futureTBA

I work in a level 2 special care nursery and discharge teaching varies depending on the needs of the infant. Are you supposed to focus on mom's discharge from postpartum without her baby? Maybe her discharge with a 36 week late pre-term infant who never went to the nursery? Define pre-term. I would start with that - figure out your target audience. A relatively late pre-term infant who is not separated from mom but rather discharge straight from postpartum with mom might have teaching focused on safe sleep practices, breastfeeding resources in the community, when to call your doctor (signs and symptoms to monitor), car seat safety (especially going into winter!) and more A mom going home without her baby may need some different information. Her 33 weeker is in hospital for the next several weeks at least, what does she need to know? Maybe about mental health resources in the community for things like PPD (also important for any mom), lactation/breastfeeding resources to help with pumping for a preemie, information on safe milk handling and storage, parents like to google medical info (and google is a scary doctor!) so sometimes I provide them with a couple of reputable medical sites to do their research on (like the Mayo Clinic or the Hospital for Sick Children in Toronto) Figure out who you're targeting and think about what you'd like to know if you were the parents.

Thanks for all the feedback! Looks like the poll splits us 50/50. Glad to know it's not just us. I was going to ask the educators on my next set in whether I had misunderstood in training! I definitely hope it will get faster, right now I feel like a turtle swimming through molasses could do it faster than I can (And thanks Missie Hannie - it's been fascinating so far - and a little nerve wracking but I will eventually settle in)

I am a new grad and had the great fortune to be hired into a level 3 NICU. I have finished my class based orientation and am starting my preceptored shifts this week. During our orientation I learned that our unit does sterile line changes. Essentially any PIV or Central Line is changed under sterile conditions. We have a 2 nurse system to put together the new lines and then it takes 2 nurses to get those lines connected to the infant. The level 2 NICU where I did my pre-grad consolidation didn't follow this practice so I'm wondering how common it is. So - do your units change lines under clean or sterile conditions? Thanks!

Hi rlsdhounds, I am just finishing my fourth year in the BN program at Humber so I can't tell you too much about the PN program. I will suggest that you might find more helpful advice in the Canadian forum (you might want to ask a moderator to move this post there!). Nursing will be pretty time intensive. You'll have classes and clinicals, including weekends sometimes. Classes may not look like they take up that much time, but once you factor in study time and mental fatigue, it's a more tiring day than you'd expect. Courses are tough, there's much more reliance on self-teaching. No one will give you week by week homework. No one is checking to be sure you're doing what you should be. It's on you to make sure you've understood what you were supposed to learn, even if it wasn't explicitly covered in class. That takes a lot of people by surprise. But as much as an instructor's job is to instruct, it is a learner's job to learn. Do you readings (maybe not all of them if you run out of time - or fall asleep!). Cover your objectives. Watch the skill videos (trust me!). Don't freak out about memorizing all the details, worry about understanding the patho - that will help you figure out why we look for certain symptoms, or why we perform certain tests or other actions. Good luck!

Trillium in Mississauga runs a Clinical Nurse Extern program every year. The app usually goes up around March I think on their website. They hire for the summer but often extend into the school year.

Oh- and I'm going to ask a Mod to move your question to the Canadian forum just so you might get more information from other sources who are familiar with the various options.

Ok. So, I'm not completely familiar with the Sheridan program. I am however really well acquainted with the Humber program. If you have taken university level courses in high school and maintained an over 80% average then all three options are available to you, Pre-Health, Practical Nursing and Bachelor of Nursing. If you didn't take U level courses or your average was under 75%, then you are usually looking at only Pre-Health or Practical Nursing. There are so many streams available in Ontario but all of the nursing programs are very competitive. Last year at Humber the admission cut off for the bachelor of nursing was about 81% according to the associate dean I spoke with at their open house last weekend. You have a few options: Option #1: Pre-Health --> Practical Nursing (3 years total) Option #2: Pre-Health --> Bachelor of Nursing (5 years total) Option #3: Practical Nursing (2 years) Option #4: Bachelor of Nursing (4 years) Option #5: Practical Nursing --> Bridge to Bachelor of Nursing --> Bachelor of Nursing (5 years total) I don't see a point in doing option #1 unless your marks in high school are not competitive for the PN program. Option #2 is good if your grades aren't competitive for the BN program or you didn't do U level courses but you want your BN If your preference is to get your PN diploma and start working ASAP, then option #3 is your best bet. If your preference is to get your BN degree then #4 is best, but you can also take on option #5 as an entry if you didn't do U levels and it will allow you to work as an RPN casual/pt while you do the BN bridge. Take a look at all of the schools and what they offer. Humber offers all of these programs, Sheridan does the Pre-Health and PN but I don't know if they have bridging agreements with any BN programs. Often, the bridging option is restricted to graduates of the PN program from the same school as the BN program (i.e.: Humber PN to Humber BN). Go to the health fairs, contact the schools you're interested in. If you have any questions, just ask!

Hi Dawntoearth - second year was way different from first year. Second year was tough! I actually try not to scare people but go into second year expecting to study more and to adjust your study methods. It was tough but definitely do-able. Just keep up with everything because if you get behind (like I did) it's a pain in the butt to dig out. Just remember, the majority of people pass every year and so will you :) Don't worry about trying to prepare, unless you have a driving interest in reading really dry textbooks, I would prepare by relaxing over the summer so that you're in the right head space for the start of year two. Good luck!

I took a LTC placement in Oakville. Got an awesome instructor (although she's on mat leave now so you wouldn't have her). Honestly, first year I would just pick the location closest to home for you. There is so much excitement for the first clinical placement, but it's really just focused on learning how to interact with patients. You'll do fine wherever you are! Congratulations on your awesome GPA -and best of luck on the upcoming exams!

I graduated with about an 83 as well, but I was applying as a mature student. I got into Humber/UNB and I'm really enjoying the program so far.

Where did you graduate from? Your best bet is usually to check with them as some schools only offer the bridging program to their grads. For example, Humber's bridge is not found on their website because it's currently by invitation only based on grades in the Humber PN program.

Thanks NicuGal for all the help - I just got my feedback yesterday during my last clinical. My instructor actually asked me to email her my care plan (they were submitted in hardcopy) so that she could use them as examples for future clinical groups :) I'm so pleased. And I think I might have the same nerdy tendencies you do, 'cause once I got the hang of it, they really weren't that bad. It's just about thinking it through. (Oh - and I'm glad you picked up on the blanket over the crib. The nurses in the Special Care Nursery were all doing it so I thought it was protocol but managed to find the back to sleep info and realised it wasn't.)

Thanks! I've now moved on to the mother half of the care plan. This one is going a little easier :)

Hi NicuGal! I wound up going with imbalanced temperature given his low birth weight and prematurity. But I'm happy to think this one through. So, the phototherapy was complete. The bili levels should have been taken the day I was there (although they might have been with the lab and just not up yet). Bilirubin is excreted through the feces, so I know we checked his diaper every three hours before his feedings. I did his diaper change twice and both times he had a transitional stool, nearly milky. So it looked like he was probably excreting the excess just fine. I would explain to the parents that feeding should occur every 2-3 hours to help pass the bilirubin through and that if he was getting more jaundiced rather than less after discharge from the hospital, he should see his paediatrician as soon as possible.

Sorry, it cut me off. Bili levels were: Day 1 108 Day 2 (am) 103 Day 2 (pm) 89 Day 3 108 On the day I was caring for Twin B his vitals ranged quite a bit HR 125-165 RR 16-62 (irregular) T 36.8C - 37.2C We transferred him from the isolette to the crib that morning. Here's what I have for my care plan so far: Risk for imbalanced body temperature r/t premature birth, low birth weight, reduced levels of brown fat due to prematurity, recent transition from isolette. Outcomes: Infant will maintain temperature within normal range of 36.5C - 37.2C during shift. Interventions: 1. Infant to remain dressed in gown and hat 2. Crib to be placed away from any source of draft (doorways/vents) 3. Blanket placed over top third of crib (taped to edge of crib to prevent dropping onto baby's face) 4. Axillary temperature to be monitored Q3h and prior to any care Thoughts?