fergus51

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.

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.

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.

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!

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.

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.

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.

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).

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.

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.

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.

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.

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:)

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?

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.

JCAHO does NOT look kindly on nurses leaving a written report and taking off. Not cool at all.

I do not believe they should unless like you say they are contraindicated for pregnancy. I am personally sick of people going to work and being unwilling to work.

Of course we do codes:lol2:. I work in a LARGE unit. We covered all those scenarios in NRP and that was specific to neonates as was STABLE. I suspect it was your teacher. I think SVT is pretty obvious, I recognized that in babies long before I took PALS. The rest (other than bradys, asystole, tachys or PVCs) are really hard if not impossible to diagnose off the ECG monitors most NICUs use and because NICU nurses see them so infrequently. It could also be because I worked NICU for years before taking PALS, but I just don't find it to be relevant enough to NICU. I think NRP and STABLE are way better. If your NRP didn't go into detail about epi, boluses, CPR and different code situations then you didn't get a very good course. You can google STABLE on the internet. It's a course specific to neonates and basically goes over everything you should be doing to initially stabilize your babies (Sugar, Temp, Airway, BP, Labwork, Emotional support). I could see how newer nurses would like pals, but if you've been in the unit for a long time I don't think it's particularly valuable. You should already know how to code a baby.

Just wanted to add: they never will. No one gets it until it happens to them. If you want to discuss NICU with non-NICU people you'll be in for trouble. They just don't get it. It's the same reason you often can't convince people about viability. Tell someone that 23 weeks or 22 weeks is viability and they'll say something like "Why not 21? I mean it's just a week. Plus, my grandma was born at 21 weeks and she's just fine"... It almost makes my head ache, but I learned to let it go;)

Unfortunately you have no way of knowing if your child has problems until they are much older. You just have to wait and watch. It's not until they get older and start missing milestones that you'll know anything is wrong. Your pediatrician will be checking for that as he ages. He may not start walking at the same age as other children. He may have muscle weakness or problems with coordination. He may have problems with speech. He may have learning problems when he starts school. He may have vision issues. I think we sometimes give parents the false sense that getting out of the NICU is the end of that part of their lives, that now they have their perfect family and everything is fine. It may be... It may not. My "miracle baby" is almost 3. She was delayed in some milestones (speaking, walking). She's still getting physical and speech therapy. She didn't have any bleeds either btw. I know her parents love her and wouldn't trade her for anything in the world anyways, but they would be the first to caution parents against thinking the NICU discharge is the end of the story. You can't focus too much on it because you'd drive yourself crazy, but I think it is a good idea to be aware that health issues can still arise and need to be dealt with.

I've got my pals as well and think it is completely useless for a NICU nurse (I took it because I float to PICUs). I didn't find the mock code scenarios or the ECG interpretation useful. Frankly, I don't believe you can stay competent in that sort of thing unless you actually use it and you really don't in a NICU.

I think it's really important not to read to much into a situation. Plus, a lot of times the parents have called or visited and the nurses just aren't aware. I used to have a primary family. They came in every single night at 825pm and called every single morning at 625 am. The dayshift nurses often commented about how the parents didn't visit, nevermind the fact that I documented their visitation. They didn't see the parents and didn't read my notes. Then they started talking about the parent's neglect to their coworkers so the unit rumour talk was they never came in and how were they going to care for those babies at home and maybe the babies should just be put in foster care and blah blah blah... Frankly, not calling or visiting for 24 or 48 hours isn't a sign of trouble to me. I know a lot of families can't make it in for various reasons and a lot of them don't like calling because of language issues. I'm at a point in my career where I am sort of sensitive to nurses talking about families because I've seen so many of their judgements turn out to be completely wrong. I think they should just mention it to social work if the parents haven't been in for a long time and then leave it alone.

I've been told L&D is the most litigious area of nursing. I really think the fear of litigation is overblown though.

One hospital here has a cash special. I believe it was under $6000 for a vag delivery.

I think it's a fad and not sustainable. Who wants to live like that? I'm a fan of more sensible eating that incorporates all food in moderation. I think Atikins is just a symptom of the sick relationship this country has with food.