dance45

Depending on your personality (and let's face it, all nurses are a bit anal-retentive), you're going to be stressed out in orientation no matter what. It's the nature of the beast. It's a new environment, new people, new situations, things you've never seen before, procedures you've never done, blah, blah, blah. And I'll tell you, there were some times I thought I was going to have a nervous breakdown. And I didn't orient initially in a level III NICU, I was in intermediate (or step-down, with the feeder/grower babies). There were good days and bad days. When I finally felt like I had my ducks in a row, I transferred to level III. Best decision I ever made. I recently went back to work after taking off several years to be a stay-at-home mom. Keep in mind I had nine years prior experience in NICU. But, I was nervous as a long-tailed cat in a room full of rocking chairs, I was scared to death, thought I was going to kill someone or maim some child for life. (Sometimes I still feel that way.) Luckily for me, I had fabulous preceptors and the unit I'm working in is very much like a family. I was sometimes embarrassed to ask certain questions, but I always asked. I didn't care how stupid it made me look. As a new grad, you don't know what you don't know. And I mean that in the nicest possible way.:) Please don't interpret it as condescending, it's simply the truth. Just realize that everyone's been in the same boat. If you don't know how to do something, why you're doing something, or if something just looks funky to you, for goodness sake, don't be afraid to ask. The only stupid question is the one you DON'T ask. If you need help starting an IV or getting labs, ask for it. If you don't understand an order or why a certain doc does things a certain way, ask the doc or a nurse who's more familiar with the status quo on the unit. My hat's off to you for completing nursing school and going into this difficult but rewarding field. You go!!!

"Another situation that comes to mind when parents want to "fire" their baby's nurse is when you happen to have their baby who has been doing very well then they decide to crump on your shift. The parent's tend to think somehow you are at fault even though you are not." I hear ya. I had that exact situation happen to me not too long ago. I "fired" myself from caring for that child. I could hear the mother in the background whenever I talked to her on the phone writing down every word I said. I had to spell my name several times for her. Her child ended up needing substantially more oxygen support at the end of my shift. The next shift I worked, as I was walking in, I heard her say to the nurse about to give me report, "Oh, that's the nurse who had her last nite." And you know she's blaming the fact that her baby needs more support on you. Sheesh! I felt sorry for the infant, as she is a sweet child who is (unfortunately) developing into a chronic lung kid; but, I didn't want to put myself in that position. My license is too important to me.

To Preemie RN Kate and Steve. Thanks for the input. I came up with 0.25 cc for the dose if diluted out to 0.2 mg morphine/ml. Because if you draw up 0.1 ml of the 2 mg/ml concentration and add 0.9 ml NS, you still have 0.2 mg/ml. It's not a 1:1 mix. Does that make sense?? I tend to be a bit anal and check and recheck my calculations. I've only ever done NICU during my nursing career. I wouldn't even consider any other area. And I know the margin for error is non-existent with the little micros. I want to make sure I'm doing everything correctly, and do what's best for the babies.

I feel your pain. I recently went back to work after 7 years off and I had worked NICU previously for 8 years. Talk about nervous as a long-tailed cat in a room full of rocking chairs. I felt like the biggest fraud on the block, and still do many shifts. I certainly feel like more is expected of me since I did NICU before. I still feel like an idiot half the time and I've been back at work for almost a year and a half. The nurse who emailed the manager was totally inappropriate. It's a shame that she was not more supportive and helpful. I've always heard that nurses have a tendency to eat their young; she's just living up to that. Hopefully, she's the exception and not the rule in your unit. Don't let one person muck up your whole mindset. You will become more confident and comfortable as time goes on. There's nothing you can do except get the experience and learn from your peers. It does get better. My biggest piece of advice for you would be don't EVER be afraid to ask a question. Whether it's respiratory, meds, asking the docs or seeking answers from your fellow nurses. It's better to ask and feel like a complete boob than to assume you know the answer or can figure it out yourself. Especially when you're starting out, you don't know what you don't know.:nuke:

Back to nursing after several (and I do mean several) years off. Hence I haven't given morphine in quite some time. Just wondering about IV morphine preparation for extremely small doses in the NICU. Ordered 0.05 mg morphine slow IV push q 4-8. On hand morphine 2 mg/ml. How far do you dilute the concentration? If you make it 1:1, you can't possibly draw up 0.05 cc in a 1 ml syringe. And how do you make it 1:1? Just add 1 cc NS to vial? I don't want to appear to be a complete idiot, but the practical aspects (i.e. the actual physical prep and admin of certain things) have left me over the years.