kmande

I feel your pain. Where are you now?

How do you feel now?

You can also buy the critical care associations review book "Core Corriculum for Pediatric Intensive Care" as a resource - you can but it off their website. Karen

Smithabbyp - I can give you some info/resources for PICCs/central lines.

It is tough out there I must admit and I don't doubt that those things aren't happening, but there are so many opportunities I can't believe that you would waist all the work you did to get your degree and license. If people are treating you bad then you need to let everyone know about it and if the hospital doesn't support you then move on, but don't quit until you have really tried everything. If you are a quitter, then you are not cut out to be a nurse!

GO to the CDC website or Infusion Nurses Society resources. The CDC recommends CL drg change weekly. Some NICU resources only change PICC drgs when wet or dirty. Every three days probably increases the likely hood of infection and the risk of accidental removal.

There is nothing wrong with lipids and TPN running thru the same line. Connect the lipids to the TPN line below the filter. Lipids are too large to got thru the filter.

Columbia is very VERY fast paced. The kids are very sick and its very busy, I think Cornell is a little easier and a more pleasant environment. I have not worked at either, but know people that work their.

Majority of facilities have a policy of changing TPN/lipid tubing Q 24 hrs. Some even go as far as TPN tubing change Q 24 and Lipid tubing change Q 12. Due to the high dextrose concentration there is a great risk for bacteria to grow therefore the frwquent change. Most NICUs also spike their IV tubing using a 2 person sterile technique. You can go to the CDC website and see there recommendations.

I agree on the skin care issue. I suggest a topic that would help the staff understand why we do what we do, something that may improve practice. If you want to go more disease specific: TE fistulas NEC IVH PPHN Apnea of prematurity Good Luck