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texas2007

texas2007 BSN, RN

NICU
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texas2007 has 2 years experience as a BSN, RN and specializes in NICU.

texas2007's Latest Activity

  1. texas2007

    Tips on Drawing from Arterial Line

    We use the same type of "open" system OP describes. Have you tried letting it drip a little more before you take the sample? I was always taught at least 5 drops but I usually count to 7 just to make sure all the art line fluid is gone.
  2. texas2007

    Please be prepared for your interview...

    My strength is being a nurse in a clinical setting, it is what I do when I go to work. I am terrible at answering contrived scenario questions in an office setting, I only do that a handful of times a year. There's only so many situation type questions you can prepare for before someone throws you a curveball. I moved last year and I spent quite a while researching these type questions and rehearsing my answers and situations. When the interview came only a few questions that I had even practiced for were asked and there were several others where I had to make something up on the fly. Perhaps I came off unprepared but I HAD prepared- just the ones I had prepared for were not asked. Instead of focusing so heavily on these kind of interviews, have you thought about placing part of the interview in the setting where the interviewee would be in the clinical setting where they would work? Have them shadow someone for an hour or two. I really think you'd be able tell so much more a candidate's abilities in that time rather than evaluating how well someone is able to BS their way through silly interview questions that are only minimally correlated to how good of a nurse/employee someone may be.
  3. texas2007

    Earliest viable gestational age?

    We get a lot of calls to transfer babies who are "24 weeks" or "26 weeks" etc. When our transport team gets there, it is quite obvious that the baby is no where near "26 weeks", more like 22 weeks with thin, plethoric, gelaneous skin and eyes fused etc. You have no idea how often this happens. These babies rarely do well (bouncing around in an ambulance or helicopter isn't the best for head bleeds). It is frustrating to say the least.
  4. texas2007

    Low census anyone?

    We've been slow since January-ish, about 20-30 babies below normal. People getting cancelled and floated left and right. Actually, it's not that we don't have admissions bc we do, it's just they dont stay very long.
  5. texas2007

    Prostaglandin Via UAC

    I have only seen it through a UVC or PIV where I work.
  6. texas2007

    Do you let gastroschisis babies with silos be held?

    Not here either. I'm too nervous to even weigh these kids with a bedscale muchless get them out of bed...
  7. texas2007

    Gum Chewing

    We're not allowed to chew gum at my hospital...it is a violation of the health dept. and you can be fined $250 if caught!!
  8. texas2007

    Neonatal Nurse Questionaire--PLEASE HELP ME OUT!

    what do you think the top 3 traits a neonatal nurse must have to excel? 1) ocd-like 2) not afraid to ask questions 3) good social skills to deal with families what do you enjoy most about being a neonatal nurse? babies getting to go home least? babies that will never get to go home (or if they do, will have no quality of life) on life support for months due to misc. reasons. what is the typical salary of neonatal nurses? depends on your location, years of experience, how much ot you work, but new nurses start around 50k here. what hours do you work? 630p-7a what are your daily responsibilities and duties? can vary depending on the assignment but i always do my assessment and vital signs as ordered, change diapers, draw labs, keep an eye out for any funky behaviors, notify md/nnp if there is a change in pt condition, carry out any orders and question orders as necessary. i also get to pat a lot of bums to sleep, chase a lot of pacifiers around and sometimes hold the fussy babies (if i have time and they are stable). some days i don't speak with an md, other days, the md is camped out at my patient's bedside all night. why did you choose nursing as a career? i liked that even though the overall routine is the same, every shift is different. what advice would you give someone considering this nursing job as a career? sometimes it is hard to not get emotionally involved with your patients and families. some days really stink but the good days outweigh the bad. and any other information about neonatal nursing you would like to leave! if you dont want to email it you can post it back on here. thanks! tasha
  9. texas2007

    Pump problems and pressors?

    Does your facility normally run Dopamine by itself? The only thing I can think of is that perhaps the line was starting to clot off (thus the pressure increasing alarm.) and then the clot cleared and the kid got a mini bolus due to the syringe having to push harder. When we have rates less than 2 ml/hr (the standard KVO), we will usually get an order to run them with carrier fluids with heparin to prevent the line from clotting.
  10. texas2007

    Newborn Blood Screening Protocol

    If we have a line available to draw the lab from, we will use that. If a kid has a line, they probably have some lab to draw along with the screening as well like a blood gas or chemistry panel for instance. We do not delay our screenings for any reason.
  11. texas2007

    Help understanding monitors and apnea?

    At my facility, we set our alarms to alarm for apnea after 20 seconds. Now if a baby is apneic and doesn't self correct, the bradycardia alarm pretty much goes off before the apnea alarm ever does. Most of the time that the apnea alarm goes off is due to the leads not picking up, not true apnea. Either way, don't go completely by what the monitor is telling you...you MUST look at your patient!
  12. texas2007

    when to stop humidity in the isolette

    You still have it going at 30%?? You must live in a low humidity climate! Our normal air here runs ~40% humidity (on a good day!) so when we get to that is when we turn it off. I've also occasionally seen the MD's D/C it earlier than the standing order is written for whatever reason.
  13. texas2007

    Early feeds...good idea or recipe for disaster???

    It could just be a coincidence too...I don't have any literature to back me up but I feel like I've seen several spontaneous perfs in fresh micros that had either never eaten or weren't eating at the time. At lunch one day we were actually talking about how it's a miracle that they don't perf more often. Their intestines have to be paper thin...
  14. We have different levels that we will transfuse for based on resp. needs, age, gestational age at birth, discharge expected soon. We go by Hematocrit, not hemoglobin. Generally, our room airs/cannulas have to be
  15. texas2007

    Formula / Breast Milk Fortification and Protein Supplements

    Our unit also has milk techs that make up all the special formulas and any fortified EBM daily. I think to make 24 cal EBM they will use HMF. To make 27 cal EBM, they will mix the 24 cal FEBM with 30 cal formula to make 27 calorie FEBM. We rarely use 30 cal. in general and I don't think I've ever seen it just by itself. The docs will also write for 1-1.5 g Beneprotein/100 ml to be added and if the weight gain is still poor, then they will also want corn oil with each feed (not mixed with the formula). In response to Allison's questions.. 1) Do you do this rinsing with formula? Never heard of it (2) Do your coworkers do this? Don't think so (3) Has your hospital educated RNs about avoiding formula exposure in breastfed infants? nope (4) Do many NICU moms ask about avoiding formula so they can exclusively breastfeed? Very rarely. This is mainly in the term TTN or rule out sepsis crowd. With the preemies, I think the parents just hope the baby survives at all. (5) Is anyone using donor breast milk (from a certified human milk bank) in NICU? Nope.
  16. I don't see anything wrong with how you gave report. I would have done the exact same. Heck, we don't even usually talk about a current PDA (or Apgars) unless it's a current concern (MD's thinking about indocin or ligating bc the baby's lungs are flooded, or significant Apgars of 0,0,0,1..). I guess we will say that a baby was ligated or indocin X 1 or whatever just for history but NOT if it spontaneously closes! Sounds to me like that nurse probably had other issues going on outside of that report and blamed it on you.