HyperSaurus, RN

I passed! I checked a week after taking the exam on the NCC website and found out there.

My last facility changed them every three days. My current facility considers them good for 30 days, however, they never last that long.

My unit uses them frequently on term PPHN, MAS, ECMO, coolers, post-op, or just freaking septic. We use Mepitel (or some clear thingy) to attach to the probe itself, which minimizes the contact with the baby's skin. Unlike our facility's CICU, we do move our NIRs probe q4hr. I don't see them on preemies very often, if at all.

I just sat my exam and forgot that they don't give results right away. smh

ET tape with cuts from the outside towards the middle (not all the way). Top strip goes on the upper lip like a mustache and the bottom strip you take both ends and wrap around the OG in a barber-pole pattern.

Ack! That's good to know...I'm planning on sitting my exam next month.

Not all NICUs are run that way (where new grads/new to specialty nurses are pigeon-holed into level 2 babies until they've proven themselves). Even then, you'll find that NICU is an odd mix of super-stable feeder growers (even in a level 4 unit), super critical babes, and stably sick kiddos. It's pretty rare for me to have 12 bottles in a shift. Give it time and don't be afraid to try a different NICU.

Oh, that’s absolutely fair. The two kiddos I’m thinking of are two and four years old. The two year old is mobile, interactive, and no trach. The four year old, I’m not sure about other than that there is a video of the kiddo singing and “helping” mom do dishes. I do also follow a former 23 weeker (the parents were recommended many times to let the baby go, as the baby was severely septic and had huge grade IV bleeds). That kid is trached, g-tubed, completely wheelchair bound, and uninteractive. It’s so sad. I know that they are very much exceptionalities. The two year old had minimal IVH and mild CLD. I still think that 22week parents should be given the choice (between resusc and comfort care, which comfort care being highly encouraged) and include an explain in real world terms what their kid would be likely facing down the road. For every one miracle 22 weeker we have, there’s 10 (at least) that either don’t make it or have catastrophic defects down the road.

I know this is old, but I'd like to update: It's rare, but we have sent a handful of 22 weekers home on room air and nippling. Two of them periodically update us, the kiddos seem to be developmentally on track. Now, I don't know what's going on behind the scenes, but it does change my perspective regarding resuscitating 22 weekers.

Daily. We don't have a consistent time like we did at my old facility. Where I used to work, it was done with the weights at the first hands on after midnight. Here, It's whenever, but must be charted and done every day. It's part of our CLABSI prevention bundle.

We do the bulk of our report outside the patient room against the patient chart, and then go in to do and chart a double check of lines/fluids/milk.

Level IV's actually don't have to be ECMO capable. Tacoma General and Swedish First Hill in Seattle are both Level IV, but can't do ECMO. They do have to be able to do surgical procedures, transports, and outreach education.

Lol, my version seems to be, "Wow, this is so much better than the way I used to do it!"

So, what's second unit syndrome? lol

I've recently gotten a new position in a larger (70 ish beds) level IV NICU after three + years experience in a small (20 ish beds) level III NICU. After a week of orientation, I have to say, I feel like I've got some culture shock going on. New charting system, more complex patients, a huge unit, private rooms (previously from an open bay unit), and while they're getting me some orientation time working with issues I haven't dealt with before (namely, surgical patients), I'm only going to end up with 4 weeks orientation. I'm not sure if there's a point to this, other than to ask if anyone else has made this transition, and if so, what advice do you have.