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palesarah

palesarah

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palesarah's Latest Activity

  1. palesarah

    Maine NICU jobs?

    a little late to the party, but... MMC's is a 51-bed, single room model with the exception of the "transitional nursery." The NICU consists of 3 pods- 2 with 10 private rooms each, one with 8 private rooms plus the 3-bed transitional nursery. All babies born 35 weeks & under are directly admitted to the NICU. The transitional nursery is for babies 36weeks & over that don't really declare themselves right away... or maybe they need a septic workup but are acting appropriate so can go to mom's room after, etc. It's extremely short-term- 6 hours or less, then admission to NICU or transfer to mom/baby. The other 20 beds are two, 10-room pods in CCN, which is basically a level 2 step-down nursery. Mostly preemies in the NICU, 23weeks+. The occasional cardiac kid needing stabilization before surgery, term babies with term baby issues, etc. Feel free to PM me for more info.
  2. palesarah

    Tips for a neat bed?

    double post, sorry
  3. palesarah

    Tips for a neat bed?

    Funny how something so simple has so many solutions. What we typically do: one blanket to completely cover the isolette mattress like a sheet, edges folded under. Second blanket, slightly smaller, to place baby on. We use cloth diapers to roll up for barriers- one for each side, 1 at the feet- and place those under the second blanket to make a little baby nest. We fold a cloth diaper in half and place under the baby's head (babies We neaten up the edges of the second blanket however we can, so the diaper rolls can't be seen usually, but most importantly however is necessary to position the baby properly. Sometimes instead of diaper rolls I'll roll a regular receiving blanket into a roll and use that for the nest. Sometimes I add more diaper rolls on one side or the other. It all depends on the baby. We can get really competitive about our beds, though, lol- it's kind of a running joke. The standard issue hospital receiving blankets are white with bunnies. Once the baby is stabilized (or stable enough) and clean, we usually change the blankets to something cute and matching, or at least clean bunny blankets is the nice blankets are all in the laundry (sometimes happens on the weekends). And a pox is wished on any nurse silly enough to make a bed with the bunnies facing the "wrong" way or with unmatching blankets, lol. Some people truely can't get through the shift without changing the bed if the bunnies are in the wrong direction! I think the NICU attracts a lot of us with little OCD traits, like that
  4. Thanks for asking because I couldn't figure it out, either, but figured I must just be tired and brain dead too and didn't want to ask!
  5. palesarah

    Halloween in the NICU

    The Build-a-Bear outfits are perfect for those 3-5 pounders! Last year one of the babies' parents bought a Superman outfit, complete with built-in muscles, it was adorable. Another baby got all dressed up as a Patriot's cheerleader for one of the games. It was adorable! Recently one of the baby's grandmothers found a stash of perfectly fitting DOLL clothes at a dollar store- she ended up using some of them for patterns to make even cuter outfits out of less scratchy fabrics. We didn't do much for Halloween on our unit, today. One of our big chronics got dressed up and a few had hats and such, but that was about it. i wished I had made some things to bring in
  6. palesarah

    My Poor Hands have been Washed Raw

    I don't know about lotions that are compatible with latex gloves (or even why your hospital still has latex gloves at all!) But I've gotten half the nurses on mu unit hooked on Goldbond Ultimate Healing lotion. I have extremely sensitive skin and if I don't use a good lotion, my hands are falling apart halfway through the shift.
  7. palesarah

    Strengths and weaknesses

    I work in a 24-bed Level 3 with a separate 11-bed Level 2. We do pretty much everything short of organ transplants and ECMO, but cardiac surgeries (besides PDA ligations) go elsewhere in the hospital to recover. We're moving to a 50-bed, single room unit in less than a year.(with Level 2/Level 3 still somewhat serapte but no longer separated by other units!) I don't know our actual rates, but I'm told our NEC and IVH rates are low. Something our docs are VERY good at is not supporting futile care. The Neos and Neuros are very upfront with the parents and most of the time, when it is appropriate, the parents choose to take these kids off the vent- and are supported by medical & nursing staff. Evidence-based practice is encouraged by medical and nursing, but a lot of change has to be nursing-initiated. If a nurse is willing to make the effort to find the evidence, changes can be made. We have a strong core of experienced nurses- some who have been in our unit for 20-30+ years. Many of the experienced nurses are the ones who initiate these changes- unlike other floors/other hospitals where it is more common (in my limited experience) for such experienced nurses to just go with the flow, awaiting their retirement. Areas of change: Developmental care. Going to the new unit in itself will help. Nursing input has been valued in the development of the new unit, BTW. One of our most experienced nurses is also waging what was once a one-woman war to make these developmentally appropriate changes. Pain control. We have a new Neo who came from a unit that was more aggressive about pain management and I was joyfully surprised to see that our other Neos are not just allowing him to practice as he is used to, but taking a page from his book. Family-centered care. This is a hospital-initated change... change comes slowly. People seem to be waiting for the new unit to magically "cure" this. Initiating breast feeding. The level 2 nursery nurses are excellent at teaching & supporting breastfeeding. Most of the level 3 nurses are scared to death of breasts. We really don't recieve any training in breastfeeding teaching and support during orientation. I came from a "Nipple Nazi" LDRP/Level 2, and even I am loosing my confidence and having trouble with teaching. Apparently the hospital has FINALLY agreed to "give" us a part-time LC when we move to the new unit. Right now, we have to pratically chase them down and drag them over to the unit, when we need their help (not their fault, there's too few of them to meet the need) so that will help. The rest of the change has to come from us.
  8. palesarah

    Family visits

    I've been working on nipping the "family rumor" mill in the bud. If a family primarily makes contact on night shift, I tell the dayshift so as part of report: mom and dad live an hour away, both are back at work, they call in the in the morning and call or visit every evening. AND I pass it on to social work. Parents appropriate, bonding well, etc but have transportation issues, whatever. I'm tired of other nurses or social work creating problems- it doesn't happen often on my unit, thankfully, but even happening once is too much. Anyway- sometimes, it takes families a couple days or even weeks, with a micro, to get over the initial shock of having their baby be born premature and/or critically ill. I like to give the family the benefit of the doubt. If they are truly neglectful or innapropriate, it's usually clear as glass.
  9. I don't know what the job situation is in your area. In some places, staright day shift positions are available in all units- in others, they're not. If it comes down to it, you may have to take a position on a floor or in a hospital that's not your first choice, to protect your health. That's a decision you will have to make. As far as disclosing your medical situation, what you discole in your pre-employment exam SHOULD be kept confidential. I have epilepsy, and ideally I should be working straight day shifts. I'm rotating right now and am planning on going to straight nights for the winter. There are nurses who have been on my unit for over 20 years who still have to rotate- straight days are basically impossible to get on, on my floor. If I need to go to straight days for my medical condition, I will either have to go to another unit or another hospital, and that's all there is to it.
  10. palesarah

    Getting sick when your a NICU nurse?

    When it's a case of "maybe I have a cold, maybe it's allergies, my nose is a little stuffy but not runny if I take Dayquil" kind of thing, most people on my unit will just work through it. Mask on at all times in the unit, gloves & gown for patient contact. Anything worse, I call out. It's not worth it. I actually had strep throat last month- what 30 year old without kids, gets strep in the summer? It was really weird, no idea how I got that (I was probably 5 the last time I had it!), but I did, so I stayed home until I'd been on antibiotics for 48 hours.
  11. palesarah

    How long does your unit leave in UAC's???

    We try no to leave any umbilical lines in longer than a week, occasionally up to 10 days. If the baby still needs an art line after a week, they usually get a radial art line.
  12. palesarah

    Communication with Parents

    :yeahthat: We expect parents to call or visit daily. If there are extenuating circumstances- parents live far away or don't have a phone- special arrangements are made. But we see or hear from the majority of our parents more than once a day. If they can't visit, most parents call several times a day. It's much easier on our unit for parents to call when it's convenient for them.
  13. palesarah

    Need some ideas RE: external NICU appearance

    the entrance to our NICU isn't anything special. Only decorations I'm aware of are the green, pink and blue baby footprints (painted with some kind of stamp) that lead to NICU, L&D and postpartum/newborn. I don't even know which color leads to the NICU. Blue? There's a bulletin board with some NICU grads, and there are also portraits of the neonatalogists and NNPs too. We're moving to a brand new unit in a brand new building in a year!
  14. palesarah

    Is an LNA the same as an LPN???

    I'm not the OP but we have LNAs in NH. They have license numbers, continuing education and active practice requirements.
  15. palesarah

    shift question

    Maybe, just maybe, if I stick it out another 25 years, I might get to permanent day shift. There are nurses in my NICU who have been there 20+ years and still have to pick up occasional night shifts. The few who are actually permanent days have been there longer! The bulk of the nurses rotate 30-40%.
  16. I was under the impression after my last communication with my DON that I will at least have a designated resource nurse for awhile, and they specifically want me to start back on days (I'm a rotator) to get back into the groove. I don't think anyone is expecting me to be able to hit the ground running, except me :)