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ittybabyRN

ittybabyRN

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  1. ittybabyRN

    Can an R.N. just be PLOPPED into ICU to work???!??

    I don't think this person realizes how dangerous this could be, you don't just "learn" icu while you have a crashing patient, the drugs, drips, procedures and even certain scopes of nursing practice are very different and doing so would put these patients, as well as nurses license in extreme risk
  2. ittybabyRN

    How often do you change clear fluids? Pressors in particular!

    We change drips every 72 hrs, if we think the kid will bottom out we start the drips running on a new pump for a few minutes and then change over quick
  3. ittybabyRN

    Funniest real orders you have seen in a chart?

    well I guess in the nicu we don't do that, anyways turns out the resident had written orders under the wrong pt
  4. ittybabyRN

    Funniest real orders you have seen in a chart?

    "Glycerin suppository, PRN" for a baby with an Ostomy!
  5. ittybabyRN

    Ratio?

    I would also like to know. I am a new grad...well I guess I was a year ago anyways while I love my unit I get pretty bored with the feeder/growers and am looking into travelling/working elsewhere eventually. Would love to work in a level 3 that is mostly just that and sends kids out when they reach a certain stability
  6. ittybabyRN

    More on "Disrupted Catheters"

    Even with PICCs, I didn't know it could happen but we had a baby we tx out to a hosp closer to her home to finish a 10 day course of abx. She came back to our unit 3 days later because her PICC had broken completely at the entrance site and was lodged in her right atrium, the whole thing! Luckily they were able to get it out via cardiac cath. You've got to remember some of those bigger, full term babies can be quite active, keeping piccs in the legs can be difficult. It's rare but it does happen
  7. ittybabyRN

    Transitional feeding guidelines to bolus feed

    We also start with bolus feeds and see how they tolerate it. It can also depend on the baby's attending on how they are fed goes too. No set protocol
  8. ittybabyRN

    Ratio?

    I work in DC in a 54 bed level 3c unit. We have 46 private rooms and 2 4bed pods. We have level 2/3 mixed (no stepdown or intermediate area). We often have 1:1's, the usual is 2:1 and rarely we have 3:1. A 3:1 assignment would be feeder/growers only or feeders mixed with NPO's but no vents/frequent labs etc, and we only have 3:1's when we are short or have quite a few critical pts. Ratios are based on how acute the pt is or how "needy" a pt is. ECMO/HFOV/Cooling/PPHN kids are generally 1:1. Other than that it depends on what the kid is doing to warrant a 1:1 assignment. We very rarely have 2 vents paired. Admits are usually paired unless the kid coming is really sick and then the admitting nurse would have to give up her babies.
  9. ittybabyRN

    Tape on the ET tube tearing skin

    I work in nicu and some of those supposed to still be fetuses have the same type of skin. We use replicare as a barrier under the tape and a special adhesive remover that unsticks the tape from skin to get it off w/o tears
  10. ittybabyRN

    Is this safe?

    I'm pretty sure that's something you need to claqrify with your pedi but I will tell you, I work in nicu and we use albuterol nebs all the time, not sure about the others though
  11. ittybabyRN

    Guidelines/ Requirement for one to one Nursing Care in a NICU

    I don't think we have any policy, just depends on how acute/busy the pt is. Any hfov/cooling/ecmo/cvvh, pd kid will be 1:1. Kids on pressors may be paired depending on how stable they are on their pressor. We pair vents if they're stable as well and kids going to/having surgery are also paired if the procedure is expected to be minor
  12. ittybabyRN

    older babies in level 3

    Movies?! Yipes! I work in a private room unit and not even the parents get to watch tv!
  13. ittybabyRN

    older babies in level 3

    Once in the nicu always in the nicu, I have spoken to a few nurses where I work since I've only been here a year, kids never get tx to picu, if they are d/c and readmitted and no longer nicu material (over 3moos) they will go to picu but kids never tx from nicu to picu...we just celebrated a first birthday last week...
  14. ittybabyRN

    Funniest real orders you have seen in a chart?

    For a chronic ex-preemie now almost 8 mos old, blind, trached, frequently agitated. Mom had discovered that the smell of cherry chapstick helped to calm him down so the nurse, joking around with the resident said "I think i'll need an order for that" and the resident writes an order "Cherry chapstick, PRN, agitation" :smackingf
  15. ittybabyRN

    Are there PAs in the NICU?

    We have PA's. They work on the same team as the NNP's under the same attending and have the same scope of practice (at least I haven't noticed any difference between having an NNP baby or a PA baby)
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