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. :)

I came from Michigan and moved to Cincinnati because my husband started medical school at UC. I interviewed at Good Sam and at Children's for their NICU. Good Sam (TriHealth) actually offered me more money than Children's and there are a lot of different bonuses you can get. (there is a 12,000 bonus that I get over two years for working straight night shift.) Also, I got 1500 in relocation reinbursement. Which was awesome, because our move cost us less than 500 bucks total. We ended up in Pleasant Ridge which is near Oakley, but the cost of housing is a lot less there and a lot less than in Hyde Park. Also, if you interview somewhere ask your HR person about getting hooked up with a real estate agent, that's what we did and I was happy with that. :)

I am moving to the Cincinnati Area, where my husband will be attending medical school at UC. I am wondering where we should look for housing. I want proximity to the school, a safe area, and reasonably priced (The hyde park area, I've found is out of our price range). Feel free to PM me! Thanks in Advance!

I mean the types of errors where there is an incident report made up and families are informed of the mistake. Do you take care of those babies the next night? How do you handle the parents? How do you handle yourself? And how do you handle your co-workers knowing that a mistake has been made and you were the stupid one to do it? What's been your experience or your perceived experience of other nurses who've done it? TIA

I'm at a teaching hospital and I know there are "cheat sheets" for the residents that come in monthly that have all of the protocols in one very condensed space. See if you have anything like that available! :)

Tips, Ah, yes, I have tips. Many tips. I just had my last day of orientation, (5 months long). And it's been a good but very up and down process. 1. Find a few people you can trust. I happen to have an amazing unit educator, and actually I have found that I have many quesitons that some nurses I'm working with can't even answer! But the educator is AWESOME and has a good sense of what my expectations as a new grad really were.... 2. Never be afraid to ask questions. Start worrying when you stop having questions. 3. Double and Triple check. 4. Forgive yourself. Everyone makes mistakes. If you have a bad day or things aren't going well, make sure that you take a deep breath and trust that you will learn from that mistake. 5. Have realistic expectations of yourself. Remember, NICU is really specialized...it's also a relatively new discipline as far a the history of medicine goes. There are a lot of different ways different docs choose to do things and the rapid changes in this area can get very confusing. Just do your best. That's all anyone can ask for. 6. If things aren't going well with your preceptor, see if there is a way that y ou can hook up with someone who has a personality that jives with yours. It helps a lot! You're going to be great! You and are both lucky to have landed really amazing positions in the area we love to work in!

Ugh! I sent my information in to the Pierson and to the state April 4th. I graduated on April 30th. And I was told by this guy to just be patient, they haven't gotten to my name and I should get my ATT in three weeks. Almost everyone else in my class has taken the test already. I hate them. I hate them! My pay won't go up until I take it and I just want this to be overwith. Okay. Done whining now. :angryfire

Well....definitely look into Chicago Hospitals. I think my roommate got a job offer at Northwestern, and Rush. Another thing you could do is call nurse recruiters at bigger hospitals and ask them what their suggestions might be. I mean, it's not your fault you're unable to get exposure in your area.

You have to have permission? That's ridiculous! High school students shadow (this is like for a day or two, not a semester's worth.) Also, call around to other hospitals. Not all NICUs hire experienced nurses who've been in other areas. Other options to think about would be possibly starting on a mother/baby unit where there are well babies there. Or some peds unit that gets nicu overflow when you start. I'm starting in the NICU as a graduate nurse (just happened to be in the right place at the right time) Contact other nurse managers. That's my suggestion... Also, do you have to stay in the area that you are? I know that my roommate was looking for jobs either in L and D, and big hospitals like Rush in Chicago, etc, hire new grads into NICUs as well. If that's all you wanted to do, then do it.

Is there any way you could fit working into your life? If you took a job as a nurse aide on the unit, the likelihood that you'd eventually would be hired would probably skyrocket. Also, try to contact nurse managers ask them what they would like to see...explain that you have no clinicals in the NICU. Another option would be (if it's a bigger institution) is set up a day of shadowing. Managers like that a lot because you get some time on the unit and you can see how the unit operates and have an example of what the day would be like. Also, while you're there, I would recommend trying to get to know the nurse you're shadowing and see if she'll put in an extra good word for you.

I just graduated from nursing school and my goddaughter was talking to her mom. Mom: "I can't believe she's done! She's going to be an RN" My Goddaughter smiled gleefully: "Yeah, a Real Nurse!"