asher315

I remember in school being told over and over again that a good nurse was a life-long learner and there you are. You can be retired but you will always be a nurse! And someday I hope to be you-retired! I'm at 32+ years and counting. Enjoy your book!

Arkansas Children's Hospital in Little Rock.

In our unit, most incubator babies are feeder/growers with temp problems. Rarely they might have a PIV but nothing else. Our incubators are oriented parallel to the wall and babies heads are usually on the left side. I like to change my babies position from time to time and will put their head in the other direction because they do get a bit flattened on one side (and I like to mess with the next nurse's mind!).

Check with your pediatrician. They would know the hospital and staff. Best wishes to you and your family!

Newborn was 2 days and had an NG and PIV running. Don't know what the doc was thinking.

How fast a resp rate is too fast to po feed? Recently had a doc go ballistic because the nurse "defied" the order to remove NG tube and po feed despite the infant with rr 70-100"s. Anybody have any input? Won't tell you what our director said about the situation, makes me angry just to think about it! Thanks!

I just lost 2nights shifts because of ice. Snow, rain, tornados I can handle, ice just scares me. I have a long driveway, country roads and several bridges and hills to navigate and ice makes it almost impossible to drive. My agency doesn't like for anyone to call off but they understand and so does the family. Back in January, before a big ice storm was predicted, was scheduled to work 3 hospital shift and 2 PD shifts. I opted to stay in a motel in town for those days. Had a good rate and quiet room and did not miss any work. You do what you have to do.

I was always taught to give ampicillin first then gentamicin 2 hours late to avoid incompatiability. Is this still the way it is done? Thanks for your help.

I work in a Level 2 NICU and we deliver approx 1800 babies a year. With the new Medicaid changes, we are really being pressured to improve our breastfeeding numbers, especially no supplementation, AT ALL, (despite a mother's request) only with a doctor's written order (not happening here on night shift!) and for with a medical indication. That would be great, if it were a perfect world. Some mothers want to BF during the day but "just give my baby a bottle tonight", they don't want to room-in so they can learn their baby's cues. They don't read or attend classes. They think it is "natural" so it must be easy! We've had babies with a 10% weight loss in less than 48 hrs. I know that BF is best and I will help any mother to BF. But I think something is wrong with the whole picture. (We have 1 FT lactation specialist and 1 PT, not enough to go around!). Okay, felt good to let it all out.

The funniest "oops" I've heard lately: The hospital operator announces overhead: "Would the owner of a black vulva, parked in the ER parking lot...." Repeated it 3 times loud and clear.

I worked in Florida with a Dr. Arriola, obgyn. Then there is Dr. Money, pysch. And I saw a print ad with a dentist named as Dr. Fang.

We had a nice one "We deliver miracles daily". And BTW, we get pizza delivered alot to our hospital!

My manager just spent the week at a hospital across the state, meaning her room and meals provided, to observe how they were surveyed by JACHO. Maybe I'm the crazy one, but wouldn't it be better for her to stay and manager her own unit? Of course, she has a team of underlings to do this. I understand the need for inspections and accreditation, but this place is absolutely manic waiting for THE visit. Just my one cent! (the economy is bad!)

We do glucose at 30 mins of age for SGA, LGA, IDM and any NB having needed resus. At 2 hrs for any newborns "at risk" mec fluid, jitteriness, If the 40 we do prefeeds until feeding is stable and glucose > 50 x 2. We can also can do one for any s/s of distress. Also, with the first check we do a hematocrit. asher315

That's the way I got into Nursery- two years after med-surg. Having 2 years as a working nurse gives you alot of experience in time-management, working with drs and other staff. The patients are different and challenging. The families can drive you crazy. There a very happy times and very sad ones. And you can hold and sing to your patients. :wink2: Good luck!

I attended a delivery just a few weeks ago where the pt had doula and wanted to go as natural as possible. She was GBS positive and had an IV for antibiotics. During labor her IV came out and as she was close to delivery the OB said leave the IV out but only if she agreed to pitocin Im following placental delivery. She agreed and everything was cool. The delivery went great, she did great but after the placenta delivered, you guessed it, she began to hemorrhage. The patient's mother was present and was a nurse, when she saw the bleeding, she asked the OB if the pt needed an IV. The OB said yes if she'd let us. The pt's mom said, she'll let you and the charge nurse got one in the ac. While all this was going on, there is fundal massaging, IM methergine and lady partsl Cytotec. All's well that's ends well and it was a great labor and delivery (natural as opposed to numbed and up in stirrups, draped, etc). Alot of interventions we do in L&D are just for our convenience but I think IV access (saline lock or running IVF) is always a good idea.

Hi I work in a Level II and I love it!. I have tried Level III several times over the years and truthfully, I'm not cut out for it. But I learned a lot of useful things. You will bring a great deal of skill and information to the unit but you will also learn a great deal. I'm assuming that the Level II is also a delivering hospital. Dealing with a "new" term newborn is always a joy and a challenge because you can't trust them or their mothers.:) Remember to be prepared for anything and let the baby prove him/herself. You may find it boring but you may enjoy holding a baby that weighs more than a sack of flour. Good luck! asher315

Thank you for all the input. Nell, you answered it best. The bilimeter reading depends of the strength and type of lights as well as how close they are to the baby. Now I know why it seems to take forever to get the bili levels down. Thanks again, asher315

I read an article last night about phototherapy and it said the bilimeter reading should be about 50 (whatever their measurement is). Our P&P says 12-14 (whatever). What is every one else using as a guide for effective phototherapy? Thanks, asher315

I used to work in a small hospital and they had the policy that if there were no OB/PP/NSY pts, that everyone was "on call" (must get there in 30 mins) and 1 nurse was left to sit/help in ER until a pt came in (all pts came in thru ER at night). A pt did come in and everyone was called to come in (2 more nurses). The problem was the pt began seizing before anyone else came in (how rude!!). It was several minutes until the nurse could get to the phone to call for help. After that, there were always 2 nurses on the unit at all times. Ya know, "outsiders" think there is nothing to caring for a laboring pt (or her newborn) but just ask them to help..."I don't know nuthin' about birthin' no babies" is the standard (trying to be cute) answer. Such is life! Bravo for standing up for yourself and the other nurses this could happen to as well.

We use the QS system and I think most everybody is used to it and likes it ok. Wouldn't it be so much easier if we could just "speak" and record all the info. "Vital signs-temp 98.0, hr-78, rr-18, fht's 146 with good BTB var". Of course, all the work would be in "editing" if the mike was left on. LOL! "Dr. Johnson is such a twit" etc, would not be good in a courtroom proceeding (even if true!!). We also use Meditech, Logicare and Formfast. The big problem here is we have to chart on paper for the peds to "see" the vitals and feedings and then put them in the system as well. I hate double charting! Merry Christmas!

Sounds like my place, too! I have tried the large Level III's and I keep coming back to the Level II's because I like the challenge of a stablizing of a very sick baby and sending them elsewhere. But I really like the TTN's, feeder/growers and pneumonia kids that get better and go home usually in days to 3-4 weeks. I like working with the families. And I am amazed every time I go to a delivery at the complexity and beauty of the starting of a new life! I work in a 6 (official number) bed ICN with usually 2 RN's on at all times. We attend all high-risk deliveries, all c/sections and some "normal" ones. We transition the c/s babies and help with assessments and general nursery duties. I learn alot from all of you, thanks!

I worked in OB and we used to save the "clean" placentas, freeze them and sell them to a cosmetic company. The mec ones either went to path or down the placenta grinder. After reading all of these, I think its safe to say that we're not getting older but improving with age.

The GP's ruled every area of the hospital. They delivered and cared for newborns. They did all types of surgery, critical care and the ER.

$15.00 gift card from Kroger's. Same as last eight years, atleast it's not taken out of my check!