nurseinnh

Is it 15 seconds from when it leaves baseline to when it returns, or does the accel need to stay 15 beats above BL for 15 sec?

How funny!!! I worked NICU for 5 years before switching to L&D. I was really nervous about it, we moved to a small community that did not have a NICU and the only position available was in L&D. I think you will really like it a lot. I absolutely love it, and feel I have an advantage knowing babies as well. My advice to you....Just be open to the fact that you are learning again. Ask questions when you don't know... My biggest obstacle was getting over starting IVs in an adult!! Best of luck, you will do fine

The last protocol we had was very reasonable and it seems to be the standard of care where most of you work! Yes, the poor babies' heels do resemble hamburger. The docs have not been "able" to produce any evidence-based research on the benefits of these frequent glucose checks. I do know that there was one baby who had a glucose of 17 that "may have been prevented" had there been more frequent glucose testing. I think that babe was at high risk IUGR. I worked in a NICU for 5 years prior to moving here, and we didn't even test that frequently in the NICU!!!! This is a well baby nursery. I just don't get it. Any good ideas on where I may be able to find good research to prove that the infants do not need this??

We have only had a couple of parents refuse....one set of parents were doctors themselves. Most parents just go with the flow, they believe that "we have to do what we have to do." I think it is pretty excessive as well.

That's the way it used to be before they changed the protocol. We have all asked the pedis to provide us with the literature that supports this new one. It has been a rough adjustment. Normally, we do vital signs on any at risk infant q4 until discharge...So we end up doing vitals q3 to cluster them with the glucose so as not to disturb them more than we have to. The babies we are most concerned about (with good reason) are the IUGR or twin gestations. But under the new protocol, we are poking the babies before feedings and then the poor things are completely worn out and won't eat!

I am curious as to what other hospitals use as a normal newborn hypoglycemia protocol? I feel ours is a bit aggressive. Here is our protocol. If an infant is at "high risk" for hypoglycemia (GDM, LGA or SGA) we need to check a glucose one hour after birth and then again two hours after birth. If either is below range (below 45), then we feed the infant and check glucose again. IF the second glucose is within "normal limits" (over 45) then we continue to check the baby's glucose via heel stick every 3 HOURS until 24 hours of age--even if the glucose is 60s-70s the whole time. The parents hate it, we feel mean and the babies can't enjoy it--they pull their feet away whenever someone touches them. I would just like to compare. Thank you!!

I am enrolled to start in about a week at ISU...I am taking Adv Patho from Jim Hughes. I am wondering what about his class you didn't like? How long before you decided to transfer? What about the professors gave you the impression that they want you to fail? Anything you did like about the program? Be honest.... Thank you!