Mithrah

While I am not technically called PRN, that's basically what I am. I get no benefits. No healthcare, no PTO, no sick or vacation, and I could get 401k but I am not signed up. I'm part time and work for $27 an hour. Last year I worked every holiday and they refused to pay me time and a half. So weekends I make $27/hr. Christmas Day paid $27/hr. I'm not happy at all with this. But my current personal situation has me here for awhile longer. There was a time I made $50/hr and had 5 weeks vacation a year and paid $5/ pay period for HMO insurance. Life takes a turn sometimes. Just have to roll with it. Please don't tell me to quit. I know that's my plan as soon as I can. The ultimate compensation is *where* you live.

We ship out our babies to another unit to have the eye injections. I read that it is cheap. Only $40. Here is an excellent article that I found very informative: http://www.wellsphere.com/general-medicine-article/avastin-lucentis-update-45-avastin-drug-treatment-of-rop-better-than-laser/1369713 Even the drug company doesn't endorse it for ROP. But of course the studies are few and long term outcomes have not been evaluated.

I think that this woman may be able to afford her kids after all. There is a book deal and TV deal in the works. And I am sure she'll make millions from it. They say now it takes $300,000 to raise 1 child from age 0 to 17. That is 14 kids X $300,000. That is 4.2 million. But we know she'll spend less because her kids will have to share toys, share clothes, be babysat my grandma, etc. So if her book deal or TV deal works well for her, then that means everyone can settle down and not have to worry about their tax money going into her pocket. Also, I have actually heard that Medical (the free health insurance in CA for poor people) will provide free IVF to women. They say they can't deny a woman's right to have children. Just wanted to clarify that for some of you. I guess I just can't get over how loose her abdomen skin must be. I guess she'll need plastic surgery to fix that.

I see quite a bit of ROP in the unit I work in. More than there should be I think. Just wondering if it is because of our narrow alarm limits. Our alarms are set 88-93%. As you know babies are always up and down on their sats. Therefore the nurses and RTs are constantly turning the oxygen up and down all the time. When they desat they increase the O2 a lot to higher concentrations for several minutes. Wouldn't it make more since to keep the oxygen level as low as possible for as long as possible instead of weaning and weaning until they desat and then have to cank up the O2? What are your alarm limits set at in your unit?

Now she has to pay for 14 kids! Was this IVF or fertility drugs? What do you think and why.

I think the best thing you can do is go to the school library and borrow NCLEX review books. Read as many questions and answers as you can. Practice practice practice. You'll learn block 3 stuff when you get there, but ultimately you want to pass the NCLEX and I always recommend those books.

It sounds like you are a great nurse! Don't let it get you down. Many facilities actually enjoy picking on the travelers. As long as you provide safe, quality care to your patients who cares about the trash!

Hi everyone, I just started a new job in a NICU and find this NICU very different from the other 4 I have worked in. I just want to cover some things I see in this unit and then you tell me what your unit does for comparison sakes. This unit does not have regular pacifiers for the babies. Instead, they take bottle nipples, stuff them with gauze and then tape them to a rolled up baby shirt that is also taped up. Are there any other units out there that don't offer pacifiers? The unit is so worried about saving money they want us to share formula. I have never heard of this and it bothers me that the bottle says to discard after 1 hour and this unit thinks it is okay to have it sit out for hours and hours at room temperature. All babies on oxygen here have the high alarm limits set at 100%. I though the new standard was to have limits set somewhere in the mid 90s. Also, nurses aren't allowed to adjust the 02 without a doctor's order. Here they do narrative charting plus the check box charting. The narrative is really redundant and they want you to re write everything every 3 hours. TPN tubing is changed daily here. Everywhere else I've worked it is q 3 days. Nurse here don't answer alarms (rarely) since it is so hard to determine who is alarming. Most of the monitors (Drager brand) are flashing when I look around the room and it is even hard for me to determine who to save. No accurate diaper scales. Here they have to put diapers on a regular baby scale so it rounds to either 5, 10, 15, 20, etc. Hand written MAR. Handwriting is hard to read sometimes so I would think this would be a big no no. Anyone else doing this? No developmental Snuggle Ups, gel pillows, Bendy Bumpers, etc. Any other units out there without these? Lights on bright at all times. Any other units out there refuse to dim lights at night? During report time most nurses are always late so the rule is to have whatever nurse who gets there first to get report on ALL babies so they can relieve you. I am just used to giving report only to the nurse who has my patients. OG tubes only here. Guess I am just used to NG tubes! Blue dye on umbilicus. Thought this was a bit outdated. That is all I can think of for now. Please compare and let me know what your unit does.

I applied for my NY license back in late Feb./early March and here it is June already and I don't have it. Does anyone know how long it usually takes? I looked on the website to call, but couldn't find a number for that. I am trying to be patient, but hoping they received everything and aren't waiting on something I may have forgotten.

I like the brand S.C.R.U.B.S. They are very soft. Check out smartscrubs.com

I used to live in Phoenix and all those hospitals are pretty good. I can't say a bad thing about any of them. My friend used to work tele at Osborn and liked it. Scottsdale would be the best place to live in that area. When are you thinking of starting your travelling position there?

There are a lot of really great NICU products. I especially love the Neosuckers. My last job didn't have them, and when my patient needed to be suctioned it was never effective or sufficient. Now at a different NICU I use them all the time and they are wonderful! I also love... Pampers for very low birthweight babies instead of Wee Pees. I love sterile water bullets and NS bullets. Feeding pumps!! My current job makes me hold the syringe for the feed. (Why???) Paper MAR! The computer seems more unsafe. I like to have that MAR at the bedside. Frederick T. Frog Leads that actually stick!

I have seen Cyclomydril drops given 3 times with 5 min. inbetween. Then 1 drop q hour until Dr. arrives. Also seen Cyclomydril given 2 times with 10 min. inbetween. I think this is an eye doctor's preference. Not a nurse's or neo's. Tylenol is ordered for PRN pain. But I have seen amazing eye docs who don't cause any discomfort or bradys!

I wonder who quoted you $24/hour because that is quite low for San Diego. I was making $24/hour in Orange County (just N. of San Diego) a year ago. But remember, in CA, anything over 8 hours is time and a half (anything over 12 hours is double time). So I was actually making like $28. With COLA (cost of living adjustments) I quickly got bumped up to where my blended rate was more than $33/hour. I would work an extra shift once a pay period and I was paying almost $1,000 a pay period in taxes. Of course I am single with no kids. But the taxes there are really high and the housing prices are high. My own apartment + utilities would have easily taken 50% of my net income. Instead of that I opted to get a roommate (where I rented a room in a house for $900/month). See, not cheap! Gas is more. Car insurance is more. Food is more. For you to take your wife and kid to Disneyland it'll cost you $189 just to get into the resort! I don't know how people afford it. I knew married couples making $120K/year and struggling. Of course this is the state where many people have 40 year mortgages. Now I am a travel nurse and happy as can be. And just so you know, I hear TX is a great place for nurses as far as cost of living and there is no state income tax!

I did this last year and what a waste of my time for only $16/hour. Maxim was the company I worked for, and yes, they do pay very poorly. I did it more for "fun" and to get out there for the experience. I doubt I would ever do it again unless the pay was at least double that.

I accrue 8 paid time off (PTO) hours every two week pay period regardless of how many hours I worked. So that equals 208 hours a year, or 17.3 days off each year. I hardly take PTO because I get to self schedule myself at work and I can schedule myself to have 9 days off in a row without taking time off. I just have to work 6 days in a two week pay period. We get the option at Christmas time to cash out our PTO hours, but we have to keep available a min. of 40 hours worth. PTO hours are also used as sick days.

The secret to happiness is having low standards.

I really enjoy teaching the parents on how to care for their baby, but at the NICU I currently work for there are no specific things to teach them (like a check off sheet). Basically they watch a CPR video, go to a CPR class, taught to keep their baby on their back, and then out the door. Also, teaching doesn't tend to get done until the day of discharge and our unit recognizes this is a problem, but never does anything about it. And then it gets more complicated when we need a Spanish interpreter. How does your unit do discharge teaching? Do you have a check off sheet? My old job used one and I really wish I had that sheet. If only I had a copy! I am looking for a simple one page sheet if anyone has one. If you do, private message me and I'll give you a fax number to where you can fax it to me. :)

I made a transition from one state to another going from a Level III NICU to another Level III NICU and it was a such a huge shocker for me. There are so many different ways of doing things. For example: My old job - used heel warmers before heelsticks, had appropriate diaper sizes for all neonates, used the Neosucker to suction nares and oral secretions, never poked the big toes or fingers on preemies, gave developmental baths, gave blood only when the baby was symptomatic and absolutely needed it. And central lines were put in ASAP when babies were going to be on TPN and lipids for several weeks. My new place of employment doesn't believe in heel warmers, uses Preemie Pampers on 1700 gram babies (lol), uses pediatric nasal aspirators, developmental baths are unheard of, loves to poke big toes, gives blood like it is candy when the HGB drops below normal, and central lines get placed, but very few nurse are able to place them and it can take weeks for a 27 weeker to get one. The list goes on and on, but when you have the equipment you need at one NICU and go to one that can't afford even appropriate diapers sizes it can be frustrating and annoying. Good luck to you and your new job. I hope that you work at a place that embraces change and thinks of the babies. The reason you are there are for the babies, but I guess some NICUs don't understand that.

I just wanted to share this with you all. There is a new nurse in the NICU unit I work in who has over 10 years experience in L&D/healthy baby. She started the same time I did at this place and the very first day there she was precepted to a baby with PPHN. That is right, she precepted on the sickest baby in the unit and was absolutely terrified and overwhelmed. Understandably she is thinking about quitting and going back to L&D. If you get the right training (like I did at my first NICU job) then you will feel comfortable and confident. Make sure you check out the unit and see what kind of training structure they use. One should start with grower feeders, RA (room air) babies, then on to nasal prongs, NCPAP, then to vents, oscillators, and drips. Organization is key to your success. Plus, you should have classes during your orientation. In my opinion, orientation should be at least 3 months.

I have spent a long time online searching for the route on how to give epi. Today during my PALS class I was informed that it can only be given IM, IV, or endotracheally. But my nursing pharmacology textbook says the routes are SC, IV, or PO (which I assume is via the ETT). Online I found some websites with conflicting info. Basically I want to know the emergency routes for epinephrine when someone needs it in case of shock (cardiogenic, anaphylactic, etc.). Also, is the Epipen IM or SC? I searched and it said to inject into the "fleshy" part of the thigh. Very vague! Also, I give flu shots this season and was informed that in case of an anaphylactic reaction, we are to give epi SC behind the arm. Someone please clarify! Thanks.

I have never smoked a cigarette in my life. I used to never know a single person who did quit smoking, but just recently I met 4 people who have quit 100%. And they all did it the same way: cold turkey. You are not imprisoned by your cigarette smoking. Just quit. If others can, you surely can.

My friend from nursing school actually worked with a lady who went to that school. My friend was amazed at the lack of education she received and how she didn't even know her medications and their actions. Maybe it is different now or it could have just been that individual. The Skills Center is known for helping the underprivileged.

I have an AZ license and applied for a CA license in mid April. So far it has been 11 weeks and I am still waiting!

(1) How long does it take to become an RN? 4 years for either an ASN or BSN. (2) Once you do become an RN can you pick and chose your area of work you want to concentrate in (like L&D?) Yes, all my friends in my nursing class got what they wanted. (3) Do all RNs have to start out working nights? No, I have nursing friends who said they would only work days and got days. (4) What are the things that most people DON'T know (or realize) once they become an RN that may be difficult? Dealing with family members of the patient. Working holidays. You may not get any breaks.