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.

hello - there are no "set number" of students hired; they do give priority consideration to their own graduates, though. in my graduating class (before the economy took a nose dive) a large number of my classmates were hired; only a few that applied there did not receive offers and we were the largest graduating class they had. i believe in this year's graduating class, less students were hired (r/t the economy) but from what i understand, they did not hire ANY new graduates from other institutions - all new graduates came from the school. i think going through their program does give you and advantage when applying for jobs there - as it should - they know how you were trained, you have familiarity with their computer system and charting, etc. with regard to the reading i would recommend doing what works best for you in terms of learning - if outlining is the best method for you to learn then by all means, continue. that being said, you will receive detailed notes from each instructor and have an opportunity to make additional notations during lecture. i chose to read the material prior to class so that i wasn't totally lost during lecture and could ask useful questions and clarify the information i didn't understand. i also found it easier to follow the lecture if i had some base knowledge. i found it most useful to go back to the book after lecture and fill in any gaps to help me understand the patho the most completely and re-read over the intervention section of the book because i always felt that after lecture, the interventions made more sense than when i read them the first time. i don't know if that makes sense, but it may make more sense once you start attending classes. you will find a rhythm and routine that work for you and i would highly recommend sticking with whatever method that is. my perception from the program is that individuals that performed the assigned readings, studied the notes, had a study group or study buddy and practiced nclex style questions tended to be the most successful students for the most part. there are always exceptions, of course. :) good luck

hrm, can you tell that it's been awhile since i've done more than lurked on here - i don't see PM anymore, either :)

you are absolutely on the right track...yes, the test questions are NCLEX style questions (deductive reasoning - very little regurgitation of notes especially once you are past nursing 1) i used saunders and lippencott in nursing 1, 2, 3 and then lippencott and davis (i think it was davis) for nursing 3 & 4...i would study the individual section of notes, then go to that section of the lippencott book and do questions...if i did well, then i figured i understood the information i had just studied and i moved on from there...if i had trouble, then i would review / re-study my "trouble spots" the week of the exam, i would read through my notes like a book (usually, by this point, i understood all the information well and just needed to brush up on the more memorization type information - clarify those "little facts") and then i would stop studying, per se, and focus on practice questions only for few days before the exam from wherever i had not already done them including the cd that comes with the texts and the text website...the day before the exam i would read over my notes one last time like a book and relax - go for a run, watch tv, read for pleasure, etc also, most students did participate in study groups and found those to be helpful...my schedule was pretty hectic between my work and school schedule so i did not have a study group; however, i did have a friend and we would bounce questions and ideas off of each other in lieu of participating in a formal study group...i would recommend either finding a small group of people with your same style of studying / reviewing and/or finding a "buddy" with whom you can trade ideas and information good luck - though it was a stressful time, it was also fun and you will be amazed at how much you really learn - it seems overwhelming when you get your syllabus at the start of the semester but the way they break down the information and tackle it in sections it all comes together feel free to post here or pm me if you have any other questions cheers :)

i graduated in 2008 i probably studied 10-15 hours a week and spent 5-10 hours a week reading...maybe more some weeks and less others (depended on the material)...the biggest piece of advice i can give is to keep up with the studying...do a little each day...there are only 3-4 tests each semester so doing poorly on just one can really impact your grade and there is too much information to effectively study only the night before...some things require memorization, but a lot of it requires understanding the nursing process and applying the material to the different disease states...my approach was to focus on the patho because then i was able to deduce the appropriate nursing diagnoses, interventions, etc on the exams and i found that to be the most efficient way to study, also - understand the patho and the rest falls into place the school gives you the tools and information to succeed as long as you do your part :) once you start clinical (few weeks in nursing 2, weekly in nursing 3-5) it gets a little more hectic because of care plans - anticipate spending a few hours the night before clinical working on your care plan

i attended that program and i worked full-time (36 hours/wk) my first 2 semesters then cut back to 32 hours/wk for my last 2 semesters and used vacation time as needed (ie. night before an exam). the last semester i found i had to use my vacation time more liberally - i don't know if i was just getting burned out or if the curriculum was just busier that semester. i was very, very busy but still managed to find time to run a few times a week and visit my family 1-2 times a month on weekends i wasn't working. if you have the ability, i would recommend not working that much. :) if you don't have any other option, it is doable if you are committed. i wasn't extraordinarily social during the semester, but i didn't deprive myself from activities, either. good luck :) it's a great program.

is the dose going to be given with meals going forward or was this a one time thing? if you have the ability, change the time so that it occurs at meal time for your dose and all doses going forward. our system enables the nurse to change med times - we "reschedule" and select the reason why from a drop down box and add comments if needed. if you are unable to change the time, either have the doctor or pharmacy re-time it (or whoever has the ability with your system). never have someone chart a med for you or vice versa. :)

no fake nails allowed where I work if you have direct patient contact nail polish is allowed as long as it is not chipped

I had an OB/GYN named "Dr. Richard Pees" at Hershey Med Center - he went by Dick, though. Why he chose the nickname he did with that last name, I don't understand...also, maybe he should have been a urologist. ? http://webapp.hmc.psu.edu/physdir/provider.cfm?id=rpees I also had a dentist named Dr. Smiley. ?

I'm in my first semester of pre-reqs at Mercer - going to be applying to Capital and probably St Francis for fall 2006. /crossing my fingers that I get accepted to one of them :)