scrabblern

What is the absolute quietest nursing specialty? A job where one doesn’t need to verbally communicate.

Not much changed while I kept in touch. I have been out of close touch for some time, and what I can see from the unit posts is that there are a lot of new faces...

Hello everyone! I was hired as a Triage/Advice Nurse in Feb of last year and suffered an acoustic incident on the job in May. I worked in a small call center environment, and the positions have been moved to remote due to COVID after my injury. I was exposed to extremely loud noise via headset. It was so loud a nurse 2 cubicles over (spaced out due to COVID) could hear it. As a result of the acoustic incident I now have disabling acoustic trauma, pain hyperacusis, permanent tinnitus and have developed trigeminal neuralgia. Worker's comp, all the fun... I've worked all kinds of light duty across the hospital system and that has been pretty interesting. Anyway... I am on baclofen and nortriptyline. I am unable to have prolonged conversations, I'm sensitive to sounds most people consider normal. As COVID restrictions ease, I won't be able to enjoy going to restaurants, movies, concerts, busy streets, etc. My quality of life has been greatly diminished. I can't do the dishes, husband opens wrap packages while I wait in another room, the fridge is an enemy now, etc. I have noise cancellation devices and they help, but they don't keep me numbness or pain free, just ease my symptoms. Per management I was the only person they've seen suffering with this issue, but research shows otherwise. There was no education about acoustic shock or trauma during orientation or at any other time. I asked my employer to investigate how this happened and they haven't taken ownership of this. Does your department offer any education about acoustic shock or how to protect your ears? If you have examples you can share I would love to see them. This is a real risk for staff who are on the phones for hours and I would like to see what is your department doing to advocate for you. I think ear protection should be a a part of triage/advice employee education. My department will return back to the office after COVID restrictions ease. I have found a number of sources touching on acoustic shock and since I am not posting articles I will just post titles and you can Google at your own convenience. "Reducing Noise Hazards for Call and Dispatch Center Operators" NIOSH (attached as PDF) "Demographic Patterns of Acoustic Shock Syndrome as Seen in a Large Call Centre" (attached as PDF) Also search: "ACOUSTIC SHOCK AND HEARING DAMAGE WITH CALL CENTRE AGENTS" poly blog (previously Plantronics) "Acoustic Shock" by hear-it.org NIOSH - Reducing Noise Hazards for Call and Dispatch Center Operators.pdf demographic-patterns-of-acoustic-shock-syndrome-as-seen-in-a-large-call-centre-2329-6879-1000212.pdf

I can't imagine the stress you're going through and seeing people who deliberately choose to harm themselves and endanger their environment only to end up in a situation beyond salvation, leaving you as a witness. There's little I can say to ease your pain. This is an abnormal time, similar to war effort nursing. The people who will understand you best are your peers. Turn to them, and try to collaborate to have a space for healing, whether online or outdoors. Look for a counselor/therapist now as they are hard to come by even when things are normal... I would expect this entire cohort of COVID nurses to be treated for PTSD, to be honest. So while you're away from the floor, just do your best right now to take care of yourself, indulge yourself however you can, whether it be bath bombs or ice cream, extra snuggles with your pet, whatever works, so that you can mentally survive the stress of being a COVID ICU nurse. Even when COVID passes, you will still have patients who harmed themselves, who are beyond salvation with ignorant families. You will still have a code on your floor at least weekly. You will see it all, just less frequently as long as you're an ICU nurse. As a fellow nurse, I admire you, and thank you for your service.

FYI... I moved to a Union hospital on West Coast in 2014. I can't even describe how much better our working conditions are. We're taken care of, our assignments have been fantastic and that really reflects in patient care we provide.

Hello, Does anyone work in a unit that uses VPT? Our unit is looking into possibly using this method for our patients but have not found any policies. Would anyone be interested in sharing the info with the rest of us? I'm aware of the study in AZ, haven't found anything else about it. Thanks!

This is in Oregon. I looked at visiting nurse association website and saw that they don't have a branch in Oregon. Made me wonder.

She said she feels uncomfortable with it. I tried to explain pros and cons but she didn't really want to listen. The staff at ER also suggested he needed a PICC.

Hi, I am a neonatal nurse and this is really out of my scope so I'm asking for help. My friend's husband just turned 65 and he's been disabled with neuro degenerative disease for many years. He is on IV abx now and according to his wife they had to go to ER 3 times for the PIV. She refused PICC on his behalf. She said that medicare would not cover for an RN to come in and restart an IV and that they have to go to ER. This makes no sense to me. I would like how is that possible? I am not sure thst she's aware of all the resources she has. Thanks!

@NicuGal: How long have you been doing HOB flat at 33-34 weeks in your unit? Do you find that the babies spit up more with HOB flat at that age, since lots of them still need gavage... Most of the nurses where I work keep babies with HOB up until the feeding tube is out. I'm now realizing that this too may be tied into the issue of demoing safe sleep...

At what point does your unit take babies out of the isolette, and why do you wait 'till you take them out? We've just had a thermoregulation policy change, making most of our babies stay in a lot longer...

We filter TPN and clear fluids in the NICU, but the Level II nursery (different unit) doesn't filter anything. Go figure.

Hi everyone, I will be doing education on SIDS to both parents and nurses of NICU patients...in our unit we tend to swaddle babies 'till almost the very end. Back to sleep is taught once by our OT prior to discharge. I did a little bit of article digging on this and found that there's been a lot of research on this... It seems that many hospitals across the nation have a similar issue. Nurses are aware that babies are supposed to be in "Back to Sleep" at least a week prior to discharge but that doesn't happen in practice. Also parents whose babies have been in NICUs for extended periods of time and have slept prone for most of they stay tend to place their babies prone at home too. I was curious to find out how and when is Back to Sleep introduced to parents in your units? Also is there any product that your unit uses to promote Back to Sleep, such as HALO SleepSacks? If you do use the product, please describe when do you put the baby in it and how is it laundered... Do you tend to lose it in laundry much, are nurses satisfied with it, etc? Thank you!

Hi everyone, In January I will start studying toward a one-year graduate certificate in Clinical Informatics at Oregon Health Science University. I am currently an RN with a little over four years of experience. I have also worked as a Systems Analyst for about two and a half years going to Nursing school. So here I am, attempting to merge the past and current knowledge. The University's Clinical Informatics program offers several tracks (R&D Scientist, Clinical Leader, Programmer, etc.) amongst which is the Health Information Management and Exchange Specialist track. According to the Department all other tracks require a 20hr/week study commitment, while the HIM track requires 30hr/week. The HIM track also allows graduates to sit for the RHIA credential. Given that I work full-time an extra ten hours per week of studying is definitely a concern. I am already wondering if I should work part-time while I am in school. I wanted to ask the professionals in Informatics field the following question: What are the real-life benefits of posessing the RHIA credential? Does the credential justify the extra 520 hours of study over the next year? Thank you! Jelena

our state does not have unions. this has been a chronic situation, it's been happening over the past several months. nurses have been to manager and complained about assignments and safety multiple times. everyone is required to work 8 extra hours per pay period which is putting stress on staff. we have been pulling staff from other units when they're available. our census has risen two months ago and the babies keep coming and coming. still we're about 2-3 nurses short every shift. yesterday the manager told the new orientee that she had to show up extra over the weekend even though the girl had planned an aniversary vacation with her husband. the orientee is young and this is her first real job so she said yes. the girl is not even on the matrix yet. she'll end up hating it here. tonight - a day nurse working a 16h shift with two HFO/NO/pressor babies, a nurse w/HFO/NO/pressors and a feeder grower who is to possibly pick up another pt, nurse w/a post-op vent and 2 feeder growers. A whole lot better than last week.

All right, tonight is my 3/3 in a row, night shift and last night was probably one of the worst nigths my unit had, the only worse thing would be a patient dying. On my 1st night the unit was busy and understaffed. I started out with 2 patients, but by 2300 I ended up with 3 babies out of which one was a term Grade 3 IVH on HFO/NO, double pressors and multiple meds, a term on HFNC and fluids/abx + bradys and a 32 weeker on NC/fluds and bradys. I should have had a 1:1 assignment. Lost 2 IV's in the middle of the night. I got help with one assessment. I thought my 1st night was awful until my 2nd night. We're a level iii, no ecmo... 2nd night we started with 26 babies with about 4 nurses w/4 pts, rest had 2 to 3 pts. Our unit has individual rooms and it's very long and spread out. We lost a nurse at 2300 who had 3 pts (she did a 16h shift), then another nurse fell ill (she was ill the previous day and decided to come to work) and was literally green in the face. She walked away and we had to absorb her 4 pts. By 2300 i ended up with the same assignment from the day 1. By 0200, I got another 32 weeker because we got 2 admits, a term with seisures and a 27 weeker who didn't look very compatible with life who also ended up on HFO and pressors. At 0200 since we had to absorb 7 babies + 2 admits everybody except for a nurse who had 2 babies on HFO/pressors had 4 patients, she had 3. Our charge nurse (who had 4 pts herself at this point) had called everyone who was at home and nobody wanted to come in. Finally at 0500 the manager showed up to be helping hands, and I transferred my "feeder-grower" to level ii which is in another building. Level ii nurses wouldn't take a HF baby so we stuck her on NC at 1L. The girl who got the 27wkr was drowning. I fed one of her babies and helped with admit just minimally and felt really bad that I couldn't help more. I knew that because of the situation we were in, everyone was providing pt care that was unsafe. I felt really unsafe, my back was in knots. I was writing down everything I did because I was so scared that I'd forget something. We all made it through the night and most of us were able to chart out by 0800 except for the nurse who had the 27wk admit and the charge. I love my job and love the unit, but dreading coming to work tonight. After two days of this I am physically and mentally exhausted and will probably have to face having the same assignment as day 1. I just hope that everything will be ok... Our unit is in process of training 2 new orientees (none were working last night), we have no techs on nights and currently we're using one traveller.

Hi everyone, My unit has had a volunteer cuddle/hold group since last April. I work in a 34-bed unit. Last year our Unit Based Council voted that cuddling would not be a standard of practice, meaning that we have to have a parental consent form signed for every baby that is to be touched by a volunteer. That can be pretty inconvenient at times when a volunteer is holding one baby, another baby is screaming its head off, and there is nobody around to pacify the crying baby. We've had a number of babies whose parents wouldn't show up for several days and here is this 38 weeker... Or here is a baby in drug withdrawal, or abandoned baby. The kind of babies that need to be held and interacted with but are not because parents are not there to sign off. We've had one or two verbal consents done but that's usually done by a social worker. So... If your unit has a hold/cuddle program in place, I would like to know whether holding/cuddling is a standard. I would like to get as many responses as possible in the next two weeks (before the next UBC)... I'm hoping to present your responses. Thanks!

I just wanted to let everyone know that as of April of 2009 our NICU has implemented a cuddling program. It has been quite a trip from an idea to actually getting it all together... (mounds of paperwork). We now have four active volunteers and will be bringing more to the unit soon! :redbeathe

i agree that in most cases the two roles could interfere... i was thinking if i pursued FNP, since i work as an RN in Neonatal ICU there would be little role confusion if i chose to continue working as an RN. obviously most RNs train to provide advanced practice to patient population they have experience with. however, since it is possible to pursue FNP from pretty much any specialty... if one pursued it from NICU i wonder how much liability would be held against them... simply because only NNPs are trained to deal with that specific patient population. i don't see how could anyone expect an ANP or FNP to know what treatments to prescribe to a preemie or be held to that level of practice...

i am 5ft9in and whenever i have to draw multiple labs from a baby who is in an open crib, i do it on a weight scale. the scales are at least 1/2ft taller than open cribs we have so that helps me quite a bit.

our ot/pt does it every day except on weekends

We have a booklet that we give parents... it contains orientation to NICU, medical terminology, etc. Also we have info that is geared more to the age of baby and its specific medical condition -- these are separate sheets that we add into a folder that we give the parents along with the booklet. Since we have individual rooms every room has a laminate "Parenting based on developmental needs of your newborn" and we encourage parents to read through it... We are working on promoting the march of dimes website as well as shareyourstory.org

Hi Goxy, I was so glad that you took the time to write about nursing in Serbia. I grew up in Belgrade and left for US when I was 18, back in 95. I became an RN here. I had no idea really what nursing responsibilities were in Serbia. I have spent some time researching the educational system in Serbia and it seems while RNs in Serbia have plenty of medical knowledge, their educational level doesn't quite match the knowledge. Let me explain: In Serbia, a student's fate is decided right after primary school. After the first 8 years of education, the kids take tests in Serbian and Math, which is very similar to ACT and SAT in America. However, different high schools in Serbia accept different percentiles so one may not go where they want to go because their score is not good enough. Also after primary school, the student must decide if they are going to a technical school or nursing school!! So, when a 14 year old enters the "Medical School" it's really a Nursing school. They attend classes in sciences, have labs, do clinicals, etcetera for four years! After that they may choose to attend more school ("Higher Medical School") for another three. STILL - even after all this education and practice they don't have a college degree, and from what I understand their scope of practice is far narrower than in the US nurse. The highest educational level I saw in Serbia was called "Visoka Medicinska..." something close to "High Nursing School" which is actually equivalent to vo-tech education here. I've recently read about Polish nurses who tried to get jobs in EU countries and their qualifications were not accepted, despite years of training and experience. ! Goxy, I hope you still read this website, I would love to compare the nursing professions in Serbia and USA. Pozdrav Jelena

thank you everyone for your replies!

i wear contacts and use saline solution to clean my eyes. the liquid produced in eyes is closest to saline. saline is definitely more comfortable than water...