HeartNIC

We get a lot of hats donated and definitely use the hats in NICU. I love the ones that are soft and a little stretchy but not overly loose. Parents (and nurses) really like holiday specific hats. At Christmas we had a lot of red and green. We just got a delivery of red hats and pink hats with a single heart for Valentines Day. Just know that whatever you choose to do parents and nurses always appreciate the thought and love that goes into the hats/blankets donated to NICU. Thank you so much!

NICU Gal - You are right on with what legal said - physicians need to be documenting that they are reviewing and interpreting the events that we are documenting! The medical director thinks having the nurses look it up and document will decrease the docs work but it is really only creating more for them...I am with you, we'll see how long this lasts!

The idea was from the medical director, our monitors are high tech and doctors were noticing A&B events recorded on monitors but not charted. The events are generally those heart rate drops that self-recover within 5 seconds or so. Sometimes a nurse many not even make it to the room to see what is happening but it happens frequently enough to cause concern and is potentially the difference of whether or not an infant is sent home on a monitor. The expectation became that a monitor event review would be done every shift with nurses charting recorded events that are not witnessed. The HR drops recorded are reliable on our monitor, recorded as a number as well as the rythym, it is clear whether or not it's artifact or a true heart rate drop. Desats are only documented IF accompanied by a recorded HR drop because the pleth recording does have a lot of artifact. Nurses are not expected to interpret, just document factual information. The entry would say something like "0900 - HR was recorded as 72 and sats 78 per monitor event review at 1230". Nurses are reporting recorded information and physicians are expected to interpret the information on the monitor. It's interesting no one has responded they are doing it.

Okay, so you have a cold baby, neonates have very limited ability to respond to cold stress. A physiologic consequence of cold stress is increased O2 consumption. This causes O2 needs to increase which can lead to hypoxia and lactic acid production. Once that starts happening ph is effected causing metabolic acidosis which leads to pulmonary vasoconstriction. Cold stress also increases metabolism. Increased metabolism increases the use of glucose. Once the circulating glucose is used the body turns to the glycogen stores and if it goes on for too long depletes glycogen stores leading to hypoglycemia. Then on top of all that, Surfactant production becomes a problem as it requires oxygen, glucose, and good lung perfusion. Neonates have very little reserves so depending on the gestational age and size of the infant all of this can happen very quickly and be extremely difficult to recover from leading to even more problems.

We do not cover IV's with anything. Our armboards are soft and cushiony and there has been no problems with babies scractching themselves. I know in PEDS they use covers to keep their patients from picking at and pulling out their IV's but we have never had a reason to cover our IV's in NICU.

We recently had a change in practice requiring nurses to do a monitor event review to catch any A&B's or desaturations recorded in the monitor that were not witnessed or charted. An event log review is to be done at end of shift and documented that it was done and whether events were found or not. This is a new practice for us and compliance is really low. Do any of your units do this and if so do have an accountability system that works? Thanks.

My unit is looking at starting to use donor breast milk and we need to decide on what population ( If anyone has any thoughts, advice, or opinions to share on starting a program using donor breast milk I would really appreciate hearing from you! Thank you!

Same here, I would love to see a copy of a nurse directed feeding protocal and algorithm if anyone is willing to email to me. Our docs are directing ours but are willing to take a look at what we come up with. Thank you! [email protected]

I experienced the same kind of feelings in the first 2 1/2 years I was a nurse. I was certain I picked the wrong profession and was ready to go back to college for a career as a teacher. I decided to try something completely different so I applied to ER and NICU. NICU offered me a job first so I accepted. In a short time I knew I was exactly where I was supposed to be and did indeed pick the right career. It's now 14 years later and I am still at the same hospital in the same NICU and can't imagine doing anything different. I love being a NICU RN! So only you can answer the question of whether or not nursing is really for you but I recommend you take some more time to try an area or areas you haven't worked yet, you never know! I wish you the best!