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Coffee Nurse

Coffee Nurse BSN, RN

NICU
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Coffee Nurse has 10 years experience as a BSN, RN and specializes in NICU.

Coffee Nurse's Latest Activity

  1. I'm trying to think of a plausible backronym to boost credibility, but all I can come up with is W-U-Z-Zero Incidental Extubations.
  2. I've definitely used the Wuzzie technique before too. Alternatively, just make sure your tape is nice and secure, and that the vent circuit won't get caught on anything and start pulling. If you have a feisty kid, make sure they can't get their hands up and grab the tube. Then just take it slow and keep a close eye on your tape/tube as you move the baby. It's one of those things you'll get used to with experience.
  3. Coffee Nurse

    Work asking all the time if I can work extra At work and home

    No. Some people pick up loads of overtime. Some don't do any. Some are anywhere in between those two extremes. Do what you want to do.
  4. Coffee Nurse

    Work asking all the time if I can work extra At work and home

    Sounds like you need to assert yourself and your needs a little more. "Sorry, I can't" is plenty of reason not to work extra. Their getting irritated with you just reflects poorly on their own staffing plans, which apparently don't work unless people do extra shifts. Also, you should be calling out sick if you're sick, not "never no matter what." It doesn't sound like they respect you too much, so you need to stand up for yourself.
  5. Coffee Nurse

    NICU new grad help with assessment/time management

    She's talking about a beginning-of-shift assessment, not a delivery room assessment.
  6. Coffee Nurse

    Swaddling

    Also, in addition to making the nurse's job easier/safer, it's actually kinder and more reassuring to the baby to swaddle while you're doing something unpleasant to them. I always swaddle everything except the limb I'm working on for IV starts, for example. The difference it makes in their comfort level, compared to people who let them flail and scream through the procedure, is immeasurable.
  7. Coffee Nurse

    Swaddling

    This 100%. How exactly does your coworker suggest you prevent the kid from accidentally decannulating himself while you perform trach care?
  8. Coffee Nurse

    NICU new grad help with assessment/time management

    Agreed that it is a totally normal thing to feel like you're taking forever compared to people who've been doing this for a while. My biggest tip for time management, especially at your stage, is to start everything early and give yourself plenty of time to do a good thorough job. If it takes you half an hour to do a full assessment, give yourself the half hour, starting early enough that you're still starting your feed (if applicable) on time. This will keep you and the kiddos on schedule. As you get more efficient, it'll take you less time, and you can start a little later. As far as your actual assessment, it sounds like you've got things pretty much in the right order. I like to go from least invasive to most invasive, so I'd start with counting resps (yes, using the hand method, or just watching the chest if it's visible enough) and doing a BP, then a temperature so they don't have much of a chance to drop after opening the incubator doors or unwrapping. I agree that the thermometer almost inevitably causes crying, but a pacifier or some containment holding should settle them down well enough for you to proceed with auscultating.
  9. As long as you maintain your CE requirements, there's no problem maintaining a US license while living abroad. I kept up my NH license for the six years I lived in the UK because I knew I'd eventually be coming back. As for what address to use, probably best to get in touch with the specific BON; I used my parents' address but different states may have different rules.
  10. Coffee Nurse

    I'm in desperate need of help!!!!

    Cool. Feel free to answer the OP's questions then for what is evidently an attempt at corrective action on the part of her management.
  11. Coffee Nurse

    I'm in desperate need of help!!!!

    Pretty sure the point of this is for you to reflect on your own practice, not for strangers to do it for you.
  12. Coffee Nurse

    I have trouble pulling up clear liquid into a syringe

    If you think your syringe is full of liquid, pull the needle out of the vial and pull the plunger back a little further. If you have liquid, you'll see an air bubble appear in the syringe. If the syringe is full of air, nothing will happen because you're just drawing in more air.
  13. Coffee Nurse

    New grad no preceptor.

    Oh nooo. There is no way a brand new grad should be working independently in an ER. Either someone dropped a heck of a ball or the manager straight out lied to you in your interview. Either way, speak to your manager ASAP and don't worry about being called a "complainer" -- if she and your coworkers can't grasp that you have no business working on your own without a proper orientation with precepting, then this is not a safe environment for you and your license to be in.
  14. Coffee Nurse

    Day shift ICU to night shift NICU? Please Help!

    Bear in mind that not every state has the level IV designation; in some places, level III is as high as it goes. It would behoove OP to do some digging and find out what the local unit is like. There's a flipside to the coin of everything adventure_rn mentioned -- while the majority of NICU patients improve from their baseline, it can be even more heartbreaking when a baby doing well takes a sudden turn for the worse. Similarly, while the majority of parents are very grateful and eager to be shown how to be involved in their baby's care, the ones who ignore education and insist that "I know my child best" (despite being brand new parents), or who are determined to "do everything" when it means thrashing a poor child who has no hope for a meaningful quality of life, are especially frustrating and difficult to deal with.
  15. Coffee Nurse

    How do I transfer non ambulatory pt from WC

    My suggestion is that if your supervisor has told you not to transfer this patient on your own and you try to do so anyway, your employer is going to offer not one iota of sympathy or support if you injure yourself or the patient.
  16. Coffee Nurse

    What is the "tension to ET tube" in NICU setting

    Agree with Emm_RN, tension/traction means pulling the ETT away from the baby just a bit. Be careful especially if you use tape to secure, as this can accelerate the loosening process and cause you to have to retape sooner. Also, I can't emphasize strongly enough the importance of clarifying if you don't understand what someone tells you, rather than waiting and asking strangers on the Internet. We don't know exactly what that person had in mind, terminology differs between facilities and regions, and by the time you get an answer here, the baby may have had a negative outcome. Don't worry about how you think it might make you look to your coworker. ASK.