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Babyboss 19 MSN, APRN

in primary care pediatrics and NICU
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Babyboss 19 has 29 years experience as a MSN, APRN and specializes in in primary care pediatrics and NICU.

Babyboss 19's Latest Activity

  1. Babyboss 19

    Covid Vaccine

    I would urge all HCPs to read over the interview of Dr. Paul Offit, a pediatrician, infectious disease specialist and developer of the Rotateq vaccine and others. Extremely thorough and well-organized podcast on how vaccines are made, the gov. barriers, long term immunity and risks of covid vaccines and why they think the immunity will mimic measles vs. flu vac. I felt less conflicted over getting vaccinated after reading. You can read the bullet points, but the podcast is better for auditory learners. I prefer to get the Maderna over Pfizer vaccine after reading this, if given the choice. You'll see why. “The difference between a good scientist and a bad scientist and a charlatan is that a good scientist can look at the data when they disagree with hypothesis and modify hypothesis.” —Peter Attia, MD https://peterattiamd.com/pauloffit/ PS- THANK YOU to all the great human beings who participated in the vaccine trials. You are heroes.
  2. Babyboss 19

    Unable to wear N95 or papr

    Agreed. I failed 6 styles of N-95. The PAPR is totally better imo anyway. In my hospital, each unit has posted, at the charge desk, a list of staff who passed fit test and those needing PAPR. This info should be avail when doing staffing - either per unit or central staffing. They sure know who is dialysis, ecmo, charge certified for the shift- why not fit tested also?
  3. Babyboss 19

    Managing Ancillary Staff

    I have approached her directly, and the manager, in the past, which is my usual MO. I agree that is often the best approach. Just doesn't seem to stick for long. Then I was asked "so, you want YOUR labs a, b, c to be fasting, etc." implying that I am being fussy or practicing differently than the MDs. And afterward then the MA is asking for me to enter every single lab requisition on my patients, like routine labs, out of spite. Guess I can have a sit down and write out how I want labs done for me. Although this did not work in the past either. The other MA, I have no issues with. Labs are always spot on.
  4. Babyboss 19

    Managing Ancillary Staff

    sorry this is long... Need some POV on how to manage ancillary staff in private practice. Which, is usually not a problem for me. Have been part time, 3 years now, as a PNP in private practice. 3 MDs and myself. We have 2 MAs, no nurses on staff. The senior MA (23yrs in) is often assigned to triage and room my patients. She is great, nice, mostly professional. The practice would be a mess without her as she has many front and back office duties. That being said, she often takes liberty when triaging my patients, ordering labs incorrectly or what the patient requests. Remember this is all in my name. I have addressed this before with the office manager, only to get passive aggressive retribution from the MA. This made my work day hard. Recently, she added a covid antibody test to a well check patient's STI labs, at patient request. I was not aware of this until I signing off my chart the next day- blood was gone to lab. Now, how do I justify the order, in MY NAME, if the insurance does not pay? I heard it can be upwards of > $1000 for this test. They are not recommended by CDC. I would never order blood for a previously covid + patient who is 3 months recovered, without issues. How can I make her accountable, stop this behavior, without retribution? I am so angry that this even goes on and the docs make excuses for her because she is overwhelmed with responsibilities. I'm always respectful, but I am being taken advantage of.
  5. Babyboss 19

    Urine output and acid/base imbalance?

    I know this is a late reply but... Sick babies (mostly preemies) are unable to concentrate their urine well. The kidneys are immature. Thus they pee out all their Bicarb, instead of reabsorption in the tubules, leading to metabolic acidosis (excess of base and low pH = unbalanced). The sodium chloride will buffer the electrolyte imbalance and restore some volume to the kidneys. I recommend taking the STABLE course or borrowing the book from your hospital library. Good luck! : )
  6. Nurses who argue for more pop-ups/alerts need to read the ample data on alarm fatigue. More alerts do not necessarily = safer. But, those in place need to be relevant. That's my point. And, in RV's case, I don't believe any further barriers would've changed her egregious actions that day.
  7. THIS. this is why facilities need to address "pop-up" fatigue for countless, unwarranted EMR alerts that have little to do with patient safety. It is known that nurses ignore these over time.
  8. Have worked in NICU for 17 years. We give Vec often. Upon scanning vecuronium in our facility's Cerner, we get a pop-up alert stating "WARNING, PATIENT MUST BE ON A VENTILATOR". When we first switched to EMR from paper MARs years ago, a senior nurse and I got this pop-up and were amazed. She laughed and rolled her eyes, saying "thanks Cerner for saving my license". ironic.