BamaGirlRN

First off you do have some valid concerns and as a new RN you should definitely talk to your NM, even if she is "completely out of touch", as you say. She would probablys really want to know because if new grads or RNs to the unit aren't happy and she can't retain these RN's it is ultimately her responsibility to know why or to figure out why. Plus I am sure you would feel better voicing your concerns with her, we all feel better when we get thing off our chest. I have only been in the NICU almost two years and I find I am still asking questions. Your Charge nurse is an excellent person to go to. Maybe the other RN's aren't comfortable yet answering new grads questions. I was also very frustrated with this when I was the only new grad on my unit for about a year. Even while orienting I'd get different answers to the same questions from severeal different seasoned RN's. While giving up a whole assignment to admit would be wonderful, it is not always feasible. But I do agree 100% with this statement, those first couple of hours(sometimes more) are crucial and it is always a welcome to have pod partners who are helpful, even if it is just to "scribe". In my unit I have never seen just one RN at an admitting bedside. About 80% of our babies are outborn so they usually already have tubes and lines and abx on board, fluids going, etc. So when a brand new babies comes from LDR it definitely needs to be a team effort.

In my hospital the radiology docs read the xrays before sending them up, isn't that how it is everwhere, lets hope so. I usually tell the neo if I have to call what the xray says on it (that the rad wrote) and if he has a question about expansion, tube placement then I'll let him know. Every NICU nurse should know how to do this IMO. Why wait to do rounds with the neo in the morning(or afternoon) if you film shows a high tube or 12 ribs, so we always glance at the films when they come up and let then let the neo know if it is something that needs to be corrected ASAP.

I am pretty sure that each facility has different protocols on who can and cannot intubate. As a NICU nurse for almost 2 years I am glad that I am at a place that encourages the RN's to become more advanced and skilled at what they do. We do have crazy pt ratios at times but I couldn't imagine only having one vent or two nc's, I would be so bored I would think. I like that we can make vent changes(with or without the RT) usually just the IMV sometimes pressures at our discretion, our MD's are just a phone call away for major changes in a patient when we need them. They really only come in at night for admits and codes, which thankfully we haven't had many of lately. If a kiddo is acting stupid and needs an xray or labs they are normally done first then we call the MD with the results and just let them know what we have done and take any new orders from there. It all works out and we have super smart RN's (some NNP but not praticing as so) here in Bama. BTW War Eagle KK7724

Lets see here, we have sent one sent of triplets home at the same time (mom was an RN) and since I have been a NICU RN (1 yr) we have sent only one set of twins home at the same time. We always have atleast two sets in our unit if not more and most of our parents understand that one may go home first. Usually the parents know which one it will be by the time they are stable. Of course there are always the set backs and the other twin suprisingly goes home first. So do you all have the parents room in with the second twin or do you just let them go home if they have RI'd with the first? Our docs vary depending on the parents and baby.

Hiya! Just wanted you to know that I have been keeping my fingers crossed for ya. A coworker of mine graduated in May and it took her a little over 2 weeks for results, btw she passed with 180 questions! Let me know if you need anything.

I never registered or went to the pearson vue website and got my ATT via email. I just field in the email space on my registration form that I sent to the NCLEX people and my state BON.

http://www.ncsbn.org/testing/candidates_info_cat.asp text: Computerized Adaptive Testing (CAT) Overview Computerized adaptive testing (CAT) is a method for administering tests which uses current computer technology and measurement theory. The NCLEX® examination administered via CAT uses standard NCLEX examination multiple-choice questions. With CAT, each candidate's test is unique: it is assembled interactively as the individual is tested. As the candidate answers each question, the computer calculates an ability estimate based on all earlier answers. The test questions, which are stored in a large item bank and classified by test plan area and level of difficulty, are then scanned and the one determined to measure the candidate most precisely in the appropriate test plan area is selected and presented on the computer screen. This process is repeated for each question, creating an examination tailored to the individual's knowledge and skills while fulfilling all NCLEX test plan requirements. The examination continues in this way until a pass or fail decision is made. CAT provides greater measurement efficiency, as it administers only those questions which will offer the best measurement of the candidate's ability. The way a CAT examination works is very similar to the way an educator might administer an oral examination. After a candidate's response to the first question asked, the educator assesses the candidate's ability level, then asks another question, based on this preliminary assessment. The candidate's answer to this second question provides the educator more information about the candidate's ability, and the educator's assessment is becoming more precise. This process continues, with the educator asking either easier or more difficult questions, based on the candidate's responses. This type of examination, like a CAT examination, is tailored to each individual candidate, and only those questions which will measure the candidate's ability the best are administered. During an oral examination, the educator makes an assessment of the candidate's ability, then chooses the appropriate level of difficulty for each question administered. In a CAT examination, this process is built into the computer system. NCLEX examination decisions are not based solely on how many questions a candidate answers correctly, but also on the difficulty of the questions a candidate answers correctly. CAT administers questions with difficulty levels so that each candidate will answer about half correctly; these questions provide the most information. Thus, all candidates answer about 50 percent correctly: passing candidates answer 50 percent of more difficult questions correctly, and failing candidates answer 50 percent of easier questions correctly. Even though candidates may answer different questions and different numbers of questions, the NCLEX examination administered using CAT is fair to every candidate. All examinations conform to either the NCLEX-RN® or NCLEX-PN® Test Plan which controls inclusion of important nursing content, and all candidates have ample opportunity to demonstrate their ability, as the examination won't end until stability of the pass/fail result is assured or time runs out. How CAT Works: A Candidate Primer The goal of computerized adaptive testing, or CAT, is to determine your ability, based on the difficulty of questions you can answer correctly, not how many questions you can answer correctly. This is a fundamentally different approach than is used on paper-and-pencil tests, where everyone receives the same questions. CAT examinations are individualized. We know the exact difficulty of the approximately 1500 questions in each operational NCLEX examination item pool because each has been taken as a pretest question by hundreds of candidates and then statistically analyzed. Picture the questions all lined up, from easiest to hardest. If we asked you the easiest questions, you'd get most of them right. If we asked you the hardest, you'd probably get most wrong. As we move from easy to hard, there will come a point where you go from getting more right to getting more wrong. This is the point where you are answering 50 percent correctly. Questions harder than that you would probably answer incorrectly (you'd get some right, but more wrong); questions easier than that, you would probably answer correctly. The goal of CAT is to find that point for you. That point is different for everyone. Nursing experts could probably answer at least one-half of the hardest questions we could ask. We'd have to ask beginning nursing students the very easiest ones before they could answer even one-half correctly. You probably fall somewhere between those two points. First, the computer asks a relatively easy question, and if you answer it correctly, it asks a somewhat harder question. As you continue answering correctly, the questions get harder and harder. When you start missing questions, they get easier until you start answering them right again, then they get a little harder. Each time you answer one correctly, the next is harder. Each time you answer one incorrectly, the next is easier. This process continues as it zigzags, narrowing in on the point where you answer 50 percent correctly, e.g., one right, then one wrong. That point represents your ability level. This is why everyone ends up correctly answering about 50 percent of the questions he or she is asked. After you have answered the minimum number of questions, the computer compares your estimated ability level to the passing standard and makes one of three decisions: One, if you are clearly above the passing standard, you pass and the examination ends. Two, if you are clearly below the passing standard, you fail and the examination ends. Three, if your ability estimate is close enough to the passing standard that it's still not clear whether you should pass or not, the computer continues to ask you questions. "Clearly" passing or failing is defined as when the "gray zone" around your ability level falls entirely above or below the passing standard. The gray zone is the region within which your estimate might vary if you answer more questions. The gray zone shrinks a little after each question because your estimate is based on more information. After each question, your ability level and the gray zone are recomputed, adding your new response to all of your previous answers. When the gray zone is entirely on one side or the other of the passing standard, you've clearly passed or failed and the examination ends. Of course, some people's ability level is very close to the passing standard. For some of these people, all the questions in the item pool still might not be enough to make it "clear" whether they should pass or fail. When a candidate's ability level is very close to the passing standard, the computer continues to administer questions to them until the maximum number of items is reached. At this point, the computer disregards the gray zone and simply looks at whether the final ability estimate, based on every question answered, is above or below passing. If you are above it, you pass. If not, you fail.

Hmm, interesting theory, did ya'll take into account the number of practice questions that do not count towards you passing/failing. There are always 10 or so they throw in to 'test' the new questions.

When I was doing by preceptorship in the ICU, the main things was pt safety, suctioning (alot) & oral/nasal care for vent pts, and like previously said, assess the pt. not the monitors.

Yup it took me two weeks and a day or so to get mine in the mail. I have a license verification number to the BON that you can call and put in your SSN, it's a little faster than the mail by a day or two..PM if you want the number.

Yeah, I am not sure if regular cuffs have latex, but here is a link for nylon cuffs. http://www.allheart.com/aneroidbp.html

Exactly what I was thinking! Don't stress out too much over this, good luck!

Bella what school will be be attending or attend now?? I am from AL and am curious? It really doesn't matter if you attend a community colloege or a state university or a private college, most of their practices are the same. I went to a big university here in AL and yes we bathed each other. I would PM you but you have them turned off.

Gotta love the ignore feature this board has!!! When I was in school they *said* we would have to wear bathing suits but we all settled for shorts and a tshirt. We had fun in lab and doing a bath, changing a bed, moving a pt, it all VERY different when it is a real person than some old hard plastic body.

Cool, check your PM's!