karnicurnc MSN, APRN, CNS

karnicurnc has 28 years experience as a MSN, APRN, CNS and specializes in L/D 4 yrs & Level 3 NICU 22 yrs.

Latest Activity

1. NICU ratios

   karnicurnc replied to mlang's topic in NICU, Neonatal

   I work in a 60 bed Level III unit. Admissions, CPAP, vents and stable HFJV/HFOV are 2 patients per RN. Other intensive care status patients are 1 of 3 patients cared for by 1 RN. Intermediate care...

2. Phasing out CNS

   karnicurnc replied to marigoldey's topic in Clinical Nurse Specialists, CNS

   I am a neonatal CNS who graduated in May of last year. My hospital paid for me to go to school as the state requires a CNS in a Level III or higher NICU. I am 1 of 11 CNS's in my hospital (a large...

3. NG/OG placement

   karnicurnc replied to kp1987's topic in NICU, Neonatal

   X-ray verification is the gold standard for tube placement, but is not a feasible option to irradiate an infant before every feeding or when the tube becomes dislodged. Best practice also dictates 2...

4. What is the common practice for oxygen use for diaper rash?

   karnicurnc replied to Laurakfels's topic in NICU, Neonatal

   Agree with post above about oxygen and it's detrimental effect. Pumping 100% FiO2 into a preemie's closed incubator can contribute to ROP (think Stevie Wonder). Also oxygen is a drug and I would...

5. Residual Checks/Abd Girth

   karnicurnc replied to ScammRNC's topic in NICU, Neonatal

   I wanted to share our newly developed feeding protocol related to gastric residuals. This is a section taken from our staff education presentation and explains the evidence behind our decision to no...

6. Should I ask HR?

   karnicurnc replied to AnnieOaklyRN's topic in NICU, Neonatal

   I agree, good idea to apply. All they can do is decline to interview, but you will never know if you don't try. Good

7. Weekly NICU MRSA swabs

   karnicurnc replied to countyERNICU's topic in NICU, Neonatal

   We do weekly surveillance swabs. If positive then infants are isolated until d/c. We recently had a large group (about 20%) of MRSA-colonized infants. We had to isolate, cohort, treat with...

8. Residual Checks/Abd Girth

   karnicurnc replied to ScammRNC's topic in NICU, Neonatal

   We do not check abd girths as they are useless as stated previously. Here are two articles that helped to provide evidence to change our practice from checking residuals to NOT checking them unless...

9. Which Milk Warmer Do You Use?

   karnicurnc replied to mgturtle's topic in NICU, Neonatal

   We have used the Medela warmer for years, but only had 1 per pod of 12 infants, so it was not very useful except for the one person who got to it first for that round of feedings. We have also used...

10. Which Milk Warmer Do You Use?

    karnicurnc replied to mgturtle's topic in NICU, Neonatal

    From Medela's waterless warmer user guide: "Medela Disposable Inserts are a limited use item. Medela recommends changing the inserts every 12 hours. Inserts should be changed if human milk comes in...

11. NAS, How do you score?

    karnicurnc replied to luvmybabes's topic in NICU, Neonatal

    Inter-rater reliability training can improve the accuracy of scoring and boost the confidence the providers have in the nursing staff related to scoring. I have read several research articles that...

12. COMPUTER CHARTING

    karnicurnc replied to mina123's topic in NICU, Neonatal

    We use EPIC also, but don't let them sell you the adult ICU version and tell you they can modify it for NICU. Buy the NICU module to begin

13. 8 weeks of orientation

    karnicurnc replied to ilsaj's topic in NICU, Neonatal

    I agree that is not enough time for orientation. Request more time, if you can. Talk with other newbies to see how they handled it. Ask for a buddy when off orientation - a person you can go to for...

14. New job!

    karnicurnc replied to jeyre1847's topic in NICU, Neonatal

    The NICU is an intimidating place. The patients are often very sick, and families are extremely stressed. So it is good to heave a little bit of healthy fear. It will keep you on your toes. Make...

15. Nicu in need

    karnicurnc replied to catken's topic in NICU, Neonatal

    I am quite concerned about how your unit is handling this escalation in level of care. The "blind leading the blind" puts everyone's license in jeopardy. You can't just start running a Level III...