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elizabells BSN, RN

NICU
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elizabells is a BSN, RN and specializes in NICU.

elizabells's Latest Activity

  1. elizabells

    LPCH-New grads?

    My inside informant tells me that at least one of LPCH's units has such low census that other units had to absorb nurses who were at risk of being laid off. So basically no outside hiring was done this year.
  2. elizabells

    Problems with blood bank

    Okay, I know I'm terrible, and I'm sorry you're having frustrations with this (and I would be BOILING mad if I were you) but I'm giggling like a fiend right now. It's late, I guess. Nothing about this yet in NYC. But our blood bank suuuuuuuuhhhhuuuuuucks at all times, so I'm not sure I would notice if they got any worse.
  3. elizabells

    One of those weeks

    The tally from the last M&M was 18 in a month. Which more than doubled our previous high, which was 8. We took the other NEC twin off the other day 2/2 a bad bleed. On the bright side, I had the most rock-star cardiac the other day. Extubated less than 24h post op, eating shortly thereafter. Woot!
  4. BWAH! I will be stealing "alcasnot" for everyday use. Although we just switched to this watery foam junk that's less like snot and more like... um... another bodily fluid. Which I am even less eager to rub into my hands. We call it "the spooge".
  5. elizabells

    You Know You're a Nurse When...

    You know you're a nurse when you find yourself trying to convince your cardiologist that it's different when YOU look to Dr Google for theories on what's wrong with you, not like when a REGULAR patient does it and it's annoying. Ahem.
  6. elizabells

    One of those weeks

    Jesus mercy. Now we have a neonatal leukemia. Our fellow told me today we've had fourteen deaths this month. The NEC kid died. We got another bad, bad NEC from an OSH a few days ago, and today they brought in her twin, also with terrible NEC. The hell is going on out there?
  7. elizabells

    One of those weeks

    So in the past week, we've had: A former 36wk TGA who was grown for a while, full feeds, used to take him off the monitor and walk him around. Then we did his arterial switch. Died suddenly just after the OR. A harlequin ichthyosis. Died. Conjoined twins who shared a liver and one three-chambered heart. Died. A growing preemie who went from full feeds to his intestines in a silo, they're all dead and the surgeons couldn't fit them back in. Peeing bright red blood, K+ of 9 with rhythm changes. Gonna die. A 6mo old with MAPCAS who was initially deemed unrepairable, then decided to take him to the OR but with a 40% chance he'd make it off the table, made it through, been two months since then, got a Nissen a week ago, was sitting in his stroller today on room air, shrieked once, asystole, coded, shocked, lido, epi. Died. Whiskey. Tango. Foxtrot.
  8. 1. PLEASE stop pretending you understand more than the most basic English. The doctors are starting to think I'm crazy when I call them back for the tenth time to explain the gravity of your child's condition to you because you keep saying "Okay" and "Yes" when they ask if you understand what they've told you and then ask me the most baffling questions the moment they leave. I know you're scared, I know you don't understand what's happening, and I know you don't want to look foolish for not speaking English. But it's okay not to speak English. This is why we have translators. 2. When you come to visit your child with a bandage on your arm and you tell me you just came from the ER because you have an infected sore for which you are taking Keflex, please don't get huffy with me when I ask you to wear gloves to touch your extremely sick child. 3. When I carefully explain HIPAA to you for the second time in under five minutes (seriously)and why it means you can't wander up and down the halls peering at every other baby in here, do not tell me you are looking for a clock. I promise there isn't one in the isolette with that 500gm preemie.
  9. "If the smell of smoke coming off you can knock me, who has smoked a pack a day for ten years, halfway off my feet and make me instantly nauseated when you come to visit your just-had-open-heart-surgery BABY, perhaps you should look into changing your shirt when you get here." Oh wait, I totally did say that. But, you know, nicer. I say this all the time. Sometimes it actually gets them to stop complaining for, oh, at least a minute and a half.
  10. elizabells

    MRSA colonization and staff

    Nope. They were off for two weeks, paid. I do know of one woman who was actually infected while working, and the strain was identified as originating with a particular patient. She had multiple abcesses that had to be I&E'ed, and it took her a really long time to clear. Our ID people told her if she didn't clear she wouldn't be able to come back to work and probably wouldn't be able to work anywhere, ever again.
  11. elizabells

    Gravity Feeds

    I promise that it's not. We just passed JCAHO, and while we did have to make some changes, this wasn't one of them. ALL of our cares on 99% of our babies are at 8-11-2-5, and the general practice is to do your gavage kid first, if you have one gavage and one nippler, so that if your nippler is slow, your gavage kid doesn't get off schedule. Nobody holds their gavage feeds. Not the younger, "poor work ethic" nurses, nor the older "supposedly awesome work ethic but still often found sitting watching YouTube videos or shopping online or taking multiple personal phone calls" nurses. People are people. Many of our younger nurses don't even take their full lunch break, while more than once I've waited over 90 minutes for a senior nurse to deign to show back up on the floor.
  12. I just had a dad who was grilling me on why we'd put an OGT instead of an NGT into his child. Not a terrible question, really, except I'd been told in report that he'd asked the three previous nurses the same question, and gotten the same answer, which was the correct one. So I explained to him, patiently, why an oral feeding tube was more appropriate for his baby than a nasal tube, and concluded with "... which is what I believe Nurse Nancy told you last night." That was the best look I've ever seen on anyone's face. And I was positive he'd hate me forever, but he did nothing but tell me how awesome I was for the next two days. Ahhhhh, satisfaction.
  13. Gagh, I know, right? Rounds end at around noon. They said they'd come by after rounds. The fact that they're not at your baby's bedside at 12.15, or even 1p, probably means that somewhere in this 70-bed unit, there is a child sicker than your room air CPAP/feeder. You know, one who's dying.
  14. You know what would be nice? If you ever said please. "Can you take her out for me to hold?" "Can you fix her CPAP?" "She needs her diaper changed." All reasonable requests, mind you. Happy to do it. But if you don't say please, I'm still going to want to knock your teeth in by the end of the day. So sorry!
  15. Stop. Touching. The. Baby. I know he's yours, and I know you're super-excited he's okay. I get it. I do. But he's nine weeks early, his nervous system is raw as hell because he should still be sleeping in a nice warm bag of fluid, he's had a tough day, what with getting untimely yanked out, he's bradying every time someone opens the unit door from the stress of hearing noise for the first time, and he's shutting down from overstimulation. Imagine the worst day you've ever had. Might have been today, come to think, what with your wife having an emergency C-Section and all. Now imagine your skin feels like a terrible sunburn all over. You have a migraine. You finally get to sleep. Okay. Now imagine a hand bigger than your entire body won't stop stroking your poor, raw skin, and you can't do anything but cry softly. Stop. Touching. The. Baby. And before I get screamed at, yes, I do use these as teaching moments to educate parents about developmentally appropriate care and how to best support their baby. The above is merely my internal monologue after I've repeated the same teaching points five or six times in two hours.
  16. elizabells

    IV air bubbles

    The other problem with bubbles as they pertain to the NICU population is that many of the kids still have PFOs. Straight shot, basically, from the right atrium to the carotid and then the brain. Emboli of any kind, air or otherwise, are much more dangerous with a PFO or ASD. There's some interesting evidence out there right now regarding PFOs and thrombotic strokes.