magRN

We do use sheepskins, we do stop using them once a baby starts to bottle or brst feed. A while back in Neonatal Network they spoke on how babys were having trouble adjusting at home without all the snuggle wear.....all fits into developmental care...we started quiet time around then too.

No, not for over 10 years now. Our staff is all RN...and our unit is a closed unit meaning we staff ourselves no floats.

In our unit we have a kitty fund for birthdays, showers and the like. Each w/e tends to have an event after thier respective w/e....like tuesday lunch........a debriefing. On the w/e's we tend to have potlucks. And on a fairly regular basis we have other evens...biking, camping, skiing..........going to comferances. We tend to be a tight group all & all.

I also knew from the start I wanted to work in some area of Peds....but I really lucked out getting in the NICU right away.

We quit doing the cover gowns a few years ago...someone somewhere did a study...and it saved tons of money. Now with this ring and watch thing, the family can still wear them...just not the medical staff. The reason being they will attend only their baby. Ya know....I like that clock on the isolette and warmer thing....ya could make yourself (or your hospital) a ton with that idea)! I'll be hard for the transport nurses too. They have to keep time very closely...I think most of them will still have a watch for transport. This water issue is a hard one, and most of us break this rule,except when the big wigs are around. (yet another reason to work nights). Now for the most part, we all use covered water bottles. The water device used by bikers was mentioned...one of the MD's is an big time bike rider. (Me TOO)! Having listen to all of you, I'm feeling better about the no rings thing, but still think it should be based on research. Now that I recall, we never used to wear rings....but I never had any to wear and now I do...not to show off, but personal emotional type reasons....as a comfort from some dear to me who died.

I believe all this started because of something stated in the Pediatric Journal...but I don't have any real info. on that. About the water...we can no longer have fluids or anything in the unit because the pt care areas are not seppartate from the central desks...this all came from JACHO.

We had LPN's in the old days, but about 12 years ago the hospital decided only RN's in all ICU's. About a year before that the hospital offered full payment for any LPN to get the RN...and some did do that...but only one still works in our unit. They were some great nurses too, I learned so much from them. It was hard because our NICU has it's own step-down area through to home going and many worked there.

I've noticed that we are running vits sooner....but with the smaller ones we generally infuse a combo of dextrose....live D5 with D20 to stabalize the gluclose (80-180)...and then the insuline drips get put in there for good measure. For the most part, I'd say we start TPN on about day 3 to 4 once the gluclose evens out. I like the idea of the extra nutrition too.

Thank Goodness, we are a closed unit...it's been that way for about 10 years. If we are slow, we can go and work somewhere else, but it is our option! Before we would go anywhere, and since the NICU was a ICU we would go to adult ICU's...even transplant....now how unsafe is that!!! (that's were I was sent the last time I ever floated). On occation I will work in the level 2 and our sister hospital...but we have been so very busy...it hasn't been an issue and I ussually enjoy the extra time off if I can get it! I is so wonderful not to have to worry about floating anymore!!! We have also been doing our own schedualing...also wonderful!

NicuGal...I'm interested in the study, do you have more specifics? What I really wished is that we would do a study, as our nursing practice is supposed to be reseach based. Mimi2RN...we have discussed this clocks thing in the nursing practice committee..and since all the clocks are not centrally controled (meaning can read different times in emergency situations) we as a hospital decided we would not add more clocks unless the times could be contral at a central location. I found that interesting...only found that out tonight.

Starting in July we will no longer be allowed to wear any rings or watches. This is in the NICU, OB, Post-partium, and Level 2 areas. The thing is that the infectous control people did not fully support this move, there is not conclusive research...but we are doing it even though it is not hospital policy. Just wanted to know what your areas did.

Yes, but our do not have one's name on them now...but if you've made an error it is your professional responcibility to do so.

I tried to reply once and it was lost...so one more time! We have no problem using warmers and putting hats on the baby. In fact many of our nasal cpap babes are on warmers still, as we tend to extubate soon even micropremies...after the first head u/s and fairly stable. We use airshields and also use the single use probe with a little heart cover that is easy on the skin. Also when placing the probe don't put it over the liver...it will read a false high...the liver gives heat!

We use all silastic tubes....generally first oral tubes because of different vent support is used. Ussually gastic feeding sometimes dued. feeds. As babes get older we have this protocol and now place NG 5f tubes they stay even as a babe progresses on oral feeds. If a baby can not take the total 2 hour volume they are given the rest by NG over 30 mins (we put the feeding on a pump). We have guidelines for progression of oral feeds brst ,bottle, or cup...babys are given a feeding score through this guideline....and If a baby can take a 3 hour volume orally we than go to every three hour feedings.

We use the syringe way too and keep a box of supp in the frig.