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Sleeping
Is there no one else on such a large unit that can go and get them? There has rarely been a time I've worked in a large unit that absolutely no one could step off the unit for 3 minutes to grab someone from the break room. Or offer them your cell phone when they go on break so you can call if they don't have their own cell at work. I don't want to read too much into things, but it sometimes sounds like you take an unhealthy amount of responsibility in your job. You don't need to leave your cell phone if you're going for 15 minutes. You deserve an uninterupted break like every other nurse. I don't leave my cell number when I go to the cafeteria and there is no way to call down there. I don't feel bad about it. That's my time and it's what keeps me healthy and able to go back and function properly. People who don't take breaks concern me as much as people who take too many.
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Sleeping
I work with a lot of people who nap on their break time, but they take one hour just like the rest of us. It always surprises me that people complain about sleepers. It doesn't matter what they do on their break as long as they come back on time. And I am not going to play martyr and only take 10 minutes break for a 12 hour shift. Unless my kid is literally coding, I take a break. I'm entitled to it and yes, someone is going to have to cover my assignment while I'm gone just like I'll cover theirs when they're gone.
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Is working in the NICU physically stressful?
It does often involve a lot of standing like any nursing job, but I'd say it's less physically demanding than a lot of specialties because our patients are light.
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Does any other night shifters feel like days has no idea how nights works?
It's a 24 hour job:) I have heard a lot of people say nights is easier, slower, quieter, whatever. I always tell them if it sounds like such a great shift to work, they should sign up to do it. Few do. I'm looking forward to starting a day shift job in a few weeks and can't wait to feel normal on my days off!
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How do you count HR in the DR
Palpate cord, 6 seconds times 10. But, I also tap out the heart beat with my other hand on the bed so the other team members have an idea. Some nurses tap it with their feet too. Then even if you don't calculate quickly they still know what's going on. Fun tip for you: the beat to the song "staying alive" is 100 beats a minute.
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What's the Difference?
I'd go with the first hospital. Children's hospitals that do all the wierd stuff are a great place to learn and all that, but they don't give you as much of the general experience. If you want to move around to other units and other hospitals, you're better off getting a more "normal" nicu experience. It's actually what I did when I went into NICU. I've since worked in a Children's hospital and it was enjoyable, but I definitely feel I made the right choice in starting out where I did. That place gave me the foundation to travel with that the Children's hospital wouldn't have.
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1 year experience
Please listen to the others. There is nothing worse than working with a traveller who doesn't know her stuff yet because she doesn't have enough experience. The reason they pay travellers what they do is because you're supposed to be able to function as well as their staff with extremely little to no orientation. After a year of nursing, it'd be hard to do.
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NICUs in Dallas?
A friend of mine worked in Baylor's NICU for years and really liked it. She also speaks highly of Presbyterian in Plano (the Texas girls all seem to just call it PresbyPlano).
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I'm never primarying again, y'all
I'm glad you asked for a bit of a breather:) The sad truth is, if you couldn't find the strength to do that, then changing specialties won't help you. You'll wind up quitting nursing altogether because you'll get burned out anywhere you go unless you learn to take care of yourself. I really hope you continue to do this. It would be a real shame for tomorrow's babies if such a dedicated NICU nurse were lost.
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I'm never primarying again, y'all
I'm so sorry for you. I know what it's like to look after a baby like that. I think the other posters have given you some excellent advice. Get the ethics team involved and step back a bit from that family. If you think the other nurses you work with are incompetent or uncaring, you may want to change to another unit. That may sound harsh, but you shouldn't work somewhere if you can't trust your colleagues to provide decent care. You should not be leaving your shift thinking that you and a small group of other primaries are the only ones who will really care for that child well. It's unhealthy to have so much pressure on yourself.
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Humiliating IV questions
It really depends on the type of catheter you're using. We use those safety clicking angiocaths (not the kind with the button). I used to have trouble advancing those. The key for me was to go in VERY slowly. Then after I felt the pop I would advance with the needle just a smidgen more. Then I advance just the catheter while keeping the needle completely still. It sounds wierd maybe, but after practicing it with an angio I just took from the unit, the motion becomes much more fluid.
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Circumcision
Work nights. It isn't an issue then cause OBs don't want to do them during the night. I don't participate in circs and don't feel guilty about it. My coworkers know me well enough to know that it isn't me trying to get out of work and I do more than my fair share of the really ethically questionable stuff.
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UAB Pre-employment physical??????
It sounds like the physicals I've done for my jobs down here in California. Except I also have to pee in a cup so they can check for drug use:)
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Family visits
Or they just aren't listening at all. I can't tell you how many times I've been giving report and while I'm telling them about family involvement or something else they are writing down their med times, planning what time to go to break, looking at labs... I've actually completely stopped and stared at a couple nurses and just waited for them to notice. Why should I stand there and talk to them when they clearly aren't listening?
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Should you be able to refuse an isolation assignment when pregnant?
I think B was wrong. If you know the kid hasn't been on the med for over a week, you shouldn't have a problem. A, I would leave up to the individual though I don't see any real reason to refuse. Standard precautions still apply. JMHO.