preemiepoweredRN

Thank you! Great catch! I know I take great pride in the sweat and tears it took to earn my nursing degree and then licensure.. to think that other people are able to carry the title nurse without any legitimate work or accountability is ridiculous! Thank God for the "Nurse" protection act.. the remaining states need to get on board.

We still use bean bags (frog positioners) and log-style bean bag positioners for the tiny babies in our NICU; haven't heard of anything about this study? Please forward if you find out officially :)

Follow your heart. Saying that, I would clearly not jeopardize my license or job for the sake of maintaining a relationship with a former patient, so if you feel that continuing the relationship would some how be non beneficial down the road, Don't do it! "Most" NICU families have pure intentions in wanting to stay in contact. From my experience, I think its a great relationship to maintain- if its done correctly, with the right families, under the right conditions. It has always been permissible for me in the units I've worked to remain contact after discharge and I have for many over the years. I NEVER GIVE out health advice/opinions at ((ANY)) time. You must ESTABLISH BOUNDARIES from the beginning, which should always include that either of you can stop the interaction at anytime, for any reason. Another thought, maybe not use social media and use a private email dedicated for this purpose? Limit the information you share of yourself; if meeting, always in a public setting. I've never had a negative experience with doing this, but you will know that families that you can do this with and those you cannot. Follow your heart. Good luck to you.

It sounds like you did the best that you could have done in this situation. The fact that you are able to reflect now is good thing and by doing so you will definitely be even more vigilant with all your IVs going forward. No matter what you do to prevent it and how vigilant you are, the IV will STILL go bad and you will feel bad each time. It happens to everyone. Those baby veins just don't hold up long especially with high IV rates. I've had IVs infiltrate within an hour, even after flushing it in every position the baby could move and protecting the site with tape/cotton balls/armboards/other deterrants. It's inevitable. I think the one thing I would have done ( which you mentioned) is advocate to increase feeding volumes to try and decrease IV rate/discontinue to the IV sooner; however with IDM babies this plan often back fires. The baby may not tolerate increased feeding volumes, blood sugars won't stay up. Also, depending on the concentration of glucose in the TPN, it may be a slower process to wean, so then the discussion switches back to placing the PICC ( which is great, but those come with their own risk as well). Just remember : You grow through what you go through! Good luck to you!

^^^^Amen^^^^

I've been given report on the " most challenging patients and families" and then went on to have a completely pleasant shift with the same people. I think if it's a matter of safety ( for myself or other pts/staff) or a matter of liability ( non compliance with care, turning off monitors/ alarms etc) these things are absolutely important. Just passing along " I think the Pt/ family ..xyz" is not important and usually just creates unnecessary tension. Every nurse/ pt interaction will be different..Let's face it, not everyone works well together even in the best circumstances. Our job is to provide safe and professional nursing care regardless of our personal opinions.

My advice would be: Do not overthink the interview. Considering that you have had some nursing experience, you are a little bit more grounded than a new grad and that is to your advantage. It will be intimidating (as any new area of practice would be) but keep in mind while interviewing "Why do I want to be a NICU nurse?" and "How will this opportunity prove different from your previous nursing work/What will I gain from this experience?" I personally believe that your passion for any work speaks louder than just answering questions correctly. Good luck to you!

I've only seen single lumen UACs and double lumen UVCs in my practice. What benefit did the director anticipate using the double UAC line/why the change in practice?

^^^My sentiments exactly.. We have to make the most of the opportunities we are presented, WHEN they are presented..

Wow- HIGH FIVE for advocating for your patient, even in such an intimidating situation with the MD!!! I can still remember at 2 years being somewhat terrified at times to do what you did, but uncomfortable is part of the territory. I'm presuming that the MD was irritated 1. because he would have to possibly do more work and 2. that he was "certain" he knew what was going on with the patient and that he was being questioned about something he was "sure" was nothing. It sounds like you did everything correct from making the calls to the MDs the day before and documenting (ALWAYS document everything) and communicating all the information in report. Only other thing I would have done is fill my charge nurse/director in about the situation (which you may have done). If nothing else, this is an example of how being a good advocate for your patient and trusting your gut can truly make a difference. Your patients are fortunate to have you caring for them!

You are definitely not too old to travel, but may want to consider more experience under your belt as a staff nurse. Travel nursing is a great opportunity, but you will be expected to know what you may not know yet(especially if the unit is super busy or there more new grads than experienced nurses)..1-2 days of unit orientation on a travel assignment cannot replace the experiences you get in a stable staff position. Good luck to you!

I agree with the above comment. As long as you are marketable and have good references, most recruiters will not hound you for too much information (in my experience)..but with that said, do not withhold any information that would be better coming from your mouth rather than found out from other sources ( ie diversions, violations etc). Honesty is the best policy.

I have worked on a couple of different units and each did things a little different (1) Triple paste (2) Vaseline/A+D-prophylaxis most places (2) Z-Guard/Hydraguard cream (3) Desitin/Illex cream or Desitin /Illex cream/Stomahesive powder-more severe rash (4)Marathon/Cavilon-nonsting barrier (5) Oxygen to open butt-moderate to severe rashes. I personally like open to air if possible, but it's hard to be consistent shift to shift due to the messiness factor and if the baby is wild, but I think it heals sometimes quicker than all these preparations.

Wow..I think about this often (especially when work gets "hard" aka most of the time). I think I still would choose nursing.. Not sure what I would do otherwise for a profession.

Totally agree with what's been shared. As a current traveler, I feel your pain related to having less acute patients than you're use to, but none the less I wouldn't trade the experience for anything in the world. You have to appreciate and learn what you can, even in your stable, "simple" patient assignment. You really can learn something new everyday.. Maybe you have more time to brush up on reading, or studying for certifications, or just being a help to the other nurses around you. I've found over the last few assignments the best way to "prove yourself" is to help the other nurses on the unit and make yourself available. Everyone likes a team player. Another thing that I did personally the last 2 assignments (not that it always works but) I went to the charge nurses I worked the most with and discussed how "although I'm willing to work where I'm needed, I would prefer to work with higher acuity patients"- and it worked. I got a chance to work with these patients when it worked out for the unit..keywords: when it worked out for the unit. It's a trust game; they don't know you or your skill set ( nothing more than what's been presented on paper and most of the time the charge nurses don't even have time to read them). The biggest thing is not to become bitter-its only a temporary assignment and if all else fails, you just go back to a staff position.