karnicurnc

karnicurnc MSN, APRN, CNS

L/D 4 yrs & Level 3 NICU 22 yrs

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All Content by karnicurnc

  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...

  16. CNA in the NICU

    karnicurnc posted a topic in NICU, Neonatal

    Hi, Just curious if your NICU employs nursing or patient care assistants and what some of their responsibilities might be, such as PO feeding stable infants, taking vitals, NG/OG feedings after...

  17. Nicu/peds float - becoming competent

    karnicurnc replied to m0lasses's topic in NICU, Neonatal

    Agree with the above comments. Our float pool receives about 3-4 days of training and take the feeder/growers. The most experienced floats can take slightly more complicated kids, but that takes...

  18. Parent Support Groups

    karnicurnc replied to msangel77's topic in NICU, Neonatal

    A support group made up of former parents who mentor current NICU parents? Or a support group where you as a nurse offer support to current NICU

  19. Looking for some support on how to keep focused in the face of short staffing and pressure

    karnicurnc replied to tinkerbell419's topic in NICU, Neonatal

    Several things I want to comment on: Rotating shifts within the same week is a problem. Can you ask to be on days or night totally, and not rotate around? Your nurse to patient ratios (5-8 patients)...

  20. Looking for some hand hygeine policy input...

    karnicurnc replied to NICURN29's topic in NICU, Neonatal

    Same as babybums, above, no rings with stones and no artificial nails. Plain wedding band is

  21. Maximum bedside visitors

    karnicurnc replied to guest769224's topic in NICU, Neonatal

    4 per bedspace, so that means 8 swarming visitors for twins and 12 for triplets. It's a

  22. Neonatal Admission Meds and bedside barcode scanning...How do you all do it?

    karnicurnc replied to Kldrn9963's topic in NICU, Neonatal

    I agree, standard ordersets and submitting incident reports will help. Be thorough, objective, and

  23. I made a mistake and feel awful

    karnicurnc replied to kerussll's topic in NICU, Neonatal

    I agree with the above posts: the transport nurse put the lines in - he/she should know exactly where they are. Nothing in your care contributed to the IVH. Being born early, in an outlying...

  24. Calling NICU nurses!!

    karnicurnc replied to jamisaurus's topic in NICU, Neonatal

    Hi! Yes, sometimes the babies cry nonstop, some are sedated, the families can be challenging, and we do titrate drips. Spending a day shadowing a NICU nurse will provide invaluable insight into the...

  25. Methadone and NAS- from a mom's perspective

    karnicurnc replied to MamaAndDoula's topic in NICU, Neonatal

    We encourage consistent breastfeeding if the mother can produce a UDS that is negative for street drugs. Most of these mothers are not able to maintain a supply because they do not visit and...