ilstu99

Interview around. Take tours of the units. Meet some staff members. Get to know the managers a little. They'll be loving you, so you need to decide if you love them. Then go with your gut.

Medium. There are multiple providers on the floor during the day, and usually a couple on nights and weekends. They do all dressing and equipment changes PRN. It seems to work for us. If I need a culture or there's an issue, I just ask if they have a few minutes, and we get it done. In a real pinch, someone on the flight team can do it, but that would be rare. Our line infections are almost non-existent. When they do happen, the team "gets to" participate in a non-punitive review of care to see if they can figure out where the breakdown might have happened. The only providers I never ask are the residents. They're the bane of my existence at the moment.

Either an NNP or an MD.

We don't use soap until they're > 1500g. Under 1500g, we use the soft gauze, and warm water (also the Enfamil stuff, left in the isolette). When they move to soap baths, we use an Aveeno baby bath.

We were pretty slow at the end of August to the middle of September, but we've picked right back up. I swear, there must have been an IVF party somewhere about 6 months ago. We're packed to the gills with multiples.

It sounds like it's going well! That's awesome. Those itty bitties don't seem to know they're so tiny. They have a lot of 'tude! Let me tell you...the first time someone asked ME for an opinion, or for a hand...I was like..."ummmm.....pardon?" I probably looked at her like she had 6 heads. LOL. You really do become great at it, and in a few months, the "newbies" will be looking to you for help. :)

So far - 26. My favorite resource RN had a transfer admit who was at 34. I don't want to even imagine!

We change at the bedside. Clean technique, plus mask. TPN/clear IVF tubing Q72. IL/insulin/aminosyn tubing Q24. RN's don't change anything other than the tubing on any central line. Any other changes - especially claves and hubs....are done by providers via sterile technique. RN's change everything on PIV's.

Are there less-popular, alternate locations for the NCLEX in your area? I drove a little farther, but it was worth it. Less traffic, cheaper hotel rooms, and less people to take the "good spots." If no....do you have your orientation schedule? Is it 5 days a week? Do you have "classroom" sessions, or is it all in the unit? I would say that the type of orientation you have will determine the day that would be best to take off. I would make sure to be present for "classroom" days, and reschedule the unit days. The babies will always be there. The chance to sit down and ask questions? Not so much. I certainly think it's okay to call your NM and ask for his/her input about the best day to reschedule orientation. Everyone remembers being stressed at NCLEX time - I don't care how long they've been a nurse. As for the notebook - do not make yourself crazy trying to write everything down. There's simply too much to take in. You will get it with time. No one expects you to be proficient in a week. If you DO want to take notes, write down questions and terminology that you aren't familiar with....rather than "how to" notes. The unit's policies should be in writing somewhere, so copy or print those...rather than just writing them all again. For now, just focus on getting ready to pass your boards. The job will be there when you're done, and they'll help you with what to bring or prepare. Remember...you aren't supposed to know anything other than the basics. And really, the ABC's are totally the crux of everything we do. Good luck! :)

We don't use heparin in our unit. All lines not in use are flushed Q6. I think there's a thread very similar to this one a little farther down the page.

We use the Vigilon, too. I :redbeathe:redbeathe:redbeathe it. It reminds me of a burn dressing. Super easy to work with, can be cut to size quickly, and holds with just a little webril. The BEST part, is that when it's time for a change, it just slides off. No hurting baby's healthy skin around the area.

"Normal" is relative. A normal term baby doesn't look anything like a "normal" 28-weeker. Some of the skills you will use will cross over, but much of it is exceptionally different: the terminology, the procedures, the population, the assessments, the equipment, etc. Peds doesn't give you much help with NICU readiness, unless your facility has a special designation for babies and is very busy. All of our very ill babies who have been sent home are readmitted to the PICU, not the regular peds floor. Don't get me wrong - all experience is good, even when it's bad. But don't choose to move from unit to unit in an effort to gain experience for your "ultimate goal." New grads around here are told that it takes 3 years, MINIMUM, to claim "proficiency" within their department. I went to the NICU as a new grad, and I don't think I'd do it differently.

No...no covering. The stump dries, and the access spots kind of shrivel around the lines. Nature's little Tegaderm. We don't even bridge, or tape the lines down. We put tape around the line, and suture that.

Ours is a closed unit with an open floor plan. No windows for "viewing." Parents are allowed 24/7, except during shift change. Parents can designate 2 "support persons," if they wish, who also can have access 24/7. All other visitors must be accompanied by a parent. After the initial wave of "awwww, new baby" visitors, no more than 2 people at the bedside. No one under 14, except siblings over 5. Supervisors and NM have discretionary control over allowing or limiting in a particular situation.

No. Our volunteers don't do any patient care. The only babies that our techs are allowed to hold are in cribs, so generally the grower/feeder population. Even then, we still practice developmental care and cluster our hands-on interventions. The only exceptions would be the kids that are closer to daycare, but we don't often have very many of those. So our need for a cuddling program would be pretty slim.