marnie

We have a new product called NeoPrep, used when a baby is on CPAP. It is sort of like a very small piece of Duoderm, but shaped in a way that there is a tab that covers the baby's septum. We had a real problem with damaged septums from the pressure of the CPAP prongs, but there has been a huge improvement since we started using this product.

I have a question for all you experienced NICU nurses: is there some reason to avoid picking up and holding certain babies? In our unit, we recently had a full-term baby. He was in an open crib and not on a vent. The poor thing would cry frequently. When I took care of him, I would hold him and rock him as often as I could. Luckily, the nights that I was assigned to him, I had only one other patient who was pretty stable and slept through the night so I could give him a lot of attention. A few other nurses made comments about "spoiling" him, or asking if there was a problem that required me to hold him? Ironically, these were the same nurses who complained about how they didn't like taking care of this baby because he was so irritable. But when he was held, he was very content! Also, we had a baby who was born prematurely and was with us for several months. As he got bigger, he was stable and moved to an open crib. He was with us for a long time because he got an MRSA infection. I was assigned to care for him often, and would spend a lot of time holding and rocking him because he would cry a lot when left alone in the crib. Again, comments from certain nurses about holding him so much. Please note, in our unit we must wear isolation gowns whenever we pick up any baby, so they don't get "contaminated" by our clothing, and vice versa. And the baby with MRSA was in isolation, away from the non-infected babies. Now, of course, with small unstable preemies you not only can’t hold them, but you must limit your contact so they don’t get stressed. But is there a reason to not hold big stable babies? Actually, it seems to me that when they are rocked to sleep, their sleep is much deeper and longer than when they cry themselves to sleep. One more question-why do some nurses hold babies away from them in their lap, with the baby facing them during bottle feeding? Is there some reason to avoid holding a baby against you (one arm supporting them, their head in the crook of your elbow)?

Yes, there is a "calling" for some nurses. I have worked in a NICU for only seven months and I still have so much to learn, but I absolutely LOVE it. It feels like this is what I was born to do. Right after I graduated, I worked for a year on a med-surg unit because that is what you are "supposed" to do when you first start your nursing career. Well, I hated it! Don't listen to the criticism of others. If you really feel drawn to the NICU, go for it! It is such a joy to look forward to going to work, and then to come home feeling like you did something worthwhile. Good luck!

Thank you everybody for your input! Kristi you are so awesome-you always have so much good information. The lancets in our unit don't look like any in the picture (I don't know the brand name either). We only have three types. All are the self-retracting with the one time only buttons. For the smallest babies, we use a purple lancet and for the larger babies we use a blue lancet. That is just to get a couple of drops of blood for the BS. For blood draws (CBC, bili, etc.), there is a large pink colored lancet. This is the only one used for obtaining blood for labwork, regardless of the baby's size. It makes a pretty large slice in the heel. And yes, so far I've taken care of two babies that needed blood transfusions! It is terrible that we take so much from them. And their poor heels look so sore. I'm going to ask about using heel warmers. So far, I haven't seen such a thing used, but it won't hurt to ask. By the way, I work in a Catholic charity hospital and I get the feeling that there are a lot of things used in other hospitals that they can't afford here. Also, they don't let us use alcohol wipes. We have to use Betadine wipes, which I hate because they are so messy! I'm going to use the good tips mentioned here. I find that I tend to pull the baby's foot up towards me, but I will now remember to let the foot dangle-gravity is my friend! I'll even try talking to the blood drops to coax them out. Believe me, I'll try anything! Seriously, I think my problem is the grip/squeezing technique. I will be practicing that. Tomorrow I'm going to be in the well-baby nursery. They want me to see how healthy babies look, to be able to better see the differences in the babies in the NICU. But I am going to track down our unit educator, who is also an NNP. I will ask her about doing toe and fingersticks instead of heel sticks for glucose testing. And if it is possible to have more varied choices of lancets. And I'll also ask about heel warmers. And dipping the pacifier in sucrose-that sounds like a good idea! (I guess I'll be asking her a lot of questions!) Thanks again everybody for your help!

First I just want to say that I started my new job, have been working in NICU for two weeks, and I LOVE it!!! My preceptor is great. But I feel so awkward with my big hands and these tiny babies. I'm having a lot of trouble drawing blood. In our unit, the preferred method of obtaining blood for lab studies is by heel stick. And we check the blood sugar q 8 hours, getting the drop of blood by heel stick. The problem is that all I can get is a tiny drop! Then my preceptor steps in, and she magically gets all this blood! I keep trying to use the same hand position and technique she does, but so far I haven't got it. Does anyone have any hints? Do your units obtain blood this way?