KatrinaPM

Hello Everyone! I work in Neonatal ICU and currently have three years of experience. I heard that some CRNA programs do accept people with NICU experience. Does anyone happen to know which schools these might be? Thanks in advance!

Our policy (I'm in Cincinnati, now) is that once babies are nippling 25% of their feeds (2x a day), then all developmental tools (snuggle ups, froggies, snoedels) need to be removed from the bed and unless a kid is experiencing reflux that is symptomatic the HOB lowered. We are supposed to give the kids 'tummy time' once a shift (2x a day), but the goal is to have them on their belly's while awake to strengthen their neck muscles. We send kids home at 34-35 weeks generally, so this can happen fast. (to set examples, we also do not let parents sleep while they are kangarooing, and do not encourage co-bedding multiples, even though we do cobed them in the unit.)

I like "Sound Advice". You could say something like, Sound Advice: a proposal for improving developmental outcomes in the NICU. Hearing the ones who cannot speak: How noise levels can be lowered to improve outcomes.

We do not feed while on Indocin. But some small kids that we give prophyllactic indocin to (23-24 weekers generally), usually are on fluids for the first few days of life anyway.

Where in Michigan are you? I used to work at Holden. I basically got the position because I had a few clinical experiences there, and was encouraged to apply for a new grad position by my preceptor. If you can shadow, I would definitely recommend that, even for a few days so that you can bond with the person you're working with... If you can get your role transition experience there, that is definitely helpful, but that's not always a choice you're allowed to make. (I know ours was a lottery). If you have questions feel free to PM me.

We don't give baths on new admits until at least 6 hours after they arrive, and are stablized, whichever comes first. The vernix has a antimicrobial property, so best to let it protect that new skin like it is designed to do. Micropremies get baths with h2o only. Older kids with J&J and tap water. I personally think that as soon as the kid loses his cord and or ivs, and is stable throw them in the tub bath. I find kids that have a swaddled tub bath that is quick maintain their temperature much better than a sponge bath where you basically are systematically cooling each body part off as you're cleaning it. Where I used to work, babies got bathes every other day, but here we only do twice a week or (if they're older or chronic) when they are stinky. We also do not use alcohol anywhere on an infant's body except the cord. We only use cholorhexadine (for anyone over 27 weeks, otherwise cholorhexadine can slough skin and it's horrible!) because of skin sensitivity.

I love the Ballard, as well. We tested other companies' inlines and there was a definite preference on our unit.

The unit I currently work at changes them every 4 weeks. But, also, if the kid is on humidity, we empty the water out once a day and caviwipe the inside of the drawer, because pseudomonas can grow. My previous unit where I worked changed the beds every two weeks. And they were ALL giraffes.

SteveRN21, I would be very interested as well. The past two years I have worked in two different NICUs and never was this mentioned by anyone regarding the positioning of infants midline for the first 72 hours. But considering that most bleeds occur in that time period, it really makes sense. Any articles or specific references would be greatly appreciated. Thanks!

Every time I've been taught how to hang new TPN, I have been taught to remove the excess TPN from the previous day's fluid due to the fact that the tubing contains quite a few hours worth of fluid due to the small fluid requirements of infants. So, essentially the policy is to change tubing every 72 hours, but you're still breaking into the line. And to think that I was oriented under the impression that the 72 hours were a money saving choice by the hospital administration!

Gross! I should think so!

Just be careful not to call in TOO early. Sometimes administration can question you as to why you 'know' you'll be sick enough to call in "already". Just make sure you know your unit culture and what is acceptable. I usually call in the early afternoon before my shift unless it's a subsequent call in. Then I cal call ealier. (But I'm usually never up before noon anyhow!)

Hey there! I am new to Cincinnati because my husband started med school at UC and I am working as an RN until it's MY turn to go back to school! Whee! Anyway, as far as where to live, my suggestion is to move to the East Side of the city or to look into living in Kentucky. I live in Pleasant Ridge and other great places to look are in Oakley and Hyde Park. Most people on the west side of the city have lived there forever and their families have been there forever and seem to be so happy with their lives that they may not be interested in new friends...that's my feeling about the city anyway. Let me know if you have any other questions, and feel free to PM me :) *Katrina

I PMed you about my experience but, reading your post, I think that NICU sounds awesome. (I wish I was in THAT nicu!) And 6 months is a great preceptorship, you're going to feel totally comfortable after you're done, and remember, you can always ask your fellow nurses about certain policies and about their opinions regarding care after your orientation as well. And if you still want MICU later, then go to MICU :)

Another trick I learned to fix the Air in Line issue was to clean the 'eye' part of the alaris pump with alcohol. When it's dirty is also senses air in line. :)