wensday MSN, RN, APN, NP

wensday has 12 years experience as a MSN, RN, APN, NP and specializes in NICU and neonatal transport.

wensday's Latest Activity

1. 

   In need of some support - absolutely devastated

   wensday replied to The_Muffintime's topic in NICU

   Sorry you had such a rubbish day, we've all had babies we struggle to forget for one reason or another. I think as the others have said, you can't presume to know the back story, but it's so hard to look at that little one and feel completely at peace with it. I think when sad or difficult things happen, you have to be hard-faced. You have to push it out. You get better at bringing up that wall. I cry on the way home and then when I get through my front door I try leave it behind. I know someone else is there on NICU doing an amazing job for them. The other thing is remembering the happily ever afters. Those babies you never, ever thought would get out of the front door. Those babies so tiny and fragile or post-op and full of stitches, or suffering from things caused by others- intentionally or otherwise...then seeing them going out of the door all cosy in their 'going home' outfit and smiles and hugs and tears and love. Thats what I push into my mind at the end of the day. The happy. Sometimes it's the only way x
2. 

   Interview for Neonatal NP

   wensday replied to ORRN1228's topic in NICU

   Hi, hope I'm not too late, been away from here for a while. I finished my ANNP MSc last year. The questions for my interview put me in different situations, one about a reg doing something you didn't agree with in the middle of the night, one about speaking to a parent re survival at 24 weeks, umm one about multiple emergencies in different places and managing them with x y and z staff.
3. 

   Any suggestions for presentation props?

   wensday replied to futurennp1's topic in NICU

   Various nappy sizes, tape measure, vest/hat, little doll about the size of a smaller prem. ECG dots and a picture of a little prem with the same dots, for size comparison.
4. 

   UK NICU?

   wensday replied to may1787's topic in NICU

   We start with eg 1ml every 2hrs, then go up by 1ml every 8/12/24hrs depending on how small/sick/tolerant the baby is. So a little AEDF/IUGR 24wkr would start on maybe 0.5ml/2h and go up to 1ml/2h 24h later. Yesterday I started a 34wkr on CPAP 2mls/2h, going up by 1ml every 8hrs as resp condition allowed. Once fully fed 2hrly, we go up to 3hourly when we think they can cope with the larger volume.
5. 

   Handling Emergencies Outside the Unit

   wensday replied to sergel02's topic in NICU

   I reckon I could get an IV in a gigantic vein
6. 

   Handling Emergencies Outside the Unit

   wensday replied to sergel02's topic in NICU

   This came up recently as mid-transfer an NNP was asked to help at a serious RTA that happened right in front of the ambo, well baby inside with RN looking after it. This is WELL out of my comfort zone after not caring for adults since 2002 and kids since 2004. If you don't fit in an inc, I will struggle bar basic first aid. We get taught up to date BLS but nothing else.
7. 

   UK NICU?

   wensday replied to may1787's topic in NICU

   Interesting to hear your perspective as this is my norm :) We've just started e-rostering and most units locally are too. Nurses here do all vent changes as standard, the medics wouldn't have a clue. With feeds, what is the 'q' and how would you do it differently in LA? ta x
8. 

   sneakers/shoes

   wensday replied to heather717's topic in Uniform/Gear

   Our whole ward wears skechers go walks. They are light as air and are so comfy with memory foam in the sole x
9. 

   Band 6 neonatal presentation

   wensday replied to cdickinson1810's topic in NICU

   Didn't want to read and run but sheesh that's a bit rubbish!! I suppose the outreach allows babies to be discharged home sooner? Nicer for baby + mum. Leaves beds for sicker babies, cot capacity and babies moving across borders is always a hot topic.
10. 

    Sedation choices for vented babies

    wensday replied to wensday's topic in NICU

    Thanks for your replies, it's really interesting reading the different practice. When I started out all our vented patients were on morphine and midazolam (Versed). Ten years later and we tend to use morphine when they are uncomfortable on the vent and usual comfort measures are failing, or if they are fighting but fail non-invasive. Midaz is rare now although we do use it when struggling. Both we wean as quickly as possible. Nurses get very protective of weaning sedation and argue the decision...pain being preventable. However we (ANNPs/doctors) are thinking about the side effects a bit more. I'm looking at other options because of the risks associated with the above. I'm currently looking at fent and also dexmedetomidine (precedex) research and wondered what everyone else was using. One of our problems is money. The NHS is poor and new drugs are expensive.
11. 

    UK NICU?

    wensday replied to may1787's topic in NICU

    Hi I'm a trainee ANNP, 11yrs NICU nurse practice. It all depends on the unit you go to, there is a great variety of acuity and levels. So the NNU I work in is a big tertiary level based in a womens hospital. A tertiary level will vent, HFOV, iNO, pre and post op etc. Level 2/1 will stabilise a sick baby and transfer out to us. Then accept back once well out of the woods and stable- started some feed, time off CPAP, no new sepsis etc. New nurses are on a band 5, onto a band 6 after a couple years experience. This again depends on the hospital, what the band change means, in smaller hospitals it means managing the NNU, our place its managing your room of 5 ITU babies. Payscale- Agenda for Change 2
12. 

    Do you filter trauma blood?

    wensday replied to IvoryLena's topic in NICU

    We use a blood giving set which has a spike and filter within the set, its pretty easy to spike and attach a syringe to, then we unscrew the syringe and push into the baby via whatever access. I've been to a delivery resus once where they couldn't find the giving set quickly and the baby had lost a lot of blood, the nurse really struggled to draw it out of the bag without a spike and it went EVERYWHERE. I can still see the resus trolley with blood in every drawer and all over her.
13. 

    Sedation choices for vented babies

    wensday replied to wensday's topic in NICU

    Thanks, yes we use Vec sometimes too.
14. 

    Sedation choices for vented babies

    wensday posted a topic in NICU

    Hi all, Do you give your babies sedation for ventilation and if so, what do you give? This is for continuing ventilation, not intubation itself. We give Sux and Fent to tube and then morphine for pain/synchronicity if they aren't going to come off quick. If we are still struggling then midazolam is used. I've read these aren't great drugs but not sure of the alternatives in regular use in nicus. Thanks Debs- trainee ANNP
15. 

    COMPUTER CHARTING

    wensday replied to mina123's topic in NICU

    We use the badger system (UK), all our care is on the computer, monitoring, fluids, blood gases + lab results automatically input to the baby notes then we add our own notes as we go along.
16. 

    Your local policy on caring for Jehovah's Witness neonates

    wensday replied to wensday's topic in NICU

    That's really interesting thanks, we tend to transfuse at least one baby each day, at least 10-15 pw I would estimate. This is a 50 bed NNU. We only use EPO for JW babies, with the recent evidence of increased ROP our consultants are wary of it. I know we can sample less that we do, that will be my conclusion.