PrudenceNurse

PrudenceNurse

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All Content by PrudenceNurse

  1. My Inspiration to Become a Nurse

    PrudenceNurse posted a topic in Nurses Rock

    I write fiction. I could compose a lovely story about the magnificent women who inspired me to become a nurse. I could tell you in poetic prose about their near-saintly lives, deep caring for their...

  2. Pulse Oximetry

    PrudenceNurse replied to Sunlight-RN's topic in NICU, Neonatal

    In our unit, the Respiratory Therapists have NOTHING to do with the pulse oximetry. We are responsible for rotating sites and for adjusting FIO2,

  3. HELP! Ostomy bag will NOT stay on!

    PrudenceNurse replied to Preemie2RN's topic in NICU, Neonatal

    How about the "Eakin ring"? It is a moldable pectin-based substance. You can roll it (like playdough) into a "snake" and then mold it around and between the stomas to form a flatter surface that bags...

  4. Preceptorship in NICU - waste of time?

    PrudenceNurse replied to 3fins's topic in NICU, Neonatal

    Our Level 3/4 NICU does hire new grads, and we would probably be more likely to hire someone who had done an internship (or preceptorship as you called it) in our unit over someone who had

  5. NG/OG tube verification policies

    PrudenceNurse replied to Sue Hinds's topic in NICU, Neonatal

    We don't have a written policy (perhaps we should), but we teach that aspiration is the best way to verify placement. Auscultation is not very accurate, especially in the micro-preemies, because if...

  6. Skin care for Premature Neonates

    PrudenceNurse replied to wrighty's topic in NICU, Neonatal

    What exactly is a "bio-occlusive dressing"? Tegaderm? Please give more

  7. Skin care for Premature Neonates

    PrudenceNurse replied to wrighty's topic in NICU, Neonatal

    We have Extremely Low Birthweight Guidelines that include: no leads; "soft touch" pulse ox probe with no adhesive; mist tent for 72 hours; after initial bath, water only (no cleanser) for two weeks;...

  8. Starting off as a New Grad in the NICU--bad idea?

    PrudenceNurse replied to iDeftones's topic in NICU, Neonatal

    I started in a NICU as a new grad 27.5 years ago, and have no regrets. I would NEVER want to do any other kind of nursing. I have never had a problem finding a job in any part of the country. I got...

  9. How often do you change clear fluids? Pressors in particular!

    PrudenceNurse replied to NICU_babyRN's topic in NICU, Neonatal

    We zero all fluids on pumps at midnight each

  10. How often do you change clear fluids? Pressors in particular!

    PrudenceNurse replied to NICU_babyRN's topic in NICU, Neonatal

    We change all lines/tubing only twice a week on Saturdays and Wednesdays as a part of a CABSI initiative. New syringes/bags of course must be put up every day. For the extremely fragile baby on...

  11. Feeding Protocols

    PrudenceNurse replied to HawkeyeRN's topic in NICU, Neonatal

    One of our NNPs developed a great feeding protocol that the nurses "order" everyday after calculating volume based on mLs/kg/day. We have the same stops and starts with the micropreemie, but it has...

  12. What to use on the nares to prevent breakdown of skin

    PrudenceNurse replied to wrighty's topic in NICU, Neonatal

    We have the same problem with RTs in my unit. I do what you do--put on Duoderm and switch from prongs to mask frequently myself. The other compliance problem we have with the RTs is their refusal to...

  13. What to use on the nares to prevent breakdown of skin

    PrudenceNurse replied to wrighty's topic in NICU, Neonatal

    We actually DO use Duoderm, but we use the ExtraThin Duoderm that is "breathable". If you cut it into an inverted T shape you can put the horizontal part of the T over the philtrum and run the...

  14. I NEED ADVICE on URINARY CATHETERS

    PrudenceNurse posted a topic in NICU, Neonatal

    What antiseptic is everyone using for insertion of urinary catheters? Betadine? Chloraprep? CHG handsoap? For daily care, just baby soap and water like a bath, or more antiseptic? Also, is anyone...

  15. preventing CABSI

    PrudenceNurse posted a topic in NICU, Neonatal

    We are doing a quality improvement program in our NICU to decrease our Catheter Associated Blood Stream Infection rate. I would love any information from other units about how you do line changes and...

  16. Tape use in Neonates

    PrudenceNurse replied to cagedbear's topic in NICU, Neonatal

    We are trying to get away from using any tape directly on our babies' skin because of the damage it causes, especially in micro-preemies. They make a "gel" strip to use instead of tape, or we put...

  17. How to treat umbilical cord?

    PrudenceNurse replied to sofiam's topic in NICU, Neonatal

    The AWHONN recommendation is for NO antiseptic treatment at all; it actually shortens cord drop off time and does not increase rate of infection/omphalitis in developed countries. The evidence has...

  18. New PDA Treatment Recommendations??

    PrudenceNurse replied to lvnurs9's topic in NICU, Neonatal

    Ours is attending-dependent. A few of ours say that it is a normal finding in a premie and should not be treated; others try indocin/neoprofen a couple of courses, then ligate. It's frustrating to say...

  19. Weaning from an isolette

    PrudenceNurse replied to luvnicubabies's topic in NICU, Neonatal

    At 1250 grams, our kids in isolettes are changed from "skin temp control" to air temp control and are dressed and wrapped like they were in open cribs. Air temp control initial setting is whatever the...

  20. Humiliating IV questions

    PrudenceNurse replied to elizabells's topic in NICU, Neonatal

    My instructor in nursing school told me I had "psychomotor deficiency", so I know how you feel. The only answer is to keep practicing and also to observe other people who do it well often. But all of...

  21. Amicillin via UAC?

    PrudenceNurse replied to I'mANurse!'s topic in NICU, Neonatal

    AmPicillin===I have been working NICU for 26 years in several different states, and I have never heard of a reason NOT to give meds through the UAC instead of sticking a baby for a PIV. Especially...

  22. Will the NICU limit me in the future?

    PrudenceNurse replied to ToughingItOut's topic in NICU, Neonatal

    I've been a NICU nurse for all of my 26 years. Yes, it would be "limiting" if I ever wanted to do something else. Which I don't. I do have my MSN, and have started doing some teaching and clinicals in...

  23. Securing UVC/UAC?

    PrudenceNurse replied to preemieRNkate's topic in NICU, Neonatal

    Hold-a-Line umbi catheter holders made out of the Duoderm stuff are the safest and the most gentle on the skin. The "bridge" or "goal posts" made out of the pink tape were what we used in 1983 when...

  24. Securing UVC/UAC?

    PrudenceNurse replied to preemieRNkate's topic in NICU, Neonatal

    I don't think Tegaderm or pink tape or really any tape should be put on any micro-premie skin. We have something called a "Hold-a-line" which is made out of the Duoderm stuff that does not tear the...

  25. PICCs Broviacs and Clothing

    PrudenceNurse replied to qaqueen's topic in NICU, Neonatal

    No "evidence base", but we have just started leaving PICCs and Broviacs uncovered and not breaking the lines to put arms in sleeves. This is being done to try to decrease central line infections from...