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.

I know Creighton in Omaha transitioned from MN to DNP only last year. Mine was the last MN cohort.

Since you asked, I will share my opinion. I had about 15 years of Level III experience (including travel nursing and extensive charge nurse experience) before starting my program. As an NNP, you will be looked at to be "in charge" in most experiences and competent at the head of the bed. A lot of that comes from your nursing voice and how assertive you are, including in dialogues with other nurses, doctors and NNPs. That voice needs to be developed time and experiences, which may take longer in a slower Level III. Only you can decide if pursing your degree is right for you, but I would really consider if you will have the depth and breadth of experience by the end of 2 years. Obviously, I don't know you or your situation but that is my advice.

You can't teach integrity. Nursing at all levels should be based on ethical behavior in all aspects of practice, and doing the right thing whether you "get caught" or not.

I'm in the PNW so I'm not sure what they have locally - I know they had clinical sites in Arizona and Florida but this was for NICU so I'm not sure what they'd have for FNP. Good luck with your choice!

We use it all the time - I wish they had an option to run a bili! We've had it for about 10 years after it was started in the ER/adult ICU.

I received my MSN-NNP through Creighton. I already knew where I was going to have my clinical placements, and they do have contacts throughout the country if you need help (although obviously more in the Nebraska area). They are helpful insofar you just tell them where it is and they do the rest of the paperwork. From what I've heard from classmates, the program is well run (at least for NNP), although expensive. Some schools just send out videos to watch/chapters to read and this wasn't the case with Creighton - there was a lot of discussion/interaction with professors.

I have a friend who is finishing her FNP - but her background was extensively PICU. For her, she didn't want to limit herself after graduation, but will be taking a job with a population she is comfortable (in a primary care Peds clinic).

You may want to try over on the Nurse Practitioners board - it has a few NNPs that comment regularly.

I have a budget of $20 but would probably throw something in from myself - thanks for the ideas!

Hi All, I volunteered to be in charge of the School Nurse Appreciation day at our elementary school. Any ideas for something school nurses would really need/want? In the past they have done a card with a plant and decorated the door. Thanks!