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LittleWonders specializes in NICU.

LittleWonders's Latest Activity

  1. LittleWonders

    Certifications to help a new grad interested in NICU

    I would usually say that the more hands-on experience the better. However, it would just depend on what those roles entail for your particular unit. In the last unit I worked in, the secretary knew everything about everything, and the PCT did mostly housekeeping. In this unit, the PCT runs most of the show. Ask first. :)
  2. LittleWonders

    checking residuals

    If they have a tube, we check residuals before every feeding.
  3. LittleWonders

    JCAHO in relation to NICU care

    Yes, ours is just as strict. If you forget to enter your action code, you're put into the disciplinary process. We have to comment, but there are only two choices that ever apply - notified the MD/NNP or no intervention needed. Even in the midst of drawing other labs or providing other care, if you look at the displayed glucose you have time to enter the code. If something happens and I can't enter the code, I'll give a shout to another RN who will handle that part. If both of those things fail and the machine shuts off, we also have to alert the lab - only because they handle all of the lab related equipment and will manually enter the action code needed with their management software. Our electronic chart also allows for a comment to be entered by the RN later, but that's not the "preferred method." I loathe to forget the first time, though. It's a pain in the rear, but much less so than the paper trail if you forget.
  4. LittleWonders

    Interested in NICU.....have an important question tho?

    L2L is right on the money. You have your head in the game and you're totally focused on the care you're providing for your patient and their family. Their needs are simply more important than your own. The two times I'm the most likely to cry are during baptism and when the dads breakdown. Crying dads get me every time (whether happily crying or sad). Families appreciate that you're moved by their loss, and they won't ever forget your compassion. It's okay to cry - so long as getting the job done remains your priority. Some losses are certainly harder than others. A 24 weeker who has been circling the drain for 3 days isn't nearly as hard for me as a 32 weeker who develops severe NEC and passes in what feels like minutes....or a term baby who had horrible delivery complications and doesn't make it.
  5. LittleWonders

    Certifications to help a new grad interested in NICU

    I would also recommend waiting on the additional education. Much of it won't make sense until you have some working knowledge of the NICU world. The NICU has its own language, procedures and even equipment. Those classes will be packed with terminology and acronyms that are completely foreign. A part-time job or volunteering in the area you're interested is a great suggestion. You might also see if your local facility offers nurse intern/externships.
  6. LittleWonders

    High Frequency Jet Vent?

    In addition to the Bunnell website, the best resource I've found for NICU vent issues is: http://www.adhb.govt.nz/newborn/teachingresources/ventilation/Ventilation.htm According to our RT director, NZ is the go to for up to date vent research. They do a great job explaining the basics. HFJV doesn't require a special ETT. It does require a special adapter for in-line suction. We use both, though we use HFJV more often than HFOV due to our population. HFOV is used primarily for term kids with PPHN or MAS. We jet the ELBW population who are struggling with tissue compliance - often those tiny guys who have been left in a dry uterus for an extended period and who have failed on a conventional vent. There is some research that connect HFOV to increased IVH in the teeny tinies and we only try it if everything else has failed.