spacey

Wondering if anyone has experience with this organization. Is this an accepted way to document additional experience and education with a legit certification? I can't afford to go into a masters program, and thought this might be a way to continue my education and beef up my credentials. (I already have a specialty certification through NCC) Thoughts? Certification and Education Health Care and Nursing, Counseling | AIHCP

I've heard changes are coming but am having a hard time finding a site where it's all spelled out clearly. Anyone have a helpful link? Thanks!

I've been charged to present info to our new hires about communicating with doctors. We've had communication problems, (misunderstandings, dismissive attitudes, lack of responsivness, putting things off to the next shift etc) with our docs for a long time. What things have you done to improve communication and collaboration with the docs? How have you dealt with uncooperative or patronizing docs? Suggestions on how to approach them, key phrases etc would also be helpful! Thanks!

Hi mdbp38 -- Sadly, right after this posted, we experienced "restructuring" and lots of management positions were eliminated and all new positions were tabled. Now, years later, we are again considering a case manager or navigator role in my area. I'm almost afraid to get my hopes up -- but I am again investigating the two roles and looking to see if what is being planned might be a good fit for me. Did you take the navigator job? What do you think so far?

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Sad to lose you from NICU world -- I have read your posts here "forever" -- haha -- and have enjoyed the humor and empathy and wisdom. I hope you continue to enjoy your new position! Nothing better than a great boss! :)

In our unit, if a nurse has formed a supportive relationship with the family (and has expressed a willingness to be notified), we will often call them to come in and be there during the death if possible. This is helpful for the nurse and the family. You might mention this option to the manager to prevent this kind of thing from happening again. While death is certainly a very real part of the job, we shouldn't expect people to just take the next assignment and move on as if nothing has happened.... especially if this was an unexpected death or if the nurse had been close to the baby / family. We want to support and encourage that kind of caring... not make it more difficult. As the responder above mentioned, you may also want to seek personal counseling, see a doctor or mental health care provider, speak to your manager or an experienced nurse you trust, or see the hospital chaplain. All these people will have dealt with this response and these feelings previously and should be helpful and empathetic. Have you considered writing a letter to the baby's family? You could say what you liked about the baby, share a memory -- for example you could talk about her eyes, they way they looked deep into yours, like you shared here. Remember to frame everything you say positively -- "she had a way of looking right into my heart"... instead of "she was begging me for help with her eyes"... (of course... I"m sure you realize that!) These families often feel like no one even got a chance to know their child... and to know that someone had a relationship with her, that they knew her personality and cared about her is VERY comforting. Saying "I'm so sorry this happened" -- is ok! Some nurses hesitate to do that, wondering if that expresses some type of responsibility on their behalf or by the hospital -- but you're simply stating that the end result of this situation was very sad and that you are empathizing with the family's pain and loss. I'm sure a note from you would become one of their treasured belongings....and I bet it would go a long way to giving you that sense of closure that you need. Also -- does your hospital have a service where they remember the babies lost each year? We have one and sometimes, especially if the families choose not to attend, a nurse will attend in honor of a special patient. All who have done that have said how meaningful it was to them to participate and to continue to recognize that special relationship. Other things you can do as a memorial to her might help as well.... maybe make a donation in her honor?, Buy a special blanket or mobile for the unit?, Purchase hats or socks for each NICU baby? You could include a tag stating it was in her honor if you'd like... or just know in your heart the reason. Hang in there... find ways to share your feelings, that will help so much! Sending you hugs!

I had to wear a mask last year, as I have always had a sensitivity to the vaccination and absolutely won't take them again. I have a lot of seasonal allergies and a bit of allergic asthma so wearing the mask was very hard to get used to. I work in a NICU so many of my patients are "under glass" in their isolettes... so for those, no mask when working through portholes. Also, no mask while charting or away from bedsides. It was irritating and the "season" got extended by about 2 months from what they had originally said.... but it was doable and I'll be doing it again this year. I didn't get the flu... didn't get sick at all and found myself thinking of the mask as a protection FOR ME! About 1 in 5 of my vaccinated coworkers got sick. What I find INSANE... is that we are an OPEN unit. Parents can bring in as many different people as they want, around the clock, from admission to discharge... and NONE of those people are even asked about vaccination history. If nurses / doctors aren't able to be trusted to stay home when sick and utilize good hand hygiene practices... why trust us at all. The last person to put that baby at risk, in my opinion, would be the nurse. It all feels like a publicity stunt sometimes.

Do any of you work in a NICU with a March Of Dimes family support specialist? Is that person an RN? Are they part time or full time? Could you share a bit about what they do? I am curious as they seem to have a variety of roles in different hospitals. Their work seems valuable yet there is only one in my entire state. Do you know if the hospital pays their salary, or MOD? I would love to see more family education and support in our NICU! Any info is appreciated! (and yes, I'm in touch with my local MOD... they have very little info about this at this time but have told me they'll look into it) thanks!

I heard the powers that be were thinking about headphones....and it seemed so weird and awkward....that's part of what prompted me to start the thread. :) I guess that IS how some places handle it.... :/ I am hoping to come up with some alternatives before they make a firm decision! Thanks for the input!

Thank you to all who have shared so far!! It seems like most units have more privacy "built in".... I'd love to hear from someone who has a more old school totally open room design about how they manage. From your comments I think one thing we might need to adjust is the sheer number of people who are participating. We usually have a member of management (at least 1) the nursing coordinator (charge nurse) outcomes coordinator (does immunizations / mst's etc) all of our Neos and NNPs, the medical director, pharmacy, 2-3 residents and frequently a medical student, a SW and frequently a SW intern or student, the RT and then there's usually 3-4 nurses (and usually a student or new-hire) in a level 3 room with 8-9 babies (and if you add in just one parent for just half the babies it brings the total up to over 30 people (not counting the babies!.. haha!) The idea of sending families out until it's their turn is awkward for us as our waiting room is shared with L&D / NBN and is outside the unit (and would require them to scrub in again when it's their turn). We could have them stand in the hallway near the HUC desk, but that hardly seems considerate of their comfort and needs. I'm open to suggestions! I really want us to think this through from the parents' perspective before we try to implement it... and I see the change on the horizon!!!

We are looking to involve families in our a.m. rounds. Our unit mostly has an open layout with bed spaces being in close proximity to one another. We are looking for ways families can participate in rounds while maintaining their privacy. The group that rounds is multidisciplinary and includes up to 20 people at times... so simply speaking very quietly isn't an option. We desperately need some feedback from others who have made this change! Do a large number of parents actually come and participate in this? How do you handle the privacy issue? What do you wish you had known when you were just starting this process? Thanks in advance for any input!!! We are really looking to benefit from other units' experiences!!

Thanks for the input -- I agree that while the heart of the Baby Friendly designation is admirable -- the complete implementation in a NICU is complicated at best and some might say simply inappropriate. We have concerns about aspiration and the learning curve for the staff. Does anyone have policies they could share? (even if the policy states NO cup or syringe feedings? --- that would actually be helpful as well!!!) Thanks

Hi -- Looking for policies on providing cup, syringe or finger feedings. Because of the move toward Baby Friendly Hospital status change is in the air. Are any of you in a "Baby Friendly" hospital and how has that changed your practice in the NICU? Thanks for any feedback! We (the nurses) are NOT at all sure about this -- seems like the BFHI applies to WELL babies and NOT NICU babies... but changes are still being discussed. Thanks!!

Curious if your hospital has a NICU. We are moving that direction as well and our NICU is looking at making some changes that the nurses have serious misgivings about. We feel like the Baby Friendly designation is aimed at WELL babies -- and besides pumping, early initiation of breast milk fdgs, and kangaroo care .. there are few elements of it that are appropriate to the NICU environment. No posts on this in a while in the NICU group -- just wanted some feedback from those commenting. thanks!

Hi -- I love the concept of the Navigator role. Did you take the position? How is it going? I am curious how your day is structured, how you organize your patient interactions and keep records and what additional training you have gotten or plan to get. Can you give us an update? thanks! -- Spacey

SappyRN -- I am interested in how you transitioned. Could you share an experience where you had to pull back a bit in friendliness / friendships... or maybe where you came on too strong. It is difficult for a team to go through any change, but when a coworker becomes "boss" there is a lot of potential for hurt feelings on both sides. We are facing this now... although we don't have a decision on who exactly will be the "boss"... LOL. ANY advice or experiences you could share, if you have a minute... would be so interesting and helpful. We are all hoping for a teamwork mindset with a lot of positivity but hard decisions will also have to be made at some point. I guess it's unavoidable but it would be great to hear some specific examples of what you learned along the way!!!

And as an addition to the OP's original question.... how did you handle leaving bedside nursing? I am in the process of considering a manger position and while I am thrilled that I was asked to consider it, I am saddened about leaving what I know and love and I am frankly a bit scared of dealing with some of the mean personalities we have on our very large unit. By far, most of our staff are wonderful, but all places have those who constantly criticize and judge and bring things down. I am just a jumble of emotions trying to sort out what I want to do and what will be best for me, my family, and the unit I love.

Hi -- I'm at the threshold of starting a new position. Actually it will be a Navigator role, so I will function as a case manager / family educator / discharge planner with some social / emotional support responsibilities included as well. As this role is still in 'negotiations' .... I am seeking information on salary for people with similar responsibilities. If your job includes these responsibilities, or if you know someone serving in this capacity... could you please answer several questions for me? I need to know how the week is structured (are there set hours, or do they work flex hours to meet with patients etc?) Is it an hourly or a salary position? (and can you possibly give me some pay range? -- even if you say comparable to a bedside nurse with X years experience at your facility -- any numbers will give me a starting point!) Is this position considered "management" in your facility? (and what level of management is it comparable to? -- charge nurse, unit manager, educator or assistant manager?) How is progress evaluated and how are raises earned? Thanks SO much! -- I'm very very excited about this position, however the pay situation works out, but I do want to go into it with some idea of what is appropriate. Anything you share will be greatly appreciated!

So several of you seem to have been just starting in a Navigator type position.... or had been in it only a short time. Could you share how your job is structured? Do you have set hours? Are you paid hourly or a salary? Is this role considered management in your hospital? Do you allow your patients to contact you outside of office hours? (finding that some social workers do provide their patients with a cell number.... sort of amazed by that and wondered if it was appropriate for a Navigator) I would love to hear how you organize your patient data and keep up with all their various educational and emotional needs. Any input you have would be very helpful... it seems we're all at the front edge of a new specialty. :)

I was casually acquainted with the nurse manager... and literally stalked her in the halls of the hospital for months toward the end of nursing school. I told her I would be reminding her frequently of my interest so that when she did decide to hire new grads.. I'd be the first in line. I got the job.... 16 years ago... still at the same NICU and love it as much as I knew I would! Good Luck!

See if your library has any books written for parents of premies in the NICU. It will help you relate to them, but will also have very simple easy to quickly understand definitions of the things you will see and be exposed to. Also recommended, but more technical, are the books designed to help RN's prep for NICU certification. Rest assured, you will learn what you need mostly as on the job training... and it will eventually become second nature. Even experienced RN's come in and feel like it's a different universe.... give yourself a year to feel comfortable and another year to feel confident. Good luck!

We currently have a discharge class....not mandatory but we have about 90+% attendance. If families don't attend, they have to have the info reviewed with them at the bedside....not as productive or as entertaining. :) I'd love to hear more about what other units use to educate families....that's sort of my passion. :)

Agreed.... PICU will be the closest / most similar experience. And a new grad needs to "belong" to a unit with a good orientation and mentors who will support them through the first year. :) good luck!

we use a suppository... slivered to an appropriate size.