rnkaytee

I thought briefly about PNP but didn't think my NICU experience really prepared me for it (I'm of the mind that NP students should have several years experience in the field before school; I know there are different opinions on that). In some respects, NNP limits your scope but I've never wanted to do anything else - have you worked with kids or just in the NICU? I know some NICUs are hiring PNPs, maybe you could go that route?

We have access badges so parents can let themselves in. We give out 2 at the beginning (not to anyone that may have CPS involvement); any shenanigans and they get them taken away. I was against it at first, wanting "more control" over the door but it's worked surprisingly well.

I read that as "I figured it out before making a 2nd error," but yes, I was unclear on that too.

I just used the hospital's address - I will say it took me 3-4 weeks to get it when I applied 1 1/2 years ago - hope yours is faster!

I can understand why you'd be stressed out but it doesn't sound like there were any ill effects, even if there was some small blood loss (I'm assuming you grabbed the stump quickly?). In memory of Tom Petty I'll quote you one of my favorite songs "Crawling Back To You" - my favorite line is "Most things I worry about never happen anyway." Try not to borrow worry until you need to!

1. Do you have access to a PT/OT that can assess his nippling? 2. When I was a bedside RN and needed a response, I would phrase it "I am concerned about x, y, z. Help me understand why you're not concerned." Sometimes it takes a direct challenge to make people re-evaluate their thinking. Although that makes me frustrated for you - I'm lucky to work with a practice that really values the bedside nurse's opinion. Good luck!

First of all - I'm kind of glad you're scared and worried, it lets me know you realize what is at stake! I felt the exact same way - I remember going home one morning just thinking I would never get it, I was in over my head, etc, etc. Now I'm an NNP with almost 18 years in the NICU and I love it - can't imagine doing anything else. You'll get the time management piece - 4 babies is a lot on your own anyway. I agree with Jennylee above - start observing the disease states/medications, etc. you are coming across and take learning into your own hands.

Per TOS we can't give any advice -- these are all great questions and I'd encourage you to speak with your OB (maybe they could arrange a NICU consult?) Hope all will be well with your daughter, I'm sorry you're going through this!

I agree, some of the policies are not ones I'm familiar with or have a real rationale for, but the OP did state they had a high infection rate with IV starts/administration. I can't begin to guess the "why" behind these policies, but if OP did a little digging there may be reasons they had to implement them. If OP has only been there for a year, there may be a whole backstory that she/he is missing.

A 1-2 cm displacement can cause a preemie to not be ventilated, for a micro-preemie it could be .5 cm. ^^ This -- could it be your unit had a history of unplanned extubations and this 2-person turns was part of a new protocol to avoid them? I would start by bringing your concerns to a unit educator, they may be able to fill in the blanks as far as where some of this is coming from. The IV start protocol seems odd to me - almost all nurses (once trained) are expected to try unless it's a difficult baby (it's kind of a badge of honor to be able to start them successfully). In general, adults and babies are so different and you may be finding this is just part of the very different patient populations.

I worked at OHSU in Portland and loved it. A good mix of deliveries and high acuity. You could also cross train into the PICU for more cardiac.

We use a combo of all that has been mentioned, but I will usually order time open to air - it helps immensely!

It was 8-12 months for me, now that I'm the NNP and am at the "head of the bed" it's another learning curve. I was lucky that I did have extensive nursing/delivery experience before I became an NNP so I feel fairly comfortable already. It definitely takes a lot of practice and being in deliveries that need expertise. Just keep going to them and ask for help when you need it - you'll get there!

Can you share what are 'meconium vitals'? We do vitals on babies whose mom's were + for GBS.

I hope others have some words of wisdom - I had to really be careful of the same thing in my state. You can ask if your state would consider accepting your program, but it's somewhat of a long process and the program has to be willing to put in the effort and fulfill NY's requirements.