Eyeknit

Not sure if you mean LDRP couplet care or MB couplet care, but at my fac we do STS by default for vag, and we have a nursery nurse assigned only to ‘catch’ babies who does the two hrs after delivery, popping in and out of the room, sometimes juggling 4 or more babies, then upon transfer to MB couplet care two RNs (nsy and l&d) report off to one RN. If it is busy the nsy nurse reports off to l&d nurse as soon as mom and baby are stable. We currently have STS at 100% of the vag deliveries for which it is appropriate. Not so good with the cs. Those we do STS on request, or start in the recovery room. The nsy rn has to be ‘in and out frequently ‘ during skin to skin, we dont do a continual presence.

As NicuGal and others pointed out there are more ways to be wrong than simply being in violation of HIPAA. HIPAA - is strictest in reference to private information you receive in the course of your job, less clear and may not apply at all to information parents post publically on facebook, or in the newspaper for that matter employer policies - vary widely, read the policy that applies to you professional boundaries - your board of nursing may have something to say personal ethics - keyword, personal! For example, HIPPA would not be violated by you clipping a funeral notice from the newpaper and sharing it as is, without adding information you know from your job - don't add "remember the sweet BPDr from Bay 2? So sad!" and share that. The clipping itself was from the PUBLIC NEWSPAPER and doesn't gain any special right to privacy by being touched by a nurse. The key here is to not add information. As to social networking, good luck with figuring out what is safe without bumping up on the next category - employer policies. To my mind the same logic as a newspaper should apply to facebook - if you set your posts to "public" or even to "allow friends to repost" then you have given consent for the info to be re-posted. In this I am disagreeing with CBabyNurse. The privacy policy on facebook is perfectly muddily clear that public means public! Again, without adding ANYTHING. (Even " I loved taking care of this sweetie!") Add something you know from work and you are in violation of HIPAA. Some employer's social media policies simply forbid any use of social media with a patient. So beware! My personal standard is to never "link up" with someone I only knew from work. Even the long termers - if I only know you because I was your child's primary, you get added to my prayers but not my Facebook. If you give me a t-shirt I will wear it. I will just say "this is a cause I support" if asked what the t-shirt is about. If I meet you later in church and you become a friend, I never speak publicly (including on facebook) about the former professional relationship. This is the hardest to rule to understand and follow - I use this trick to make it clear and avoid the "where's the harm?" rationalization : If I had been your nurse at an STD clinic, would I bring it up now over coffee with the knitting group? No? Well then, I don't need to bring up that I was your baby's nurse. Instead, I use the good old standby intro "I hope your family is well!" This approach validates that I know them, recognize them, and care about how their sick family member is now doing and allows them to decide if they want to talk about it at all. The most common violations I see are violations of professional boundaries that don't reach the level of HIPAA violations. But that is probably because I don't work in STD clinics. :-) Where I work it seems patients' parents are almost always happy to befriend the nurses.

Remember it? Used it last shift I worked. Cotton ball in the diaper, crossing the fingers that the pee hits the cotton ball. Recently had an extended discussion about the fact that we don't actually label the cotton balls with name, MR, and DOB while we walk to the dirty U where the refractometer is kept. Someone actually thought it was a serious conversation. I just laughed. That said, they do work. I have one for my aquarium and you cannot beat it. ;-)

Thank you. I thought that the kiddo should have been treated as inadequate coverage gbs pos kids are, but was overruled and it made me uncomfortable, so I pursued it to the neo and was double-overruled. :-( I am now looking for documented authoritative resources for the NEXT time this happens to me.

My experience - extension tubing every feed or at a max every four hrs. NG/OG tube was silastic, changed every 30 days per manufac. guidelines. Haven't worked anywhere yet that discriminated between breastmilk and formula although as a nurse I know that formula was more prone to clog the tubing . . . . so it makes sense to change it more frequently.

When a GBS pos mom misses her 2nd dose of Q4 penG, delivers 6.5 hrs after the first dose was on board, is her child considered "gbs pos but adequately treated" or "gbs pos inadequately treated" and can anyone guide me to a reference about this type of situation. This resulted from a med error (med missed at change of shift), and I am wondering - - if the kiddo is covered by the one dose 6.5 hrs prior to delivery (as this one was deemed to be by the docs) then why do we give a second dose at all? Why dose every four hours? Why can we not just give mom one dose and be done with it?

Same experience - varying workplaces have varying policies. Some filter everything (except lipids/insulin/prostin) to include D10W through a PIV, others have charts to show what fluids they filter through what types of lines. I just wish the long termers (nurses with ONE place of work experience for the last 30 years) would stop acting like any policy other than their institutions policy is downright unsafe.

Recently my unit has had a relatively high census for several weeks and it got me wondering, what happens in your unit when the beds start to fill ? Do you see overtime? More PRN staff? Do you ship babies elsewhere? Do your assignments get harder to handle? Does your unit work short (need more nurses than it has and not for want of trying to beg, borrow or steal?) Do you have staff float in from other NICUs or other units? Do you turn down transfers or divert admissions? I am curious to know what it is like elsewhere. Can you tell me what is it like in your unit?

We use sheepskin even on the giraffee mattresses . . . frankly, although the company has high claims for their mattresses, plain ol' sheepskin sure does feel 'cushy'er to us and it is probably just a case of whomever makes sheepskins not having the advertising budget that the giraffe people have. We use snuglies. We also have zflo packs and gel pillows . . we had prone positioner "sponges" too but they got lost fairly quickly - we think people mistook them for disposable items. Fancier is not always better, IMHO.

Recently we went to almost 24hr visitation, with only change of shift closed (and we have been fuzzing the boundaries there too.) It is great. Great for the families. It does require the nurses to be more . . . assertive. When you have a family that wont stop stimulating a little premie, for example, you cant just think "oh, dr rounds are in 10 minutes, then they will have to leave, so I won't say anything." Same with sibling visitation - we now let in young siblings for "as long as is beneficial to baby and the sibling." Now the nurses have to learn how to politely say "Your crazy 3 year old with the poopy diaper and the wandering fingers is driving us all nuts so get him out of here!" Politely. :-) Personally I don't have a problem with it and think that when said with a smile, most corrections go over well with reasonable people. The unreasonable ones . . . well, they were going to create trouble no matter what I say or how lenient/strict the rules are.

I dont remember seeing a cord problem in the three years I have worked at my current facility. We don't put anything on them and we do tub baths every three days. We don't treat them with anything when they have lines in either.