tracy6fan

What type of nursing job are you looking for?

I live in the far southwestern side of the county so it takes me 40-50 minutes to get to work on a good day. I know that sounds like a long time, but you get used to it living in Atlanta. Plus I don't get on the interstate. I'd rather drive 10 minutes extra on the back roads and be calm than stressed out from those flying fools. All my coworkers that live up in town (Douglasville) can get to work in 30 minutes or less

Prinzess, I just might be able to answer this one... I live in Douglasville and work in the NICU at Cobb. We're level III and transport out all surgeries to Scottish Rite or Eggleston. Don't know that we're hiring today, but that could all change tomorrow. Kennestone in Marietta (a stone's throw from Acworth), is our sister hospital with a level III NICU too. Same docs, same set up as us. Douglas Hospital (in Douglasville, of course) doesn't have a NICU. They have a 6 bed L&D that does all LDRP and send any sick kids to us or Kennestone. Tanner in Carrollton is a 10-30 minute drive from Douglasville, depending on what part of the county you live. I'm pretty sure they have a level II or III nursery. Southern Regional is in Riverdale, not far from Stockbridge or Fayetteville, and South Fulton Medical Center is in East Point near the airport, and about halfway in between Douglasville and Stockbridge/Fayetteville. They both have NICUs. Good luck with your move and I hope you find a place you'll enjoy living and working!

We tended to have the same problem with the "last day teaching" and found it to be extremely overwhelming for the parents. We've been working on it hard and have just added a "To Do" checklist for the parents. We put it on the cribs once the babies transition to a bassinette and the parents love the idea of knowing what they need to work on before discharge. We've also started ordering the home monitors and teaching a week or 2 in advance so the parents can practice with it when they come in. Those 2 things alone are making a big difference in our process. I forgot to add we use the language line when we need to, but it sure helps having several spanish speaking nurses in our unit to assign those patients to.

I don't know how it is in other states, but here in Georgia now, Medicaid/Medicare has added their own set of questions to the PG surveys, and they're basing their reimbursements on the scores.:angryfire My favorite question was rating the quietness of the environment!

BBG, we use the hydrocolloid gold hearts and put a hat on.

Or a 5Fr feeding tube if you have them.

My thoughts exactly Gompers. We use the green tubes too, but change them every 3 days. A product rep for the 30 day tubes showed me something on the green tubes I'd never noticed before. There are holes along the distal side of the tube, but no hole in the end. Which means a small amount of formula/BM can sit in the bottom.

You will surely learn alot in any of those units that could apply to the NICU. I worked in a PedsER for a few years when I became burned out after 9 years in the NICU, and I felt like I had never been a nurse before. I learned so much practical knowledge that you're not exposed to otherwise. It really helped me become better at parent teaching when I returned to the NICU. Any of those child abuse cases are sad. The burns were the worst for me. It seemed like there was nothing you could do to relieve the pain. What bothered me most about the SA cases were the parents. I'd say over 90% of the kids brought in for SA exams had parents in a custody battle, fabricating reasons to win their case. We saw alot because we were the regional referral center, but it's unimaginable why an accusing parent would lie and put their child through that exam. Let us know what you decide and good luck in your new position.

NICU_Nurse, if you're seriously interested in doing a poster on car seats, I can help you out with some great websites. We redid our parent teaching notebook on car seats a couple of months ago and I learned SOOO MUCH. It was one of those things I took for granted all these years since I gravitate toward the itty bitties. Interesting factoid: in traffic stop studies, 4 out of 5 parents had the car seat installed incorrectly. WOW!! After all the hard work we do getting them to the point of discharge, if we don't teach them, who will??

Oh, you're going to love, love, LOVE the Giraffe beds!!! After I said this I remembered there is one drawback...those darn temp probes! They're a little stiffer than the disposable ones we use on Ohmedas and come loose alot. We played around with it and had pretty good luck positioning Giraffe probes axillary or on the ant. fontanel with the ELBW babies.

We use the transilluminator attachment on the bili blankets all the time for IV lines/PICCs or to transilluminate a chest. I will say it kind of ruins you after you get used to using it. One of our product reps gave us a hand held mini-transilluminator a few weeks ago and we love it. It's especially nice for resting a little foot on. If a proctor say it's ok I'll post a link to it.

Jennica, if you're still job hunting, what part of Atlanta do you live in?

A couple more to add Respironics/Children's Medical Ventures: http://chmv.respironics.com/ Specialty Medical Products: http://www.gopreemie.com/shop/customer/home.php

We've seen a marked increase in belly defect babies here, 6 gastros in a 2 or 3 week period during the spring. The genetisists are finding a link between belly defects and meth use, which is also pretty rampant here.

I've worked in units that have done it both ways and I prefer opsiting to the belly. It seems to hold the lines more secure and I haven't experienced any problems from humidity on the ELBW babies. Which brings me to a comment you made "lovemyjob" about not adding humidity. There is plenty of information out there that humidity is good for the little ones' skin and helps with insensible water loss. Do you have a unit educator that could look into this? Perhaps you could help and earn some brownie points on your annual eval;) Our "old school" docs are usually willing to change practice if we bring them enough evidence. Tracy

The Lynchburg to Roanoke corridor may be what you're looking for. Both are beautiful areas with the Blue Ridge Mountains for a backdrop, smaller towns (pop~100,000) and less congested than northern Va and tidewater. I'm pretty certain both have Magnet hospitals. Bedford is an even smaller town halfway between Roanoke and Lynchburg that would take around 30 minutes to get to the "big cities". Bedford is right at the foothills of the mountains with lots of rolling land. Absolutely gorgeous in my opinion! I live in Atlanta now, and every time I go home to Lynchburg where I grew up, I breathe a sigh of contentment from the beauty. Good luck in your search for a new place to call home.

We self-schedule in a computer based program (active staffer). It can set the maximum number of people that can schedule themselves for a shift, let's say 8, and once 8 people sign up no one else can. Full-time people are given 2 weeks to put in their schedules then the part-timers followed by the PRN staff. We can also put in vacation or other time off requests. We love it and it has freed up a great deal of time for the manager.

Not all NICUs will offer a nurse externship, so you may be limited by that. From those choices, decide how much you want to see. Scottish Rite and Eggleston NICUs would offer the most as far as seeing surgical and ECMO patients too. Besides the ones already named, there's Crawford Long, Grady, Atlanta Medical, South Fulton, Cobb and Kennestone. I'm sure there are others I'm not as familiar with.

I'm responding too late for your interview, but I work at Cobb in another department and like it. I've worked in several hospitals in 3 different states in 18 years of nursing. It's been a good fit for me. Cobb is just large enough to keep you busy and small enough to still have a homey atmosphere.

The manufacturer of the product you use may offer certification classes. We use Kendall PICCs and they're doing a class in the Atlanta area in May.

After the Vapotherm was pulled here, someone in RT management jerryrigged a "high flow" cannula together with a concha heater to use in place of it. Some docs will use it, some won't. It was cleared for use by biomed and risk management, however some of the RTs and nurses are still uncomfortable. Just last week, a baby practically drowned from water spewing out of it. Anybody else using a makeshift Vapotherm? One of the therapists told us yesterday the Vapotherm may be back in a couple of weeks. Anybody else heard this?

KK, I think my nurse manager just toured your unit about a month ago. She came back and told me about a unit that nurses did everything you described, and as an 18 year veteran, it gave me the willies. We treasure our therapists' knowledge of the vents, and even after all these years I'm still learning all the intricacies of how different vent modes and settings work for the lungs.

The CDC's website is a good place to start when you're looking for various practice recommendations. www.cdc.gov It's often difficult to find full text articles on the web unless you're a member. We leave our UACs in for 5-7 days. CDC says 5 or fewer days is optimal. Also use alot of PALs until they don't work any more or don't need them.

One of the reasons I joined this forum was to network and see what other units are doing. This was one of the questions at the top of my list. Like Luv, I too am having a difficult time finding evidence based information on changing isolettes less frequently than weekly. We're seeing some breakage and breakdown in parts from the weekly cleaning cycles. We do leave the unstable, ELBW babies in the same Giraffe until they're bigger and more stable to move. In some cases that could be 4-6 weeks. Most nurses are good about wiping down their beds every shift with disinfectant. As for labeling, we have cut-out houses made from construction paper that say "please change my house" or "please change my condo" with multiple lines for writing the next change date.