jlb_rn

we don't use barcodes, but unless the patient is off the unit for testing (in which case they do get an ID band on their person), their identification is attached to their ekg leads so that it can be positioned outside of any blankets / clothes / swaddling devices / etc for checking as necessary without disturbing the baby.

We only use NTT for our older (usually chronic) population - probably at least 6-8mos old. I think the cardiac ICU at our hospital almost exclusively uses NTT.

i currently live in central nj and work in pa (philly). i grew up down south and occasionally contemplate moving back. i was researching unc/duke medical system the other day as well as the cost of living in nc and i will say this - the cost of living is much less in nc than nj (just go online and search for real estate and you will see lol) so it's likely that the pay is equivalent to the cost of living - try not to look at the hourly rate but at the cost of living, instead. there are many calculators online where you can figure what you would need to make living in a different region to live the same lifestyle you currently live. good luck.

I work at a children's hospital and our hospital policy is "kid friendly". We do need to wear scrub bottoms, but the facility is liberal with regards to tops. most nurses wear some sort of t-shirt or scrub top - solid or prints. Nothing too form fitting or of a graphic nature or generally recognized as offensive. also, specific to the nicu, nothing below the elbows. i favor scrub tops because i think they allow the most range of movement without having to worry if anything is hanging out. plus, they are comfortable, easy to care for and inexpensive. and, hey, let's not forget how fashion forward they are! :)

Our pneumograms are done mostly on night shift for an 8-16 hour period. We do allow holding by the parents and we feed however the baby is currently feeding (PO, NG, etc) but since night shift involves less patient activity in general, there are still solid blocks of time with very little stimulation. We document any activity (ie. nursing care, feeding) on a flowsheet as well as any "events" (brady, desat, periodic breathing, etc) including the time and the Ph at the moment of the event or activity.

Must say I agree with the previous poster on all points. Also, I like how with tape the tube can be secured slightly off center & moved with each re-tape to prevent gum breakdown.

The majority of the time, we use tape; kiddos with a ton of secretions will sometimes get a neobar. Personally, I prefer tape for no reason other than that's my comfort level. Whenever I take care of a kiddo with a neobar, I'm amazed at how much of the tube is visible and I feel like it's going to come off / out. :) For securing taped tubes, we use duoderm on the cheeks, mastisol (>30d) on the duoderm, upper lip and in between each piece of tape and secure the tube itself with 3 pieces of "Y" shaped tape in opposition candy-caned up the tube as well as being secured ear to ear. We use the white opaque surgical tape.

Minimum that I've seen in our unit is 0.5ml/hr continuous infusion with heparin & 0.45NS 1:1. 1ml/hr is what I see most often, though, with the aforementioned solution. As another poster stated, we also pull PICCs ASAP once they are no longer needed. Usually, the only time I see riders is when we have a double lumen and we don't really have need for that second lumen anymore, but can't quite pull the PICC yet or for that 24-48ish hour period when we are making sure the line is no longer needed. We also very rarely use a PICC for meds alone - we would use a PIV in that instance.

our unit follows the instructions noted in the article with regard to frequency and procedure for our NPO kiddos (ventilated or not). also, at the end of the NANN article, there are reference articles - perhaps you could do a lit search for those articles for additional information. good luck :)

Yes - instances where peripheral access is an issue, the docs will consider ordering meds centrally.

We treat a UVC as any other centrally placed line and bi or trifuse fluids as needed; if it's a double lumen, we'll run continuous sedation via the UVC as well. The hospital at which I work does not run antibiotics centrally unless we are treating a line infection. Antibiotics and other non-continuous meds are infused via a peripheral IV.

each facility is different, but my opinions in critical care as a new grad: PROS - shift differential, free parking, more laid back environment, more independent decision making (r/t docs not actively walking the unit at all hours of the night) CONS - less learning opportunities, messed up sleep / social schedule

erm, pardon my ignorance (i work in critical care so my patient load is 1-3) but where do you work that you are responsible for 60 patients? I didn't even know that was possible - how do you provide nursing care for 60 patients in 8 hours? sincerely, confused nurse :)

I have the same ailment on my dominant hand at the knuckles. I haven't found anything to cure it, but after trying various meds & creams the thing that keeps it under the best control is liberal application of Palmer's cocoa butter lotion & exercise to help with stress. In addition to the bubbles on my knuckles, the skin on my dominant hand fingertips peels - sometimes to the point of bleeding. The eczema patches I used to get on my arms & legs are totally controlled (to the point of being nonexistant) I wish my hand would get better. Good luck & please post if you have any remedies that you come across.

calling to check on things is a definite from my experience - also, you have to apply online from what i had been told (granted, this was 2007/2008) they only considered applications submitted from their website. i was also advised as a new graduate to choose and pursue only 1 area, not to cross-apply for several units. hope that's helpful.