IttyBittyBabyRN

Our manager actually said that anyone who possibly could should get intermittent FMLA. Work the system......We say all the time how we would LOVE some California nurses to come over here to Tennessee and teach us how it's done . The problem here is that no one believes "They can't fire us all at once." It is incredibly frustrating to work in a system that has always been known for treating employees poorly. But they spend a whole lot of money advertising as the best hospital around......wait until next year's infection statistics come out

Sorry this is so long but I really want to get a perspective on how other hospital's attendance policies work. Consider what our hospital implemented this year: There is no longer ANY excused absence. Absences and tardiness are assigned point values as follows: 1. Any call-in, whether a week before your shift or ten minutes before your shift--1 point A weekend shift is 2 points. 2. If you leave after half your shift is worked, you get half the point value. 3. If you arrive at work sick, and are told you must leave---yep--still get the points. 4. A tardy is1/2 point; weekend tardy is 1 point. 5. If you, say, have a week long illness-you accrue points for each day in a row missed. So a 4 day stomach bug/flu/etc. could get you 6 points if it crossed a weekend. 6. The ONLY way to avoid points is to be an inpatient or to have FMLA papers (which they may or may not approve.) 7. If there is a giant wreck, bad weather, etc. that causes multiple people to be late, HR may excuse that "if they deem it affected enough people." You are terminated upon earning 14 points in a two year period. So, if you ONLY work weekends, you can be sick three weekends in 24 months and then you are fired with the next absence. There are obviously always some who call in frequently and it is frustrating. But this policy is horrible!! We have already lost some amazing nurses who either were sick themselves or had sick kids a few days and have been fired. Our manager actually encouraged anyone who can to get FMLA for something so that they will not be penalized if they call in. People are scrambling to get it for migraines, asthma, etc. just for security. The main issue is that WE TAKE CARE OF CRITICALLY ILL BABIES!!! And nurses are literally being forced to come to work sick, because you can't risk needing your points later if you are sicker, have a car wreck, etc!! We want to warn everyone not to come to our hospital! We do not want your baby to be put at risk because of this. It is so frustrating and demeaning to everyone who is a loyal employee. Loyalty is fading fast. We we really want to know if other nurses are being treated this way. We feel helpless and literally have no recourse it seems. Looking forward to your feedback :-)

I do the tongue depressor thing if they are in a small crib. If in the large metal crib, we usually string rubber bands together to stretch diagonally across the crib and hang the syringe from a couple in the middle. Really high tech :):)

Due to our having some short staffed days on our unit schedule, or manager has implemented a "mandatory on-call" policy. While our unit is in no way nearing a staffing crisis, I work in a unit where you NEVER take care of more than three babies. Those who have never worked elsewhere PANIC if it is suggested...........anyway, everyone in the unit, including part time and supplemental positions, are required to sign up for the same number of extra shifts. Even if you voluntarily signed up during the initial scheduling period for more hours than your position requires, you are expected to do the same amount of on call time. So a full time nurse who, say, voluntarily signed up for 48 hours each week, is expected to add on additional on call time as "extra.". Our manager put out the list of days that may be somewhat short, and everyone has to grapple for the paper and try to find two shifts to sign up for. No seniority.......no "I'm already working a ton of extra, so I'll go last"......nothing. You call two hours before the shift to find out if you are needed. Horrible for a night person, because obviously if you work the night before and then are on call you have to sleep all day "just in case.". Is anyone else dealing with this or are we just in management hell????

I had a BS when I decided to go to nursing school as well. It was the same length of time for me to go to the BSN program as it would have taken to do the other. My advice is to compare each based on length and cost. A BSN will be required to advance to management or the CRNA program obviously. Both are a ways off for you. If you have an accelerated program locally since you have a degree already, I would definitely look into that. I have heard they are intense, but most are only one year an it would have been totally worth it to me to get it over with that soon!! Just look at all your options based on time/money/ how quickly you need that salary coming in.

Don't quit!!! It is like this for everybody--I promise!!! I just changed from one unit to another after doing this job for 7 years and I still felt like a new grad orienting at the new unit. Once you get on your own, you can stand at the bed and just think about things for as long as you need to and it will be so much better than when someone is watching over your shoulder making you nervous. And if you have 4 different preceptors, you will learn 4 different ways of doing things. You have to eventually just take it all with a grain of salt and pick out what is actually mandatory that you do a certain way and what you can make your own decisions on. I came from a unit with written policies for almost everything to a unit that has almost no written policies except for critical things. It took me forever to be confident in making my own decisions about things like when to wean babies to open cribs, when to call the doctor, etc. The most important thing for you to always remember is DO NOT EVER DO ANYTHING IF YOU DO NOT UNDERSTAND WHY YOU ARE DOING IT!!!!!!! Realistically, it is not going to hurt a baby if you toss or don't toss his residual from feeding AS LONG AS NOTHING IS WRONG WITH HIM. At my first job as long as it was under 1/2 of the original feeding and looked "normal" we would discard it and continue feeding. At my new job, the docs are a lot more paranoid about belly issues, and would most likely stop the feedings and xray the bellies, etc. I've learned that if the feeding amount was small to start with, often there will be some left in their b/c there isn't enough to stimulate the stomach to push it on through. I don't ever worry if my baby has 2cc of a 4cc feeding left as long as everything else is normal. However, if the baby had 15 of 30 ccs left and I knew that the feeding wasn't hung late, I would do a lot more investigating before feeding them again. All of this will become second nature to you eventually. Just hang in there and DON'T HESITATE TO ASK QUESTIONS. If your preceptor isn't very friendly, ask for a new one or pick someone really nice to vent to!!!! Good luck!!

I think I would vomit if I heard someone tell a parent that or saw them actually do it!!!! I view that as being very unsanitary for the parent and especially the baby. We always ask parents to use hand sanitizer if they touch their face,nose,mouth, etc. before touching the babies, so I can't see how I would tell a parent to stick the baby's hand IN their mouth????? I don't know if our unit even has a policy about clipping nails, but I have used the very pointy scissors and done well. I would have no problem teaching a parent to use small clippers.

It's great that you care enough to find out for certain before feeling comfortable with this--more people should be that way. You can never get all the little bubbles out and "thumping" on it, like we all were taught to do, will drive you nuts eventually!!! All the tubing I have ever used has a filter on it, and I can't imagine a neonatal unit ever NOT having one. That's what the filter is for--to catch the air bubbles. If for some reason it doesn't, I would question why. I always make sure to run my fluid so that any visible bubbles are through the line--meaning anything that is making an actual gap in the tubing. After that don't worry about it--the little tiny ones are not going to hurt anything. Just use common sense, which is 99% of what our job is made of. It is always better to be over-concerned and ask, though, rather that to just assume something is ok. Never hesitate to ask questions even if you think they are dumb. I have been doing this 7 years and still have questions all the time. You can never stop learning in nursing. Always err on the side of caution and make sure you absolutely understand WHY you are doing something before you do it--even if someone is trying to rush you.

Ok, need some info on everyone's CPAP experiences. Most of our babies have the kind with 2 corrugated hard plastic tubes held on their head with 2 blue sponges and a cap that has a band to secure around it. Sorry, don't know the brand name. Anyway, the babies end up with these horrible dents in the side of their heads from where the band goes around the sponges. Their heads end up really long like their brains get squashed to the back. Apparently I am the only person who finds it inappropriate that we are disfiguring the critters....regardless of how well they eventually mold back into shape post-cpap. WHAT IS GOING ON????????? We have finally started paying attention to septums and nares and have decreased the horrible plastic surgery candidates.....yippee for us.....It's like everyone is just ignoring this issue which in my opinion is totally a nursing responsibility. Am I alone here??????? Is everyone else in the country creating our future kindergarten classes of aliens???

Do many of you have lipids mixed in the same bag?? Do you run it in the UAC? We have to run the lipids separately in a PIV only.

I would bet that no one who works in a NICU would ever recommend at home birth!! It is somewhat of a blessing and a curse that the average mother has no idea of all the things that could go wrong during a pregnancy and delivery. I was pregnant with my first when I started working here, and may I just say I would recommend having all of your kids BEFORE becoming a NICU nurse!!! It was very scary. And still is each day that I come in and have full term babies that ended up horribly sick. Have one tonight that was 42 wkr, PPHN, on NO. Very very sick. People think we just take care of preemies and don't really know what can happen even if you do make it to term, regardless of how well you take care of yourself!! When I read this post I thought how sad it would have been if this baby had been born at home.