usameisje

I too have bipolar disorder. I'm a mom for 2.5 years and a neonatal ICU nurse for 7 years. I really see no need to inform anyone of my BP II at my work. A couple of close friends know at work but I don't really want it public knowledge. Your decision on that one. I like what the last poster said about not being able to take something back. The only real issue I see here is making sure you have a current license and maybe a refresher course. Welcome back to nursing, we missed you!

Our private rooms are big enough to keep the food and drink away from the bedside area. Parents can room in 24/7 and most do. They can use the in room fridge for parent food, but one whole shelf is for breastmilk only, as is the freezer portion. A hospital benefactor donated 27 inch HD LCD TVs for all of the patient rooms in the hospital and we have satellite TV with a DVD player as well. We also have in room bathrooms with shower and toilet. Twice daily housekeeping usually keeps our linen and garbage under control. We also provide the families with our hospital linens so that when they want to change it is easy to put the dirties away in the linen bin. We used to have a family laundry room for their personal use but we stopped that because of a MRSA outbreak (aaaaargh). We tell families that having a few hours away to do their chores at home really does help with the strain of being in the NICU all of the time, parents agree that it feels good to have clean clothes and blankets. Occasionally we have stinky food around but I try to point out that trash that doesn't fit in their can or is smelly should go in the large trash in the coffee/microwave room. The first time mom smells breastmilk that stinks like steamed kidney with garlic and the baby won't nipple it she makes her own NO STINKY FOOD IN BREASTMILK FRIDGE rule. (Don't even ask, it was the grossest thing ever) The old alarm system at this job was awful, we had pagers that didn't tell you much at all. Our new IP phones will show us the alarm, a snapshot of the monitor tracing in question, and allows us to send the message to another RN if we are unable to leave the room we are in at the moment. The only annoying thing is when I have both hands occupied with a draw off of an arterial line or I am in isolation and I get a phone call from the front desk. I end up ignoring the call and then get chewed out for not answering my phone. I have never had a parent be upset because I missed their call due to needing to perform care for a baby, their own or someone else's. I just call back when I am finished. The only time we ask anyone to leave the room is if we are inserting central lines. It's almost impossible to keep the sterility we want if a parent is crowding the bedside. We also do not let parents stay in the room during a bedside PDA ligation. We limit visitors to parents only when we are initially admitting. We let parents stay for codes.

Nope, not 20 weeks. The earliest surviving gestational age I have ever cared for was 23 weeks, 0 days. She was a miracle baby and I doubt I will see another 23 weeker do so well. At my old job the Neonatologist would attend any delivery 20 weeks and up , just in case the dates were wrong. Upon OB request the Neo would also examine fetuses at delivery to give families more reassurance that the baby really was below 20 weeks. Of course 95 percent of cases were no prenatal care so we had to guess a LOT.

I work in the NICU of a baby friendly hospital. I can't say which one or it will become obvious who I am and my opinion is NOT popular. I do support keeping baby in mom's room when possible, and getting baby skin to skin within the first hour of birth along with putting baby to breast during that hour. The longer you wait to breastfeed, the harder it is to do it. After working there for three years and having my own child there, I think the hospital has lost all sense of why we sought baby friendly status in the first place...which was to do what was best for infants and their families. Mothers who arrive in labor at the hospital are being harassed about their feeding choices. Yes, I am sure you will convince that woman who takes Lithium to switch from formula to breastfeeding while she is in the throes of active labor. I am sure her OB, Psychiatrist, and therapist would love to hear that bipolar disorder can be controlled by breastfeeding. I almost fainted when I heard the LC say that. (there are mood stabilizers that can be used in breastfeeding, but they don't work for the mom, read the chart) The poor mom was in tears, because Lithium is the only thing that controls her disorder and she didn't want to risk another crippling postpartum depression. Half of the time moms love our extensive lactation help, therefore I love it. The other half of the time I have the mothers of my primary patients in NICU ask me to never tell lactation dept that they are in their child's room, that they are being told that if they loved their children they wouldn't mind the sacrifice of pumping every three hours with no sleep breaks. I explain that frequent emptying of the breasts is what drives milk production and if they take a sleep break at night they must pump even more during the day to keep the same supply. I suggest they use a pumping log to see if the altered pump schedule is hurting or helping supply. If the baby can go to breast at all I maximize that opportunity, the baby is better than the pump. Moms with delayed onset of lactation are told that their child won't learn the breast if they bottle supplement while waiting for milk to come in. Yes, because when I get a readmit who has lost 15 percent of birth weight and has a bili of 22 while fingerfeeding for 5 days that is a desired outcome, right? The SNS would have helped here...but mom was told to only use 10 cc in it per feed.... I support baby at the breast, but I just can't say breastfeeding comes before all else. I sure hope other Baby Friendly hospitals are better at it that we are.

Don't worry too much... you will develop a rhythm for when three kids are all due at the same time. It comes with experience (it did for me at least) In my unit, you could have two intubated patients, but usually you would not be expected to do an admission with such an assignment. Usually we try to even out the acuity for the ICU assignments so nobody is dumped on more than anyone else is;) Intermediate level assignments can have up to four babies. We try to make sure nobody has four IVs. The worst assignment I had in intermediate was a full term kid with a UVC, and the rest of my babies were PIV. Thank goodness nobody's IV access infiltrated, came loose...etc. The unit was an absolute zoo with admissions, and none of my kiddos had anything more than a regular nasal cannula. Find a "brain" sheet that works for you and keeps you organized. Some nurses make fun of me with mine...but I don't really give a meconium about that

Hi! Glad to meet you. USAMEISJE

Always trust your gut feelings. That little voice telling you that something is wrong. Almost every time I get that feeling... there is a sepsis starting or some other process has begun. Be willing to get help immediately if you need it. Ask questions. Always be willing to learn. Nobody knows everything, and it always helps to know multiple ways to do something. Respect all members of the team. Everyone. The housekeeper came to me one time saying that she noticed a hole in a IV bag was dripping...the baby's nurse wouldn't listen... dopamine was running all over the floor! The lab techs and RTs have taught me a lot of useful stuff and my skills are better for it. Not everyone follows this rule. Most babies survive. Some do not. Remember your successes to get you through those tough moments. And everything everyone else on this thread says too! USAMEISJE

Thanks! I got a good sleep and things feel much better in my head now. I do feel very supported by everyone at work, it made things much easier. This was a moment when everyone put aside pettiness and grouped together. I knew this was coming eventually, I don't pretend I can save all of em... I still can't imagine working anywhere else! THANKS Usameisje

Actually, my first patient death ever. I have seen patients die in NICU and elsewhere, but they weren't assigned to me. I have helped in unsuccessful codes of NICU babies, and had one patient with alobar holoprosencephaly (comfort care until mommy out of recovery). I was sad, but I was able to deal with it. At the beginning of the shift I got to hold a little boy who is now 13 months, but was one of our real miracles...born at 23 weeks. Doing extremely well now, his parents were so excited to see me because they remembered how much effort I put into caring for their little one. Scrubbing back in, I was so excited to get to work. Through two years of being a NICU RN... and no deaths until just this weekend. Sepsis really is the dirtiest word... the little 27 weeker had spent weeks without any real problems...doing very well. I had spent time with mom and dad teaching them how to care for their little girl, things were looking great at 8 AM. Labs and all. Nothing had gone unnoticed. Doc and NNP agreed with me about how well patient is doing. Well, you know the story of sepsis. By the end of the shift, my little patient was dying. NNP and Doc said I had caught it extremely early, we all worked so hard. It wasn't enough. We had done everything we had done with hundreds of babies before...but this time it didn't work. So many nurses stayed after their shift to help us out, and to see how I was after I had given report hours late. Nurses who I thought would never give me the time of day told me they had a lot of respect for my work, and I should know that it wasn't my fault. They had seen me not leave that baby's side, working with the docs and nnp all day long. They said I couldn't have done anything else. I had stayed together to support mom and dad, but I needed to let the stress out. They had already checked my schedule, preparing to cover my shift for me if I had to work the rest of the weekend. It turned out that I had three days off after this shift already. They said I would cry, blame myself, blame God...but I would come back and fight on for the ones that do make it. Thanks for letting me vent USAMEISJE

Usually the charge nurse and a neonatologist attend the C/S deliveries where I work. If the newborn is doing well, they leave the baby in the care of the OB and LD staff and return to NICU. Our charge nurse is the only charge nurse in the entire hospital not to get a patient assignment because she or he attends all of the deliveries requiring NICU assistance. If any issues arise they will take baby to NICU as soon as they can for treatment or observation. NICU non charge nurses and NNP stay in NICU unless we have multiple simultaneous high risk deliveries. We always keep one NNP or neonatologist in NICU though. If we don't have enough neonatologists or NNP available, the OBs will have to handle the full term deliveries and NICU staff sticks with the preemies. Of course we might call in more docs if required because we only have one NNP on staff! Usameisje, the newbie NICU nurse

Try not to panic....I just took my test this morning and got shut off at 75 as well. I got lots of questions about ESRD and normal physiologic changes in older people like sight and taste. All of my psych questions were about schizophrenia. I got done in 45 minutes, so I either went down in flames or I did great... my last 15 questions were all "what should you do first" or "who needs to be seen first", or patient teaching. I have a feeling that if you prepared for the test, and usually do well on exams that the result will be what you want! Lexi:roll