cswain12000

In my unit, a level III + ECMO, our ratios are never more than 2:1. A vented baby is almost always 1:1, very occassionally we might have a very stable baby with a vented baby. The charge nurse does not have an assignment, and the transport nurse does not have an assignment. We also have a backup transport person who has an easily absorbed assignment, and a first admit nurse who will have an easily absorbed assignment. Admits are always 1:1. In our level II unit, which is separate from level III, and staffed by it's own nurses-assignments are also never more than 2:1. We are very lucky compared to what I have read hear from other units, but overall we are well staffed, and the reason we are well staffed is because we are well taken care of as employees at my hospital.

I just recently purchased a set of custom made orthotics--from a site on ebay!! They were $75.00. They sent me a foam impression kit which I sent back, and with in a week, I had my orthotics. After an initial breaking in period, they are absolutely wonderful!!!!! I was skeptical-purchasing something like that from ebay-but I thought for $75.00-what did I have to lose?? So, I ordered them, and I have noticed a difference in my feet, hips, and my back as well. Now, at this companies website the orthotics are $289.00, but on ebay the very same ones are 69.00 + shipping. Just to let you all know--I am a nurse in Minneapolis-I do not work for this orthotic company, nor do I have stock in them or anything like that--just wanted to share what I find has really helped me. If anybody is interested you can PM me, and I will send you the info, or if enough are interested-I will post it here in a message. Also--these orthotics are made to last for 10 - 12 years, so when you do wear out a pair of shoes, you are still putting your feet into the orthotics that they are used to, and still getting the benefit of a custom fit. Cindy

Yes--you are right--and hopefully those nurses caring for your dad did not let bitterness show that they had to be there on Christmas day.

Working holidays goes along with the privilege of being a nurse-it's one of those things we do. I have worked every other Christmas Eve and Christmas for the past 14 years. I could be working somewhere else that closes down for Christmas every year--say a food manufacturing plant--but then I wouldn't have the privilege of doing what I love. Hopefully next year should be your year to have Christmas off. Cheer up and ask yourself what you can do to make the day a little brighter for the patients in your care. I know they will be grateful that you are there, and that there are caring people in this profession who are there every day of the year.

At our hospital-when it is our turn to work either Christmas or New Year-we work both the day and the eve-but we get paid holiday pay for both shifts. You are fortunate in this field to have had the last 8 years of Christmas's off. Ours is a profession that doesn't quit just because it's a holiday. If you are feeling badly about being away from your family on the holiday--think of how your patients feel, as well as their family members who have to be separated from their family and sick on the holiday--what can you do-since you have to be there anyway-to make their day brighter? the way I see it--there are alot worse jobs to have if you have to work the holiday--for example-convenience store attendant--so even though I have to work every other Christmas-I'm thankful that I'm doing a job that I love, and I look for ways to make the day a bit brighter for my patients and their family.

And I always think of the ones who have died as angels who have come to teach us lessons that only they can teach...I have seen many tiny babies touch hundreds of people in their short time here on earth. I feel just as privileged working with a family whose baby is leaving this world as I do caring for the babies who do well and go home. Each and every life has a purpose for being a part of this world-no matter how long or short their time here. Some just accomplish their purpose much quicker and get to go "home" much earlier than others of us. I know I am most profoundly touched by the babies who die.

We are using Vapotherm more and more, and WE LOVE IT!! My primary pt and her twin were both extubated today after being intubated and on vents for 41 days, and they are doing beautifully!! They just seem to settle in right away, rather than using all of their energy fighting the CPAP and trying to wiggle out of their prongs and masks. Right now in our 38 bed unit we have 10 Vapotherm units running. We would have more running, but we are out of them right now.

I too want to go down there to help-but we need organization and guidance. We can't just hop on a plane and get there. Ideas anyone? Where can we start calling and what can we do? I feel so helpless sitting here in MN where I am safe. All evening at work, I couldn't stop thinking of those who are fighting not only for their patient's lives, but for their own...

Have some compassion--it's no longer about what "they should have done". It's about what can we do to help them now--some of those people were too poor to have a way to get out of there ahead of time-if anybody should have done anything to help get those people out ahead of time--it should be our federal government! Oh, wait--our president was on vacation at his ranch--guess he couldn't have been bothered.

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I don't think that being expected to pass the drug calc tes with 90 - 100% is "unfair". When it comes to the responsibility we have with meds-there is NO room for error. especially even more so when it comes to peds and neonatal. I would not want a nurse caring for my critially ill child or baby who could only get an 80% correct rate on a med test. When we have the privilege of the jobs we have, we have to take on the responsibility to know 100% for sure that we know our dosage calculations. Sorry this sounds so harsh-but we have the lives of others in our care.

In my unit we are staffed 1:1 with vent babies and freshly extubated, and with new admissions and 2:1 with everything else. We are all level 3 & 4 here. Feeder/growers go to a completely separate intermediate care unit, where they are still staffed 2:1, or 3:1 at the very most, or they are transferred back to their own hospitals. I am sitting here tonight with my one intubated baby. I did have to pick up a trached baby earlier as his nurse had gotten an admission, but I only had the second baby for 4 hours. I will admit, we are very spoiled here in my unit. I have worked in other units where we had a mix of level 2 and level 3 babies and staffing ratios were more like other units. But our unit here is level 3 & 4 only.

hi BabyNurse513--I realize that, and I apologize if I seemed to imply that--I really didn't mean to. Just wanted to let you know. It's a policy that I definitely don't agree with. I've thought about going back to scholl for my bachelor's degree--but the .80 more an hour that I would make doesn't justify me spending the money to go, and it wouldn't teach what experience has taught me. However--I give alot of credit to all of those who do have their 4 year degrees--it's alot of extra hard work. When I went to school, I was a single mom with two babies, and the thought at that time of two extra years in school was more than I could do at the time, and now, as I said--the end doesn't justify the means. I'm just grateful that their are hospitals who value their AD nurses, so that I can continue to do what I love. If my hospital were to now initiate a policy that we all had to have BSN's, then I would go back to school in order to stay in the job I love. I couldn't imagine doing any other kind of nursing. Just wanted you to know that I didn't mean any thing towards you for stating your hospital's policy... :)

Hi BittyBabyGrower--Sorry--didn't meant to rehash an old subject, and I'm sure that BabyGrower513 also was not implying anything by sharing her unit's policy--it's just that I love what I do, and I am passionate about my job, and I feel that 2 more years of school would not give me the wealth of experience I have gained over 13 years in the NICU, and I would be offended if I applied for a position, and was told that because I don't have a bachelors degree I am not experienced enough to work in a NICU. Everything I know about NICU nursing, I have learned over the years--from LPN's, RN's (both AD and BSN) and yes--sometimes even CNA's who have worked in NICU for longer than I have--you are so right when you say the degree doesn't matter--it's a love and a passion for the job, and being open to learning from other's years of experience and wealth of knowledge. Cindy

For those of you that use Vapotherm, or are trialing vapotherm--what do you think of it? we don't use it yet in my unit, but I would like to know what others think of it... Thanks for your thoughts...