minniemiteRN

We had a 28wk trisomy 18 born to parents after several failed pregnancies and stillbirths. After extensive repeated counseling throughout course of stay parents wanted EVERYTHING done including HFOV and multiple drips at one point. Ended up going home with home health with and GT attempting to PO feed every other feed. She is now over a year old and only 10 lbs. I did hear recently that she was changed from home health to hospice.

I unfortunately came across this book by accident while I was pg with my first and working as a new nurse in my large unit. We had just received a "funny" kid and were looking up his symptoms/characteristics. Unfortunately I was already on edge due to the fact I was seeing what would/could happen if I delivered early and all that could go wrong in the process of bringing another life into this world. This book although very informative gave me nightmares. I have worked in my unit almost 3 yrs now and I think our prevelance is higher than most areas. I have seen at least 5 trisomy 21 one of which was mosaic, 3 trisomy18's, 2 trisomy 13's and several other oddities ranging from pierre robin, sticklers and treacher collins. :uhoh21:

But you are able to take the PTO days you earn? See, the problem with my units program is not that we don't earn the appropriate amount of PTO, it is that we are only allowed to take 3 days a quarter and it is also a first come first serve, seniority, census, etc based thing as well so some quarters we don't get any requested PTO days the only used days are sick days and we only have 1 per 6 mos so we are stuck having to cash out at a lower percentage after we max out our hours to pervent losing the money/hours we rightfully earned even though we really are losing.

Exactly! How involved is your infectious disease dept in writing this protocol? Something tells me that if they were to get more involved and do what ours did when our "whiners" started up and break out the black light they would be able to kill two birds with one stone. Shut the whining nurses and fix the protocol once and for all. No matter how hard and long you scrub you don't get all the germs...you must eliminate the most amount of grooves and crevices "bugs" can hide and that includes jewelry. Our normal hand anatomy is perfect breading ground without setting up more places.

I have two words to say about false nails in the NICU...NO WAY!!! Our staff are not allowed to wear them under any circumstance and random nail checks are done by coordinators to make sure that our nails are the correct length and that we are not wearing nail polish. At first this policy was met by a lot of those who felt that their rights were being violated but our admin stood strong on behalf of our babies safety with the backing of the infection control department. I personally believe that parents should be told that if they must keep their false nails they need to wear gloves. No, they are not going from baby to baby like staff but artificial nails are known for harboring fungus and bacteria and even causing sepsis is severe cases in wearers. Nails need to be kept short and smooth when working with preemies delicate skin...I feel a lot of this should be common sense and something your coworker should want to do for the good of their tiny pts:banghead: Same goes for diamonds and other gemed jewelry...this only provides groves for "bugs" to ride from one baby to another no matter how well you wash your hands. We were wearing one plain band until random swabs of the skin under our rings showed that this was also a good spot for germs to harbor. I know I'm probably "preaching to the choir" because you are the one doing the research you are the one that is concerned for the health of the babies. Good for you! Keep it up!

I'm so glad your daughter is doing well and your experience in the NICU was a good one. Congrats to you for getting into LVN school!:yelclap: We have 2 LPN's working in our unit that have been with us for 15+ yrs and are no longer hiring LPN's. My recommendation for you would be maybe to try to get a job as pt care tech in the NICU in your area while you are in school which will give you experience for when you get out of school and also once you graduate try to work in newborn nursery. A lot of NICU's want you to have well born experience before you start NICU anyway so while you work on your RN you can work in newborn and get your degree and kill two birds with one stone. Good Luck...

I'm glad I'm not the only one who see's it that way. It would be a little hard not to have any PTO days for the first 6 mos in your unit though...but you don't have to stick to all the other unreasonable rules. Well hopefully they will offer you a weekend contract soon. Good luck with school.:)

Sorry guys, this really isn't a NICU specific topic but I haven't posted anywhere but here before so I hope you don't mind... Question is: Do you have a weekend program and if so what are the rules/benefits? The reason why I'm asking is our program is known as WOW and we are paid well for the region in which we work (fl) but the rules are extremely strict and with every contract we sign (we sign every 6 mos in april and oct) it gets worse. We used to be close to the regular staff aside from having to work every father's d, mothers d, easter, and so on... this year christmas eve, christmas, new years eve and day. The last two contracts though, they have added that we are only allowed one call in per 6 mos and 3 PTO days per quarter. We all have very small children and as you know not only do we get sick our little ones pick up everything coming and going and I still have to take my dd to daycare on fridays. As far as PTO we are losing the time we have earned because we are only allowed to rollover so much per year and it does not cash out at 100%. They are also doing such things as keeping track of our disciplinary actions and tardys in a separate book. It is beginning to look like their trying to get rid of the program by weeding us out by our own inability to follow their strict rules bc of our sick children and so on. What I don't understand though is, if that were the case why do they keep renewing our contracts? Any input or opinions will be appreciated!

We switched to computer charting from paper about a year ago much to our dismay. We are "supposed" to be charting as we go but our charting system is Mckesson and it is VERY SLOW for one and two our keyboards do not have covers and I don't even want to imagine what is growing on them. We wipe them down with our aniseptic wipes between pts but there is no way to get down between the keys and all the cracks. Doesn't the list go on and on. This thread started with jewelry... - jewelry -OR -family -keyboards -shared equipment

Staff already are have no jewelry; now we just need to work on parents and vistors.

Actually we are seeing more and more MRSA as a community wide infection, not just solely a nosocomial infections anymore.:uhoh21: We swab each new admits nares as well as their parents for staph aureus non resistant and MRSA. In the last year we have had 2 babies born with MRSA and multiple parents to be treated for the infection. Luckily we are not yet seeing VRE or C Diff clusters. The big reason I wish we required our parents to wear gowns is they come in either plain dirty or reeking of cigarette smoke. Infants in RDS or just plain preemie with an repressed immune system deserve to be protected and if their parents don't have the sense to refrain from smoking in the car on the way to the hospital to protect their infants airway...then its our job.:)

My favorite type of patient to take care of has changed. When I first came into the NICU I loved the high acuity of a micropreemie. I enjoyed taking care of the babies on the high frequency vents and multiple drips. Now however, after taking care of several of those babies and becoming their primary nurse and seeing them throughout the course of their care. I now have developed a love for the more chronic baby...the ones the other nurses tend to shy away from. I am currently the primary nurse to a 10 mos old (5 mos AGA) boy who is trached, vent dependent, and has a GT. His care is further complicated by CF like symptoms yet all the gene studies have come back neg. So...long story to say, your favorite now might not be your favorite tomorrow.

Thanks for the replies! I agree with the policy...just find it strange that parents and other visitors are able to wear as much jewelry as they want esp. since we don't know how well they are scrubbing before they visit (there is a scrub demonstration for each parent/visitor but often we catch them either not scrubbing in at all or just doing a quick soap up and rinse). Also was curious about the policy about parents and visitors wearing gowns before holding.

I was just wondering what everyone's policy is on wearing jewelry in the NICU. When I first started we were only able to wear our wedding bands, no watch or stones of any kind due to the grooves where germs could be harbored. Now, we are unable to wear even our wedding bands. However visitors and parents are permited to wear all of there jewelry and are not even required to wear gowns when holding the babies anymore. Just wanted to know your policies and opinions...Thanks!

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