LR_C

Hello all, I'm doing some research about NICU and I came across Thermoregulation. I'm so confused at the relationship between hypothermia and : - hypoxia - acidosis - hypoglycemia - pulmonary vasoconstriction If anyone could explain any of the above to me, it would be VERY much appreciated.

Thank you so incredibly much everybody- your responses mean a lot to me.

Thanks so much for the reply! And I also have Gardner and Merenstein and I agree. Thanks so much.

Hello all, I am a new graduate RN who is looking for an NICU job (I have a few interviews coming up). In the meantime, I am planning on attending a Perinatal Neonatal Stream Nursing Certificate course in a few weeks. In addition, I have been reading some neonatal books such as the "Core Curriculum for Neonatal Intensive Care Nursing". I feel like I want to go into the NICU as an RN who has a really strong foundation- I don't want to walk in the first day and be COMPLETELY 100% lost. I don't know where to start though. There is SO much information in these books and I feel like I can only learn so much from a book and I would be able to learn more by hands-on. I don't think that nursing school prepared me to all of a sudden jump into something so specialized that I know nothing about. I just need reassurance and advice please :) It would be GREATLY appreciated!!!!!

Hello, I don't know if you'll get this as you posted a while back but I have a question about you doing research prior to your NICU interview. I am anticipating a NICU interview in the near future and I got a few really good neonatal books out and I've been studying quite a bit. I am just confused as to what I should study, what they could possibly ask me about in an interview, etc. What did you study/ research? Simply things like physical assessment of a newborn? What do do if you walk in and a baby is having difficulty with _______? etc. Thanks so much! I just have no idea what to look into!

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I love this question because I am a new grad RN and it is my absolute DREAM to work in the NICU and I've been applying to a number of NICU jobs and I'm scared of what they can possibly ask me in the interview (especially at this one hospital because my friend had an RN interview there and apparently it was the hardest interview she's ever had). My friend had an interview in the Oncology ward at the hospital that I'm anticipating an NICU interview from and she said that for her interview, they asked her what the main traits were in the population that she was going to work with (i.e. if it was mostly elders, things like pressure ulcers) and then after she identified a number of typical problems that the population she was going to work with had, they followed up by asking her what immediate interventions were. So I'm guessing if they have the same interview style for NICU, they'd ask things like what typical problems are (although I'm unsure if they would seeing as to how vast of an array of problems an NICU baby could have) but I'm thinking of things such as hyperbilirubinemia and whatnot. They also asked her to walk through a physical examination of a patient (so I'm guessing, if they did this for NICU, they would ask for what you're looking for when doing a physical exam of a healthy baby so things like symmetrical features, patent airway, normal heart rate, etc.) This probably isn't much help but as mentioned above, I'm anticipating an interview in the NICU and I've been brainstorming what they could possibly ask me in terms of specific questions and this is what I've been really looking into/ becoming familiar with. GOOD LUCK!! I know what it feels like wanting NICU so badly.

Hello Everyone, I just graduated from a BScN program and passed the CRNE and am now an RN :) I knew ever since going into nursing that my dream is to work in the NICU. It is what I was born to do and I know it. I'm in Canada though (ontario to be more specific) and there are not very many hospitals that allow new graduate nurses to work in the NICU. Obviously, I am open to working in other wards first and eventually working myself into the NICU. Unfortunately the job hunt has not been going well as I have yet to score a job, but I am continuing to apply. I feel like I am stuck in a rut and I don't know where to go from here. There is a 4-month Perinatal Intensive Care Nursing Program that starts in September that I plan on applying to in the next few days- I am just unaware if this is the right thing to do. It is a program designed to prepare RNs to work in any Level II or Level III NICU. I know that a few hospitals in Ontario don't let you apply to their NICUs unless you have this program already, so that's a plus. However, I am unsure if as soon as I graduate from this program if I can apply to work at a NICU? What happens if I don't get a job by then? Any suggestions? Advice? etc. Anything would be greatly appreciated!!!

Thank you so much! And that was a really good point- about what you said regarding what you would do in the "perfect world of nursing" because it just hit me that whenever I do my practice questions, I always think about what I'd do and (stupidly enough) never thought of what would be the "perfect" thing to do. That really helped a lot. Thank you very much for your reply!

Hello all, I feel silly asking this question but I've been doing some practice questions for the CRNE using the CNA "Learn" books. And I've been doing worse than I have expected- most of the questions just seem so odd for lack of a better word. Aside from Maslow's Hierarchy of Needs, what other processes would you suggest using for answering the multiple choice questions? I know obviously the answer would be "Everything we've learned up to this point" but a lot of the questions have 2 answers that are pretty much both right and I always have trouble picking out the right ONE. Thank you so much

I was wondering if you guys could help me out! I'm taking the CRNE on June 1st 2011 and Im so SO confused on what I should study! I was going to focus on anatomy and pathophysiology and whatnot but apparently that wouldn't help?! Any pointers? Thank you so much. AND CONGRATULATIONS! I am so happy for you :)

How do I get to the Canadian forum?

Thank you so much! Yes, I am educated in Canada and I as well have heard that it is not-so-science-based. Since it is based on psycho-social aspects, however, I feel unsure as to how to prepare. Thank you again for moving this over to the other thread!

Hey! I wouldn't for the life of me be able to translate my understanding in my head to words so I'll copy what my "Clinical Pharmacology Made Incredibly Easy" book explains regarding ACE inhibitors because I totally understand what you're saying but I think that this explains it well. Let me know if you still don't get it after I send you this. ACE inhibitors reduce BP by interrupting the renin-angiotensin-aldosterone system. Normally, the kidneys maintain BP by releasing the hormone renin. Renin acts on the plasma protein angiotensinogen to form angiotensin I. Angiotensin I is converted to Angiotensin II (potent vasoconstrictor) which increases peripheral resistance and promotes the excretion of aldosterone. Aldosterone> promotes retention of sodium and H20> blood volume increases BUT! ACE inhibitors prevent the conversion of angiotensin I to angiotensin II> angiotensin II is reduced> arterioles dilate> peripheral vascular resistance decreases By reducing aldosterone secretion, ACE inhibitors promote the excretion of sodium and water, which reduces the amount of blood the heart needs to pump> BP is lowered I really hope that helped!

Edit: Are just reviewing the review books adequate in your opinion? Or should I go subject by subject with other books and then at the end do the review books? Thanks!

Hey everyone! So I have my CRNE this coming June. I already have 3 review books (I have a mosby one, a lippincott one and the CNA one). BUT- I feel like I REALLY want to know my stuff inside out. I love the "made incredibly easy" series and I was going to divide my next 7 months into studying patho, pharm, med-surg, mental, pediatric, mother-baby, fluids and electrolytes, etc. etc. and then have 3 months (March, April and May) to go over my review books and review everything again. In order for me to get through all this material- I would have to study about 4 hours a day from now until June. I would be willing to do so as I would do ANYTHING in the world for my nursing career. It sounds crazy to me though. Would this be too much studying? How did you guys study for it? Thankyou. So. Much.

THATS EXACTLY HOW I FEEL! I feel my problem was not only rooted in the exhaustion of pre-planning but the fact that my university has MANY electives you have to take (that have NOTHING to do with nursing) that take all of your time and effort that when it comes to clinical its like you're pooped already from all your work for your electives you have no drive left. I wish it was just ALL clinical. Best of luck to you. and thanks SO much for replying.

Thank you so much for that. Im sorry that you're going through the same thing but it really helps knowing someone is in the same boat. I know 100% that we will be okay- it's just hard going through a (long) phase where you feel like you're not like everyone else no matter how hard you try. I wish you the best of luck in the future- and I know this sounds hypocritical of me but : we can do it :)

Thank you so much everyone- I really REALLY appreciate it.

I totally agree! That's like when I graduate, I know I 100% want to work in NICU but everyone says "do general medicine or something because if you do NICU and then realize you hate it, they wont accept you in another ward because babies are so different" but I KNOW that I want to work with babies no matter what (its what my gut tells me) so even though its a less practical route (in the long run) to take- I am definitely going to work with babies. Go with your gut :) and good luck.

Im in my final year of nursing and I am going to have 2-3 days of clinical a year in a pediatric ward. I LOVE kids so I know that I will love the ward- I am just worried SICK about my critical thinking! In my ENTIRE 3 years of nursing I have felt like I know nothing- I really don't think I do. I think I know as much as any average person who has not been in nursing school. I can barely remember ANYTHING i learned in first year (i.e. anatomy, pharmacology) and I have to constantly review things (EVEN STUFF LIKE PHYSIOLOGY OF THE KIDNEY!!!) EVERYONE seems to know more than I do. Even last year when we were in groups for clinical, it seems like everyone knew more than me! I was having to review anatomy and physiology of the liver and kidney when in the meantime some other people in my group were lecturing us on receptors I have never heard of! And just today for example I was looking up the urea cycle to remind myself what it was. WHAT AM I? LEVEL 1?!?!??! How am I expected to in 8 months (when Im an RN) be like the nurses I see in the hospital who are like "doctor I think we should up the oxygen on this pt because hes struggling to ______ and feel that the contraindication of _____ would affect his condition" do you know what I mean? I love nursing. I just feel like an IDIOT!

Hey all :) I am going into my 4th and last year of nursing and my school is having a "lottery" to assign placements to us. I want a placement where I get to learn as many skills as possible. I want to learn EVERYTHING I could possibly learn about every part of the body, every organ, every system, etc. and i want to know it all. I want to graduate as an expert with IVs, needles, suctioning etc. and I have NO idea what placement to choose! Has anyone had any good experiences in clinical theyd like to suggest that I could possibly choose as well for next year? Thanks so much :)

Hey everyone, I'm just extremely stressed right now. Im currently in third year of the BScN program (which ends in 4 weeks) and I'm having a bit of a crisis and I can't handle it anymore. I'm having A LOT of trouble putting things together and I can't see myself magically being able to do so when I get a full time job next year! Im in THIRD year and I feel like I know NOTHING about electrolytes, I can't name the name of the receptors on the lungs for example... until someone brought up last week in class that when you're giving someone oxygen it affects the chemoreceptors on the lungs. I WOULDNT HAVE KNOWN THAT IF SHE DIDNT SAY IT!, I'm still not understanding 100% how the kidneys affect the liver and vice versa, and don't even get me started on acid-base balance. I feel like I know absolutely NOTHING. Everyone is always saying stuff that they remember from pharmacology like 2 years ago! I still need a reminder on what corticosteroids do! and I don't even know what beta blockers do without looking it up in my notes and reminding myself like every time. I can't believe this is happening... I feel so mentally inept! And it feels like I need another like 6 years in school to be competent. A part of me feels like just furthering my studies after I graduate in another field... but I know there is nothing else in the world I rather do. I just want to work in the neonatal unit. Its my dream and I cant wait. I just dont think I can do it. Help. Any books I can read/ study over the summer to refresh my memory on stuff do you think? Any suggestions about ANYTHING I can do? I just want to be an incredible nurse. I know I have the heart, but definitely not the knowledge. And I can't believe I'm admitting this. Thankyou!