curly73

I have realised over my 15yrs of nursing that everyone feels out of touch with reality on the night shift, check out with other nurses you may know or have a chance to work with. I have many times had giggling hysterics with my collegues at 4am over something not really that funny! I ensure I double and triple check my planned list of pt activities cause its easy to miss something. You have to practice good self care when you're on nights like eating healthy meals at regular intervals even if eating breakfast at 2am feels wierd, and then i try resting as much as you can when you're off and still doing some exercise the week I do night shift if at a reduced intensity and duration. When I finish night shift I try to have some facial direct sun time on my days off to help with the reset of the internal clock. Kind of like jet lag treatment really. Messing with the normal rhythm of being awake when you should normally be asleep is what makes the night shift difficult as your thinking processes are somewhat challenged and I figure is why so many mistakes that would not normally be made can happen at 2am. And daytime sleeping after night shift is never as restful as nightime sleep so give yourself a chance to catch up once you finish night shift.

I have always used 0.5 - 1ml or cc/kg/hr to be a good range hope that helps you to calculate so if a 3kg baby then 1.5 - 3mls/kg/hr or in a 12hr span at 18-36mls, or for your 75kg person 38 - 75mls per hour or in a 12hr span then 450-900ml is adequate, of course assuming reasonable hydration and ongoing fluid supply. Hope it helps.

I always look forward to working with a new nurse who listens, who asks a million questions, especially if they are not sure about something, and who remembers what has been previously discussed (may I suggest a little notebook in your pocket). Also make a list of everything you have to do for your patients, and ask for assistance to priortise if you are getting behind. My biggest hope is that you quickly learn to do a total patient assessment, and are able to figure out what is a deterioration or an issue that needs something done and how quickly should this be done. Best wishes in entering an exciting profession, no one expects a beginner to have everything at your fingertips, that comes along as your experience grows.

We have several paper fluid balance sheets that we use in our hectic paeds ward with varying accuracy. Which may give you some ideas. We also ensure that the offgoing RN charts are checked by the oncoming person as a part of handover process and any discrepancies sorted there and then. Am happy to send you some fluid chart copies if you could let me know where to post to.

We use the duoderm/comfeel on the cheek to nares (to dry skin, warmed with a hand to stick) with elastoplast tape on the tube, sometimes an extra elastoplast loop onto nose, but some children do react. We have also tried just using the white stretchy hypafix/fixomull tape straight to face. Have had some recent sucess with a product by Salter Labs called a 'cannulation fixation device' or Tendergrip, which is a round dot - kind of hypafix looking, with a highly sticky clear inner section, and a clear plastic cover that is reusable/lifts up and down. The skin under tends to breathe better and we use two dots, one near nares one on cheek, to hold to NGT to a little face. We find this is also much easier for the single operator to apply or reapply as you can leave one in place while replacing other. hope that helps cheers