doularoz

For those of us that have been doing this for YEARS, it can get frustrating to see abuses of the welfare system over and over. I think it was clear that this was not a judgement about the mom being on medicade, however that does not help when the child does not need NICU care yet the taxpayers have to pay the bill. Respectfully, I thought your comment was more condecending than the origional post. This is a place where we come to vent. Just curious, are you a NICU nurse?

I was wondering what everyone's experience has been taking care of babies exposed to subutex during pregnancy. We have mothers tell us that they were told by their Dr. that Subutex does not cause withdraw in infants. From what I have read, that is not true. In my experience it most certiantly does cause withdraw. These kids are miserable and stay in NICU for 2-3 weeks. The mothers just can't understand why their baby isn't doing well. Also, how does your unit treat withdraw symptoms. Do your docs give meds? We give the baby a neonatal abstinance score every 4 hours and sometimes medicate with morphine but our Drs. would rather not. It's terrible to watch them scream and not be able to eat. I hate to think that we are not doing everything we can to help them recover as fast as possible. Also, do you ever send these kids home with narcs when the mother obviously has an addiction. Thank you for your imput.

We have the same issue only our alternate method of feeding is "finger feeding". Basically you put a 5F ng tube attached to a syringe full of formula into the baby's mouth with your finger. Then squirt the milk into the kids mouth and hope he is able to swallow it. We have had admissions for low chem strips because of the anti bottle law. It's sad because the postpartum has these mothers set up for disapointment when we insist on bottle feeding. Then we're the bad guys.

I may be moving to the Charlotte area but I have no clue about the area. Whad are the suburbs called around the city so I can look for a house I want to work at a BIG hospital with a good NICU. What are the income levels. What kind of a house can you get for 100-150,000. I willing to live outside the city. I feel desperate here. Any help would be appreciated.

NICU seems to be a popular area and can be difficult to get in to. You just need to be an RN as far as degrees go. Some units hire new grads and some want experiene. A good place to start is regular newborn nursery if you can't get right into a unit. It gives you a good baseline of what is normal and will make you more appealing to a NICU.

I think it's great that you are taking this much time to gather information to increase your skills/knowledge in an area where you float. Your NICU should be thrilled to have you in the unit. Most people would not do this. It sounds to me that the staff should be resoursing you more. We would never expect float nurses to do blood draws unless they want to. Also you should not feel responsible to answer other baby's alarms when you are a float nurse unless you are really comfrotable doing so. It sounds with a little more time you will feel much more comfrotable but that you were thrown into it. You ask really good questions which is important.

I am having a similar problem. It seems that a majority of our families have major social issues ie. drugs, abusive homes, parents that don't seem to care to have one more baby etc. It kills me to send these kids home to a bad situation. Childrens services doesn't do a whole lot in my opinion. We had one mom that had all of her other kids taken away but she was allowed to take home her preemie. If she did well with the baby she might get her other kids back. HELLO!!! Then there are the wonderful families who seem to have more than their share of tragedy. It is terrible to watch them greive for losses and bad outcomes then deal with parents that have relatively healthy babies who don't come in or even call for a week at a time. Sorry this is so long. I too have been taking it home with me.

I had that conversation with a GN who had just taken the NCLEX and we both agreed that you would have to have had done really bad to fail in 75 questions so don't worry about it. She failed and now I feel stupid. Foot in mouth, again!

Never in a million years!

I had a postpartum patient call me to the room to ask if I thought it was ok that her poop smelled bad.

If you have trouble getting into a NICU try mother/baby nursing first in a hospital that has a NICU. Then aks to shadow or work per diem in the NICU. Maybe they will orient you to feeder/grower babys to start. Good Luck

I would definately get some mother/baby experience. I'm not opposed to hiring inexperienced NICU nurses (we all had to start somewhere). You might have better luck finding a job in maternity as a transition job. I actually does help to have a good feel for normal newborns and their transitional problems before you focus on sick infants. Also, maybe you could ask to shadow in the NICU. Let them get to know you and vice versa. I started working per diem in my hospitals NICU before I got hired. I was a postpartum and nursery nurse also. I not only got feed my NICU cravings but they got to know me. Good Luck

we actually have charts for things like dopamine, dobutamine, epi, prostaglandin. You look at weigh in grams across the top then the mcg/kg/min down the side. It then gives you the hourly rate according to our hospitals standard concentration. It's nice because there is less room for error and is quicker in an emergency.

Some of my friends at work are joking about starting a book series about the preemies perspective of NICU. By the way, a lot of our families could be on Jerry Springer. Any suggestions for titles i.e. Is crack a vitamin? Why's my daddy in prison? How I got my head bleed. Coke-It's not just a soft drink. Please don't let these people take me home. This is just a joke. We're not trying to offend. What are your suggestions?

Yes, unfortunately I got to to see it for myself. They were teenagers and I guess he thought it would feel neat or something. They took a shower together later that day. I bet she was pregnant at her 6-week check-up!

If you are having breastfeeding problems it will not help for the FOB to pump his own breasts. Not a pretty sight!

We change our NG's every 3 days. Another local hospital is every 5. We generally use a 10 cc syringe to check residuals and whatever size we need for a feeding. We use a pump for feedings but used to feed by gravity. It's mostly nursing preference and feeding tolerance of the baby.

Try intensivewear.com. They have great designs.

Good luck!

Since new moms are usually not sick you are looking out for abnormal things in mom and baby. Make sure mom can empty her bladder withou diffuculty. Abnormal vs in mom and baby esp temp and resp in baby. Babies can go bad even if they seem ok the first day you want resp 30-60. Above 60-70 and they should not be fed po bacause there is a risk of aspiration. Report abnormal vs to a coworker that knows unit protocals. You also need to make sure they are not cold. Parents tend to leave their babies very loosely wraped and they get cold easily. PP moms have hot flashes and they assume the baby is as hot as they are. As far as the moms go you need to check for pp hemorrhage and uterine atoney. There should not be big clots or gushing when you press on the fundus and the uterus should be midline and at the umbilicus or below. This is a general rule some people do vary. Hopefully you will have a resource person and I would ask about anything I am not sure about. The other thing you should watch for is s/s of preeclampsia. This can occur during the postpartum period. S/S are increased BP, swelling, clonus, headach, visual changes and epigastric pain. This doesn't usually happen but it can. Good Luck

I currently work in a post-partum and newborn nursery unit but have applied for a NICU position. My question is how much weight do you give bad cord gasses on a newborns transition. L&D has a fit when they're below 7.15 but a NICU nurse said that they mean nothing. I suspect that the OBs at my hospital augument labor too aggressively My unit is very busy and 95% of patients recieve pit because the OBs want nights and weekends off. It is not unheard of to have 8 c/s a day out of 8 deliveries espically after 1700. We have a ton of babies with TTN. What are your thoughts?

It varies in my unit. We usually try to tape then everyone hears the entire report. If it is really busy we give a verbal which takes longer because people tend to chat and sometimes you have to give report to more than one nurse. We have a rule that report is supposed to be no more than one minute per pt. We also get medical care plans that are up to date on each pt from the computer. It has all the labs, meds, orders, consults etc. It works for us.

Thank you so much! I feel much better. I get this way every time we move and having a toddler doesn't help. I think it's partly postpartum depression. I know when I feel better I will look back and wonder what I was so worried about. I really appreciate the support.

I am an RN with a long history of depression and anxiety. I have received counseling and medication therapy with good results. I just recently went back on Effexor because I had a baby and breastfed for 1 year. The last time I took the drug it worked like magic but now it's not working as well. It's been about 3 months. I am currently in counseling again and have an appt with a MD to adjust my meds. I also have a Rx for klonopin PRN. The problem is that I just moved to a new area and am looking for a new job and I am scared to death to take the klonopin because it will show up in a drug screen so I suffer in silence. I am terrified that if a potential employer finds out about my Dx that I will be seen as unfit. I am a good nurse. How much of a stigma in the medical profession does dep/anx really have? I am terrified that I will someday need hospitalization and that will be the end of my career. I just need some honest and friendly support nurse to nurse. Thank you.

Perfume on your shoulder works and I've also heard of waving alcohol swabs in front of your nose as long as it won't embarrass the patient.