likeminz

Thanks for your feedback both on hypoxia and on orientation. I am frustrated by lack of good orientation, however this is the only opportunity to work in Neonates in our town. My experience in SCBU stands me in good stead... I am much better prepared than nurses who are employed directly into NICU who also only get 2-3 days orientation. I have some previous experience in nursing, and an ability to keep asking questions until I have an answer. I refuse to do anything I dont know how to do without proper supervision. The part that can trip you up is that you don't know what you don't know. I am religious about only checking drugs with senior staff... only suctioning with senior staff. We run so short staffed that we are constantly having to use ICU nurses and casual staff, the honest truth is that the parents are thrilled to have nurses that actually work in NICU care for their babies. In terms of not knowing about the hypoxia and pain issue... I guess that is really about me liking to explore stuff. I too respect the parents decision to turn their baby off. I think that being mature, knowing your limitations and asking lots of questions play a huge part in keeping yourself (and your patients) safe.

Special Care Baby Unit....Level 1&2 nursery

We have a very strict policy around the signing and storage of EBM. All EBM has to be double signed. When you add calories to EBM or formula they have to be double signed. EBM can only be kept for 5 days in the fridge (not on the door), however we freeze it, defrosted EBM is only good for 24 hrs. We have quite an extensive policy detailing care of EBM. cheers

I wouldn't want to think that the baby was suffering... not at all, and would always want comfort measures where appropriate. The only reason I queried it, was that I felt that in this instance it was the morphine that killed the baby. This baby was relatively stable, had been off CPAP for a few days, went backwards a bit, was being weaned off, when a headscan was done that showed extensive PVL. Parents decided to withdraw treatment. I felt that the baby would have survived without the morphine. That worries me. As to orientation. Our unit does very brief orientation periods... I had 2 days when I started in SCBU, to their mind changing to NICU doesnt require further orientation. I think they are wrong, but that is the way they do it, and they are not flexible. I believe it is one of the reasons we have poor staff retention.

HI.. I'm new to this forum, and fairly new to NICU nursing, having recently moved to NICU from SCN. Our unit doesnt believe in orientation (like none) so I find it hard to figure stuff out. However the point of this letter is about a situation that occurred at our unit, where a baby's parents opted to discontinue treatment. The doctor charted morphine to maintain the baby's comfort. I queried this as I didnt feel that the baby would be uncomfortable (he had been on CPAP). I felt that the morphine contributed to his speedy demise. Other staff said that hypoxia was very painful and that they required morph. i thought hypoxia was relatively painless. opinions?...