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sparkyRN

sparkyRN

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Married, kids, active in church and school activities

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  1. sparkyRN

    What are your nurse:pt ratios?

    There's ideal and then there's reality. Ours is a level 3 referral, 80 bed unit-usually 20 ICU, 40-50 level 2/special care babies. We often carry 3:1 and even occas. 4:1 in ICU, and 5-7:1 in level 2. We'd love to maintain a 2:1, 3:1, and 4:1 standard bu there just are not enough nurses available. The nursing shortage is a real problem for us because we're in a large medical community so lots of competition for the same small group of applicants. You just have to make do, support each other, don't let nurses become "black clouds" in your unit. They will drive people away faster than any bad assignment will. Step up and be a preceptor to the new hires and remain a mentor to them when they are on their own. That's how we've managed to survive for years. We are nurses for our babies first, for each other second and for ourselves last.
  2. sparkyRN

    HELP - need vent advice

    The March of Dimes has some great resource material that may be what you need. http://www.marchofdimes.org
  3. sparkyRN

    A Celebration for Gompers

    Best of luck to you and your husband!
  4. sparkyRN

    Pregnant and terrified NICU nurse here...

    So late in sending you my congratulations...my apologies. Glad to hear the 2nd trimester is looking up! I hope you'll be able to enjoy the rest of your pregnancy. Well, I don't think any of us really enjoy those last couple of weeks! Take care of yourself. Sparky
  5. sparkyRN

    NICU nametags and cribcards

    We do something similar. One of our charge nurses buys seasonal cut-outs from an education supply store. They are approx 5x5 inches and have a glossy surface.This summer it was suns, bugs and flowers with little smiley faces that had lots of room left to write the baby's name with a permanent marker. We'll have apples this month, pumpkins in October, turkeys in Nov., an assortment of Christmas ones, etc. I don't know how expensive they are, but they are cute and personal. :)
  6. sparkyRN

    X-ray and CMV exposure in NICU during pregnancy?

    Worked nights, rotated shifts, been sleep deprived...still managed to have 4 normal pregnancies over the course of 8 years. My advice to you is to keep up your precautions because it will decrease your anxiety about all the "what-ifs" you might face. When you do get pregnant, let your NM and charge nurse know so you can avoid the TORCH babies if at all possible. You may be extra tired, so rest when you can. Sparky
  7. sparkyRN

    What things are permissable to infuse per UAC's?

    Do you know what your unit's rationale is for heparinizing fluids in your UVC but not your UAC? We've used hep in both as well as any peripheral art line. There's a noticable decrease in circulation problems since we started doing this 10 years or so ago. Just wondering. Sparky
  8. sparkyRN

    What things are permissable to infuse per UAC's?

    Any maintenance IVF except lipids--PA(hyperal),dex/water,ns. No pressors, bicarb, prostaglandins or blood products.
  9. sparkyRN

    Little curious abt NICU levels!

    In a nutshell... Level III is the ICU. These are the most acutely ill term and preterm babies. All intubated and CPAP babies, those that are septic, symptomatic heart babies and a host of other issues. A Level III has attending staff (neonatologists and NNPs) available 24/7 for DR resus and unit needs. Level II is a step-down or intermediate care nursery. Babies are either admitted there post delivery or they transition there from the NICU. It is for babies who need to be monitored for various problems due to maternal history. They are generally more stable than an ICU baby. They may need IV therapy/antibiotics; may be on O2 though not in acute resp distress. Also, the feeder/growers hang out there. Level I is well-baby nursery, normal newborn; usually it is part of a mother-baby unit and the nurses are often (not always) cross trained to care for the mothers too. There is also Level IV designation used in some parts of the country. It may refer to a regional referral center or one that does surgeries or ECMO. Someone smarter than me may be able to give exact info on what a Level IV is.
  10. sparkyRN

    Just got accepted in MSN program!

    Congrats to you!!! :balloons: Is that TX or TN? Sparky
  11. sparkyRN

    staffing ratios

    That's the standard that most hospitals try to maintain. IMO those that are tightly regulated, such as California and unionized hospitals, as well as most top-tier hospitals seem to have consistent ratios. Other hospitals aim for the same ratios, but often fall short for numerous reasons, and have to "make do" with the staff on hand.
  12. sparkyRN

    U of Southern Indianna?

    Fergus, I'm applying to the University of Wyoming's Nurse Educator program for Fall 2006. It is entirely online, can be done on a 2,3, or 4 year tract with, I believe, 6 years to finish. It is accredited. The best part is that it has been the least expensive option I have seen. For this year it is $195/credit hour which includes $40/credit hour delivery fee--I'm assuming this fee is to cover the access costs. (I received this info directly from the school; it has not been updated on their website.) It would actually be feasible to pay-as-you-go. They do require the GRE and a thesis or non-thesis project that is defended by teleconference. You can get more infromation at http://www.uwyo.edu/nursing --you kind of have to hunt around for the online information, but it is there. Let me know what you think. Sparky
  13. sparkyRN

    nec;are we doing something wrong???

    Sometimes that is just how NEC happens. Please remember the damage to the gut could be the result of an anoxic or hypoxic episode the baby underwent before, during or after birth. And really, the "experts" will tell you no one knows exactly what causes some babies to get NEC. Speaking from experience, NEC does happen in full term babies, though thankfully it is rare. Usually their first presenting symptom is abdominal distention. Being a 30 weeker, there may have been subtle clues of illness before the baby showed abdominal distention. The classic precipitating event that I've noticed with preterm NEC babies is apnea. I start to get very nervous if I have a feeder/grower who starts to have apneic episodes where before their were none. Or, they have had a few, but the episodes become more frequent or require an increase in stimulation. Granted, this does not always mean NEC. But it could. Fortunately, our doctors and NNPs will take a change like this seriously enough to at least get serial CRPs to check for infection.
  14. sparkyRN

    Im trying to decide my career and I have some questions

    RN4NICU gave you some excellent information and advice. I'd like to add something. In reference to your question about courses to take: I would recommend any class that will help you with written and verbal communication. The ability to communicate effectively is a necessary part of being a nurse. So many errors happen in hospitals because of miscommunication. Even in this high tech age, nurses do a ton of charting. Now we type instead of write. But the liability remains the same. Your ability to present information clearly, chronologically and concisely will be your salvation if a lawsuit is ever brought up for one of your patients. We also do a lot of teaching with families. Being able to "know your audience" will help you in providing the best, most easily understood information to them. If you can start now by taking writing, typing, speech &/or intro to psych classes, you'll be one step ahead of the game. Good luck!
  15. sparkyRN

    guideline for photography on Neonatal unit! HELP!

    I would think that implied consent exists if the picture is one taken by the family and sent in or given to you for display. You may want to label the back of the pictures with the family's name if they should ask later for the picture to be removed.
  16. sparkyRN

    guideline for photography on Neonatal unit! HELP!

    Another issue to consider is families taking pictures in the unit. While we encourage them to bring their cameras and shoot pictures of their baby, they are not allowed to take pictures of other babies or any video pictures. Our unit is older, with a large open room that allows easy visualization of many patients. It really is difficult to maintain privacy in such a setting. Most of our families are very understanding. For publication, their is a consent form that must be signed before pictures can be used.