babennp

Yes, we look at both dextrose concentration, calcium, and osmolarity. 900 osmoles or less for PIV. Dextrose 12.5% or less for a PIV.

We do use UACs for TPN/IL administration but only if we have IV access issues. No, we do not run TPN/IL through the transducer because it clogs up the transducer and you cannot obtain a good wave form

Normally it is the primary role of the NICU RN. However, I have worked in units where the NICU RT can or will draw them if the RN is busy. Currently, I work in a unit where the RT's have little to no NICU experience. They are checked off on drawing adult ABG's and think they should be able to draw off a UAC. We have decided at this point only the NICU RN can draw an abg from a PAL or UAC. Today, I walked in the unit and an RT drew a gas from a UAC and she had no idea how to flush the line because the set up is very different from an adults. Atleast, she knew her limitations and asked the appropriate questions. So I think you need to consider the RT's NICU experience.

I work in both a level III NICU and NBN. Near term infants who are able to go to newborn nursery, may be syringe fed but only if a lactation consultant is involved. We prefer to use the supplemental nutrition system. Our system looks like upside down bottle that has a small tube connected to it. The tube is taped to the mothers breast and as the infant sucks, milk is pulled through the tube and into the babies mouth. It is our policy that any near term infant admitted to NICU will not be cup or syringe fed. They are either gavage fed, bottle fed, or remain on IV fluids until breast feeding is well established and mom's milk is in. We feel there is a greater risk for aspiration, oral aversion, emesis, and respiratory problems when cup or syringe feeding any infant.

Our hospital in the past has cross trained L/D nurses to NICU. Even the best L&D nurses have difficulty transitioning to this area. If your hospital has a good internship, you may do well. You must have a good foundation before you can build a strong building and the same applies for NICU. A good baby can turn bad in a matter of minutes. You may not need to be full time to learn the basics but I think it will be extremely difficult ito master the basics f you work only 2-4 shifts per month.

I don't recommend cross training to NICU. I suggest an internship. It is easy to perform tasks but difficult to identify neonatal decompensation and when intervention is necessary. Especially if you don't under stand the physiology/pathophysiology of neonatal disease processes.