LucyRn4

Thank you, everyone for your input. It seems NICUs are run pretty similar, just with a few minor differences. Good to know!

Thanks so much for the input! Glad to see similarities in our units!

I am a NICU nurse and *might* do travel nursing. I was just curious how different NICUs operate across the U.S. For example, in our level II, the babies eat at 9,12,3, and 6. We do vitals Q4 hrs. In level III, for the micro premies, we do touch time at 8 and 2, vitals Q2 hrs. Labs/weights are for night shift. IV fluid changes/procedures happen on day shift. Any input is helpful! Thank you

Your other option is a a venous or arterial draw. Both of those hurt WAY more than a heel stick would. Venous draws have the risk of "blowing" veins which means you can no longer get blood from that vein so you have to stick again in another. I'm sure you can attest to the fact that an IV poke is worse than the finger pricks you used to get at the pediatrician's office. Arterial draws can be DEEP and very painful. Babies cry for almost anything- even when you take their temperature and that's not the least bit painful. Heel sticks may hurt for a moment but please trust your healthcare workers when we tell you we are using the least invasive method first.

Just a side note, not ALL hospitals hire only experienced rns for NICU's. I got in as a new grad.

I had a patient a few months back that came to us for bowel obstruction. The baby had an ELAP and bowel resection done so the obstruction was resolved. A week later, still NPO, the baby was having bilious drainage from the replogle. I know bile is a normal secretion, but I was always taught that when you see green, it means obstruction. Would this be true in this situation? I got confused as well since I know that bile is secreted into the duodenum and not the stomach where the replogle is. Any explanations are helpful. Thanks!!

Thanks for your response. So, then what is the difference between a kid with PPHN and one with just a PDA who frequently desats? Why don't they have PPHN?

Hi all I'm a NICU rn (kinda new) and I am having such a hard time understanding the physiology of PPHN. I have read descriptions over and over and just have a mental block with this subject. I understand that PPHN occurs when fetal circulation fails to covert to newborn. So, the blood is still bypassing the lungs because of the PDA and PFO, correct? Why does this fail? Why do the lungs have high pressure? Is this just because that's the way it was in the womb? And is the high pressure preventing blood from entering the lungs, therefore causing the poor O2 sats that those babies have? What exactly is right to left shunting? I know I have lots of questions but I need to understand this. Also, how for you explain PPHN to parents? Thank you! - Lucy

Thank you for your responses

Hi all I am a relatively new NICU nurse. I am trying to understand why doctors order line placements when an infant is in RDS and can't maintain their sats? Does it have anything to do with the fluids they are getting through the lines? Any insight will help. Thank you! Lucy

Ladyjedimaster,I have actually been tested for SLE and for thyroid issues as well. All my tests were negative.

Hey everyone. I'm a new nurse, going on 5 months now. I got my dream job in a NICU and I am happy to be in the unit I am in, but I am constantly battling my energy levels (or lack thereof). My #1 stress reliever before becoming a nurse was exercising but now, on my days off, I am just TOO tired to do anything. When I do go to gym, I have to force myself and the entire workout is just a battle. I hear my co workers talking about their exercising habits and how some of them even run after a shift and that's just mindboggling to me! I will admit that I do not get much sleep before a shift, often because of nerves, or sometimes I just don't get to bed until a late time. My average is about 4.5-5 hours of sleep before a shift. I am trying to work on that, thinking that may help, but even when I sleep 8+ hours after a shift, I am still wiped out the next day. Anyway, I was just wondering if anyone else experienced this problem and how you coped with it. I'm desperate. I've been off for 2 days and I am STILL exhausted.

Start PPV and transfer. The baby is apneic...he's not breathing. Monitoring the heart rate will just waste time that could be used resuscitating the baby. Getting someone to supply a 100% O2 tank = more time you have to wait for oxygen. You already have the bag. PPV is the #1 intervention for a baby in respiratory distress. Always.

Hey all! I was discussing infants of diabetic mothers with some of my co workers and no one seemed to understand WHY IDMs are poor feeders. We've seen plenty of cases where the baby just sits there with a bottle in his/her mouth or even tries to fight us...but what is the physiologic rationale behind this? Thanks

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