bmsrn

I give it together frequently in the PACU. Are you thinking of Phenergan with Dilaudid?

Level 3. 70 beds. We had someone celebrate their 1st birthday in our unit. Our docs will NOT transfer them out. When we are full we are continually transferring babies to nursery.

I work in a level III NICU. The only thing we don't do is ECMO. I'm guessing that the only thing that makes somewhere a level 4. I don't think your transition is going to be hard, since you have already had critical babies. You should pretty much know everything already. If you can take care of a critical intubated 1:1 patient, then you should be able to take care of a cooling baby or a post op baby.

Our policy is that you HAVE to scan the patient. Every bedside has a computer and scanner. We have to scan the baby, then the med. Our ID bands are these little labels that look laminated. We usually get 2, so we wrap one around the ankle, then somehow loop the other one through it- we get creative. We do this because the barcode on the first band is so curved(around the ankle), it's usually doesn't scan. I personally like to make the 2nd one pretty long, so I can easily scan the barcode without disturbing a baby in an isolette. If it's a crib baby- almost always, their meds are timed around their feeding so they are already awake. If they aren't, I usually have pharmacy re-time them. The barcode on the ID band matches the barcode on every piece of paper in the chart so technically you can scan that, but if caught, it's probably a write up. If a baby has a HUGS tag, we just loop a ID band through the HUGS strap. Not every baby has a HUGS tag though.

We will tape our feedings like others have mentioned if it's under 10ml. We use 4fr, 6fr, and 8fr feeding tubes. We don't use the 8fr that much. I don't think it's unsafe like mentioned above. It goes pretty slow. I personally think it's a waste of time and supplied to put a feeding that's 10ml or less on a pump. We usually don't have tape residue all over our beds.

I only pop the top when necessary. It depends on what I'm doing and the babies size. If they are a micro-preemie I'd only open for an intubation or re-taping the ETT. I see a lot of newer nurses that open it all the time. We don't really have a policy.

Get your bachelors degree.

We also never help lock a line. Any kind of central line will have KVO fluids running, it's usually D5w with 1:1 hep, going at 0.3 or 0.5 ml/hr. Our PIVs are saline locked.

First congrats on your pregnancy. Where I work its very hard to hide it. You may tell one person but what if you don't work the same schedule as them?Besides, the minute I see another nurse always doing someone's X-rays we all know what that means. I agree with the other posters. Your charge nurses need to know- you don't want to be assigned a cmv baby. We've had a lot if new hires recently and a lot of them got pregnant soon after being hired. I've never seen anyone fired for being pregnant in our nicu.

I have both of the main ones. They each have their pros and cons. The big difference for me is that one is outline format and the other is like a textbook with paragraphs.

How about a family nurse practitioner. That way you can do adults or children. You can work in a pediatricians office or even a Walgreens 1 minute clinic- that would have nice hours. I agree with previous posters- get a degree in something you can actually find a job in. I've never even heard of a CNL.

That's how I always thought it was too, and that's how our unit has always been. Since people have complained about having their assignment being switched(especially when they work 3 in a row) when I primary nurse works, our unit manager decided the other nurse keeps that assignment and the primary nurse does not get their primary. Any ideas on how to approach her or what to say to maybe get her to change it back?

How does your unit handle assigning nurses their primary? Will a nurse have their primary every day they work- regardless if the nurse who worked yesterday( and had that baby) is back today- but the primary nurse is working too?

Surgeons and docs assess our babies when they can. I won't really say it's at their convenience. Our docs are extremely busy. They are gentle with our kids. After they assess, I just re-wrap them and they go to sleep. Our level 2 kids are usually on a q3h schedule which starts at either 8, 8:30, 9, or 9:30. Our level 2 kids are on a Q2 vitals and hand on Q4 schedule, that starts at either 8, 8:30 or 9. With almost 60 patients and nurses always changing the babies schedules around, it seems like it'd be very hard for this to be coordinated. If I have an extremely cranky baby, I will ask them not to wake the baby up and usually they'll just tell me to call them when the baby is awake.

It's going to be stressful, especially since this a lot of this is new to you. Honestly, I don't see how someone can expect you to just stroll on in and NOT be stressed. You just need to take it day by day. Maybe you should look at level III NICU's that aren't in the biggest childrens hospital in Texas. Not trying to sound sarcastic at all, but not all level 3 NICU's are created equally. Some can have a way higher acuity then others. Maybe you can talk to your charge nurse, and discuss the kinds of assignments you have been getting. As for a baby dieing- no body likes this part of our job. It happens though. You should see if your hospital offers some kind of course or training. Some nurses in my unit have done Resolve Through Sharing.