jnsatc

we have 9 transition rooms on our unit that parents can room in with their babies. every baby is on a central monitor, but the parents are heavily encouraged to provide all personal care to their baby. We have a rooming in sheet that the parents can fill out the temperature how much the baby ate, if the baby had a wet or dirty diaper. Most of our discharge teaching such as careseat test, ALGO, Hep B, CPR and second hand smoke video is shown in transition. Parents are not required to stay 24/7 (we do realize that they have jobs and other kids) and no consents are needed. Our most stable chronic kids go their and kids most ready for discharge, so we've had kid occupy a room for a couple of days to several months, theirs no hard rule about the amount of time you can be in transition. Every nurse that works ICU works in transition and intermediate, but we have nurses that only work intermediate and transition, which is aggravating when you are trying to follow your primary through to discharge. We make sure all parents are comfortable with all aspects of their babies care before we discharge, it all seems to work pretty well

Thanks for everyone's input. We do baths on the night shift, but we only have 2-3baby assignments, so i can't say that the baths aren't getting done because we are over worked. I think alot of people are afraid to bath a real sick kid, but like i said, if i'm going to die over a bath i want to go clean. We use Dove soap as a rule, have you found better things. I saw mentioned johnson's baby bath and cetaphil. We are starting to be told to bath with just plain water which I find totally disgusting. I'm convinced that with regular linen changes and bathing that our infection rates will decrease.

I was just wondering what everyone's doing as far as bathing their neonates. We are a level 3 with no current bathing protocol and unfortunately it has been known for some of our kids to not be bathed in 2wks which is totally disgusting. Personally I change linen every night that i work and make sure that my kids have had a good scrubby bath at least that week. I feel that if a bath is going to send them to heaven then they are on their way anyway and at least they will go clean. just wondered if you had any written policy or anything.

If we have a UAC and a UVC then the TPN and lipids run through the UVC and 1/2NS with heparin 1:1 runs through our UAC; otherwise our TPN and lipids run through our UAC. We never run pressors, bicarb, or blood through our UAC's

I was in the same position that you are. I worked adult med surg for three years then out of the blue decided to go to NICU, never dealing with kids or babies before in my life. I had a 4mth orientation, great preceptors and my unit is great, everyone works together and you are never alone. I was always encouraged to ask questions and ask for help. That's my best advice to you. Always ask. I'd rather work with someone who will tell me they don't know how to do something than work with someone who is afraid to ask and just try to figure it out on their own. Now there is no other place I'd rather work. It is truely rewarding and I'm learning something new all the time. Also try to remember that these parents are scared and overwhelmed and try to put yourself in their position. Explain as much as you can to them and keep them informed, they will appreciate you so much.

We don't check residuals on our trophic feed babies (1cc q 4 or 8hrs) since it will take a while for the stomach to fill and then empty. We are starting to stop checking residuals unless we fill a need and then if a residual is 2/3 of the feed, we give it back and give the difference in fresh milk. The kid usually buys a NEC workup if we see a change in stools, increase in A's and B's, increased blood sugar, abdominal discoloration or distention. Any residuals that we do get is refed due to the electrolytes, however I tend to discard if it is very bilious or nasty looking, but that's my own preference. s

I work at Mission Hospitals in Asheville NC and highly recommend it. I have never worked in an area where everyone works as a team and truely likes each othe and gets along. We call the docs by their first names and they treat us with respect and ask our oppinion. Our director is the best I've ever known. We are a 51 bed level 3 NICU that accepts transports over the entire western NC region. We do not do ECHMO or major corrective heart surgeries. We do PDA ligations. The hospital is acquiring magnet status and is a pleasure to work for. The hospital system is truely patient oriented. The Asheville area is beautiful with lots to do. Housing is a bit high 150-300k depending on where you look and what you want. Lots of places for your husband to ride his horses!!! Please consider coming for a visit and see our unit. Feel free to contact me if you want. Amy Wallingford Asheville, NC

We change our isolettes every 2 wks

We leave our UAC's in as long as they continue to work. I've seen them left in over three 3wks sometimes. I've not noticed an increased rate of infection or cloting. We don't use radial lines. Once we remove the UAC's we try to place midlines, otherwise we use peripheral lines unfortunately.