NICURN29

I know I am often in the minority on this one, but I am friends with former patients' family members on FB and often follow them on Instagram. I do not ever initiate the social media relationship, and I won't be friends with them on social media until after their babies are discharged, but I do love seeing updates and such. I also let that sort of inform what I am willing to share on social media. Knowing that patient families are seeing my posts and also because I am very serious about conducting myself appropriately as a member of the nursing profession and an employee of my network limits what I am willing to put online about myself.

This has some good information on Sudden Unexpected Postnatal Collapse and how hospitals are dealing with the risk for it. http://hospital.nuroobaby.com/wp-content/uploads/2016/04/Infant-Assessment-and-Reduction-of-Postnatal-Collapse-Risk_-The-Skin-to-Skin.pdf

I was not talking about any particular physician. I was talking about the medical model vs. the nursing model. There are plenty of fine physicians out there, but their education is very different from nursing education, and that makes a difference to me.

I became a nurse because I wanted to be a nurse, not because I was not smart enough to go to medical school. And I am becoming an APRN (I am in a PMHNP post-Masters) because I am passionate about mental health care and believe that our education in treating the entire patient and not just the illness is one of the most important things we can bring into an AP roll.

We use 1/2 NS with 1/2 unit heparin per mL to flush our second lumen. However, we put a bifuse at the top of the line with the heparinized flush on one port and a NSS flush on the other. We have to break into the line to piggyback a med, but if we are just flushing, the connection between the port and the heparinized flush is always intact, so we break into the line a lot less often.

We also use Cannulaide. Cannulaide - Infant Nasal by Mercury Medical | Medline Industries, Inc.

My opinion differs from most here (and I don't need you to convince me I am wrong...I am perfectly fine with my use of social media where patient families are concerned), but I work in the NICU, and I accept friend requests from my patients' families after their babies are discharged. Our families sometimes become very close to their nurses while we are caring for them and their babies, and it's a great way to see the babies grow and change. I don't put anything on Facebook that I would not want them to read, and if they try to overstep by asking for medical advice, I put a stop to it. My organization does have a social media policy, but it does not forbid Facebook friendship, as long as we are representing ourselves, our profession, and our organization in a positive and professional manner. Seeing babies who I have taken care of grow up is such a highlight of my Facebook experience, and I am so glad to have the opportunity. Of course, if I worked for a network that forbid it, I would follow those rules.

We currently use a McKesson product that is called Care Manager, but we are moving over to Epic in three months. There are several other L3 NICUs in our area that also use Epic.

Hello! We are currently looking at our evidence regarding the wearing of rings in the NICU by nurses and medical providers. Currently, we are allowed "nothing below the elbows" (so no rings, bracelets, watched, Fitbits, etc.). However, in trying to align our guidelines with those in other units of the hospital, we are reconsidering this and thinking of going back to allowing the wearing of one ring. I was wondering if anyone would be willing to tell me what kind of rules you have regarding this in your NICU. If you don't allow rings and have some evidence for that practice, I would love to hear it. And if you do allow a ring and have some evidence for that practice, I would love that as well. Thanks so much!

We use Neobars. I think they are fantastic. They have cut down on our self-extubations and have allowed us to stop nasally intubating babies...which is what we used to go for our teeny-tinies.

We also use the little Posey bands.

Ideally, if I have two patients, one is on each schedule. And the goal is for the feeding to start at the care time, so the assessments and cares are done with that goal in mind. If I have two babies on the same schedule, I just always care for them in the same order all day.

I am not sure why you are documenting in the medical record information about parents' interactions with other parents. It sounds like maybe it would be a CYA strategy, but I would think that, should a case go into litigation, that would be information that you might not want to be discoverable. I think that is instead something that should be discussed with your nurse manager and medical director so that they can approach the parents and encourage them not to share medical advice. We do often have frustrating families, and I try to put myself in their place and remind myself that this is perhaps the most stressful experience they have ever had. I also have a nurse manager and a medical director who I can count on to intervene if there is something like this happening in our unit, and this is hugely helpful for me.

After the cleaning solution has dried, we rinse our beds with plain water to remove any residue. They are cleaned by our unit clerks/PCAs.

We have two care times...8-11-2-5 and 9-12-3-6. Our level III babies are assessed and have vitals done q3h. Our level II babies are assessed qshift, so 3x/day. Baths are done whenever parents schedule them or on nights if parents are not taking part. We bathe every four days. TPN/IL are hung after 1900, and labs are done with the 0500/0600 cares for babies on IV nutrition and with the 0800/0900 cares for others.