rnpilot

When I started in NICU in 1983 we were pioneering jet ventilation with a machine literally built by our RT department. If the study was from 1984, I would consider it too old to be very applicable now. In 6 years we never had a case of tracheobronchitis and although I haven't been around HFJV since the '80s, I'm guessing it's been much improved since then. We used it for the same reasons listed by SteveNNP.

The university hospital I worked at quit retrograding meds in the early 80s. They had a talk for the nurses from a pharmacist explaining why it isn't a good, reliable or safe delivery method for neonates. I'm very surprised it's still being used in any NICUs.

I did my BLS here. It was inexpensive and they also do ACLS. I was very, very happy with them. ACE - Academy for Career Enhancement

I have been a preceptor in a university hospital level III. I've dealt with similar issues. As far as I'm concerned, it was your preceptor's fault. She is the one there to teach you and catch the potential mistakes before they happen. This is precisely why you have someone there to work with you. There is a reason we double check meds, I.V.'s, etc., in NICU. She didn't catch your error to me = her fault. Also, all new nurses have "time management issues." Working in a level II, even for 3 months, really isn't preparation for a level III. IMHO, the orientation should start with level III and us older folks should retire to level II. There are very different issues between the two types of units. Last night I sat and had a talk with someone new. She had "time management issues." I explained to her that this is normal. It will take a very long time before you feel you have things organized, know what you are doing and have things under control. Knowing it's normal I think helps. It's not bad nursing, being a moron, etc., but time management and not being distracted is something that is built with time and experience. Please do something kind for yourself. It sounds like you need it.

Yes, but give yourself plenty of time. Gratz, and hope orientation goes well.

I work at St. Rose and am very happy with the hospital and the people I work with. They don't offer a sign on bonus, but pay is competitive. My hospital will train people in Level II NICU because of the shortage of qualified nurses. I don't know about L&D though. St. Rose has traditionally been the prized place to work. We're working toward gaining magnet status. It is union, but it is not an adversarial relationship with the hospital. I like living here. I live in the Green Valley area, but have also lived in Summerlin. The cost of living is high, but I tend to be pretty frugal. I don't eat out much, drink Starbuck's, etc. My daughter's school seems to be pretty good, and the Summerlin schools were great. We do plan to enroll our daughter in private school next year though. My complaints about the area are the heavy traffic, crazy drivers, and the transient nature of the town. I've lived all over the world and I'm pretty happy where I am right now.

Topped only by OR. LOL.

Having heard enough stories, and learned a little from life, I smell a rat. It would be too easy for them to pull a bait and switch. Bait you into accepting a job, thinking they'll put you in NICU, and instead end up in med-surg indefinately. Med-surg would be practically worthless experience for NICU. I wouldn't accept a job until they can put you directly into the program.

It definitely depends on the unit. Did they give you a tour of the unit before offering you a job? When I worked at a university hospital, I developed a "12 hour" bladder and could eat a hamburger in under one minute. I quit smoking because I couldn't get out to smoke, and that was when we could smoke in the next room. I also worked in a level III that had 14 beds that was much, much quieter and less crazy. We didn't keep any babies under 26 weeks, so our acuity generally wasn't that high, but I really loved it. It was still challenging without being hair-on-fire crazy.

Absolutely. You'll get "face time" and have the opportunity to become familiar with the hospital and staff. When you are ready for a job, they'll already know you so you'll be like one of them. This is good from a manager's position because they'll already know how you interact with other staff. I'd say this is one of the best ways to get an "in."

It's been more than 12 months for me, but I did take the test in 2004. I had been out of nursing for roughly 10 years. I had 12 years of NICU experience. If you've working in a level III, you should do fine. I felt kind of clueless as to specifically what they wanted and thought I must have done very badly, especially after being out so long. I was told I did very well on it. It was looking at a situation and determining what actions are appropriate- chest x-ray, doing a glucose, getting an ABG, notifying the doctor, etc. I also suffer from severe test anxiety and having this sprung on me without notice was rather unnerving. It really was just very basically- what would you do if your baby did this? I would expect anyone with 6 months of NICU to be able to do fairly well. Good luck!

Thanks everyone. My husband decided he doesn't want to move, but that's ok because I just got a fantastic job where we are :)

Shannon, I hear ya'. At about 10 years into NICU, I felt burned out and bored. I decided on a career change. I started working towards a commercial pilot's license. I loved flying! After a few years, and a couple ratings, I met my husband, a professional pilot. I had the opportunity to fly with him in the cockpit. My dream was killed quickly and I felt that I'd suffered "the grass is greener" syndrome. There were about 10 minutes of challenge and hours of boredom that would make a critical care nurse suicidal. A great break and breath of fresh air for me was doing some traveling nursing. I was out of NICU for about 11 years being a stay-at-home mom. I was really happy to go back to the babies. Despite the pitfalls, I really missed NICU and I knew what my passion was. Only you can find yours. Sometimes it helps to step back and try something else or different "scenery." You'll either find something better and move on, or know that it was only a temporary slump. Biggest things- know thyself and don't be afraid to pursue your dreams.

I don't think nipple confusion is a theory. I've actually seen it...once in 13+ years of practice. LOL. It was in a 36 weeker. It took all of about 2-3 days to get over. In the well baby nursery we routinely offered bottles after breast feeding unless the mom didn't want us to. Most nurses asked the mom if it was ok first.

It's not about the O2 per se. It's about ensuring gas exchange, thus the canula with a little positive pressure. That way ideally, CO2 is kept normalized in the hopes of encouraging closure because it's not having a negative physiological effect. Also, IIRC, the best chance of it actually working is within the first 24 hours. Considering the physiology involved in the transition from fetus to newborn, it sounds good in theory, but I think it's doubtful that it works in actual practice. I think there was only 1 time I saw it done. Also, if the infant was having problems with feedings such as desats, then it wouldn't be having good exchange. That's what I remember, however I could be wrong. Yes, keeping the duct open is only important if there is a duct dependant defect. In that case, the infant would be on drugs to keep it open. The O2 would have nothing to do with keeping it open, however with the defect the infant would likey require more O2.