acerila

for #5 The ph is in the higher range of normal. So you have to look and see what can cause a high ph, is it your CO2 value or HCO3 value. Can your CO2 (of 47) cause a high PH? No. What about a high HCO3 (28) can that cause a high ph? Yes. So it is metabolic. The HCO3 increases causing a high PH so then the CO2 increases as well and brings the PH down. #6 The CO2 is low and the HCO3 is high. When those two go the opposite way you have a mixed disorder. In compensated cases the CO2 and the HCO3 will always either both be increased or both be decreased.

I loove the Servoi. Can't imagine using anything else, I'm spoiled. Hated the babylog (you really should have good graphics on a vent, it can tell you a lot).

well I come back to find that my baby died a few hours after my shift. I was getting so attached At least this time I feel like we did everything we could.

that's what we use and we cover it. We recently had an incident where a new nurse took the baby and carried the baby in her arms. She was stopped in the hallway by some family members (of another baby) who wanted to look at the cute little baby (thankfully they didn't realize the baby was dead..I guess they thought the baby was asleep?! who knows...) Anyways, she got in a lot of trouble since some of my coworkers noticed it and were not happy with the whole incident.

We do it. I always wondered how good it really is for the babies. I feel like it's something that's done more for the parents so they can sit there and admire how adorable their babies are/look. If it really is good for the babies I would be all for it but it obviously shouldn't be done to save space or please the parents.

I had another baby getting sick today. I was proud of myself because I feel like with each day I work there I begin to notice the little signs of a baby going bad more and more. I was worried about his tummy from the start based on that past experiance I posted about in here so I was definatly keeping an eye on it. I knew that this time I was going to have to be more persistant with the doc as well. Thankfully, the doc that was on call was amazing. Everyone there hates him and thinks he is mean but he does listen (unless he feels like you complain about something that is a normal part of prematurity) &will always write orders and is really on top of things. He was worried about the belly as well and a really bad blood gas had us convinced that that might be the issue. We took x-rays and he was on the phone with the radiologist and the surgeons right away and was in there checking on the baby a lot in addition to all the times I was calling him. Lets just say I know who I want taking care of my baby if I ever have on in the NICU. It's weird because we are such a big NICU but we don't really use our NPs or residents. The residents really don't do much on their own and the NPs area always on the computer but they never look at a baby (&no one trusts their opinion and goes to the docs anyways regardless of what they say).

Exactly the same situation. Except that baby had no previous belly issues and was fine one day, going bad when I got him and dead when I was back for the next shift. He straight out said that he was not worried and that he doesn't want an x-ray at this point. He finally agreed to one a few hours later after I asked him for the second time. This was an attending that has been there for 20+ plus years like most of our docs. Some of them are great..others never listen and do their own thing and only agree to anything if the baby is right there about to code (or so it seems). In fact, after all this, I have heard from someone that this doc will never order anything if you suggest it even if he knows that it's something that should be done. He also kind of came across as not wanting to ordered anything on a baby that's not his because he wanted the baby's primary to come back and deal with all this and didn't want to step on any toes (common for the doc on call to write orders just to have the primary come in the next day, get mad and change everything).

..when you know a baby is getting sick, you tell the doc repeatedly about it but they think the baby is fine (when you know they are not!) and they don't write you any orders. Then you come back the next day any the baby is gone. Afterwards you feel terrible thinking that maybe if you more persistant or said/done something different. I'm sure you all have experiances. And how do you deal with those kinds of docs?

I get that one too. The other week I had one of the docs come up behind me, I turn around and he says "I was going to scare ya" and he pulls on my ponytail. I wish I had nice hair though. I always have to wear it up because it just so crappy

Only if you feel you are personally in danger. Otherwise quitting without notice seems just unfair to your coworkers because they are going to be picking up the slack.

who's talking about finding dates? 99.9% of people i work with are female (nicu). i'm saying that in general i do not receive bad treatment from males but from my experiance i have come across some really moody females. i feel like in general (from what i've seen) females can get a lot meaner to other females in comparision to how two acquaintances of the opposite sex would treat each other.

To be perfectly honest as a young female I feel like I have an advantage around males that I do not have around females. Most men when they see a younger, relatively attractive female they will be super nice right off the bat. So it is an advantage that you don't have around the same sex.

I would love to work at a place like that. If this happened where I work people definatly would not be laughing. Instead the people involved would probably be trash talked and would be in trouble.

I've been told that before (the more you write the more they can pick apart later) and I tend to follow it. I'm not saying I'm totally not going to chart certain events but for example: We have one baby on the unit that's been there forever. She has been doing alright for a while but one day she totally crashed and had to be intubated. The whole thing was a mess the doctor on call was in the middle of putting in a line on another baby, so we had to call another md. The whole time the baby was being bagged, sats were in the 20s, the heart rate wasn't coming up too quickly either and he had trouble intubating the baby and it took him a few attempts. The nurse that had the baby was charting every single little thing about this whole mess (this baby's family was totally difficult as well and would have sued in a heart beat) while I personally would have just charted the sats&heart rate and that the baby was being bagged, md notified and the baby was intubated with this size tube and this location and breath sounds were noted. I don't think it's necessary to sit there and chart that it took a million attempts to get the tube in etc.

funny that you mention this because I just saw a student last week pick up his phone in the middle of the unit and talk on it very loudly. This is after he went around saying he wants to work at our hospital there in the NICU because the babies don't complain like adults and we have longer breaks then anyone :icon_roll