidently all confused and kept thinking that I needed 3 units, not 3cc. That "3cc" couldn't possibly be the right order... Sheesh...
Preemienurse23
214 Posts
Our lab is great at calling and saying that your CBC clotted, you didn't send enough. Most of the time I would love to send a very full diaper though the tube system.