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prmenrs RN

NICU, Infection Control
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prmenrs has 42 years experience as a RN and specializes in NICU, Infection Control.

42 years in nursing, ~ 27 years in NICU

prmenrs's Latest Activity

  1. prmenrs

    Nicu resuscitation nursing

    Paper towels. Just don't accidently throw it away. Find the clock in the room, use that for your time. You have the time of birth, so you can extrapolate age in minutes. We had a stamp w/all the admission data we could use on our charts. (showing my age--paper charts)
  2. prmenrs

    Interesting study

  3. prmenrs

    Flu is CRAZY

    I don't think it's too late to get a flu shot. Might help! Maybe the Health Dep't would be interested in putting on a flu shot clinic @ your school site, or someplace near by. Just a suggestion. If someone is incubating the virus, the shot probably won't much, but, it would be worth a try.
  4. prmenrs


    I think old school docs used to call appendicitis, "the great pretender". It was almost expected that 1 out of 4 appy's turned out normal. I went to the ED w/abd pain, they worked me up, (the 3rd guy that came in to check for rebound tenderness was denied! took me to the OR, and took it out.
  5. prmenrs

    NICU new grad help with assessment/time management

    Start w/observations: position, color, activity, O2 sat, what equipment, what drips, IV site(s). Resp status and support. Then tactile: gently place your hand on their back to count resp; place stethoscope to listen for breath sounds, move to front (preferably w/o waking the kiddo) listen for murmurs, count heart rate, listen for bowel sounds; feel fontanels and sutures, pulses. Turn the baby over, slip the measuring tape under the baby; take the abd girth @ the umbilicus, that's standard. Check NG tube placement, note measurement. Diaper change, skin integrity. Close your diaper up completely to prevent urine evaporation. Change your gloves. If there's a bath, give it now. Dry and re-diaper. Meds and feeding. Until you develop a routine, it will take take as long as it takes. You will speed up as time goes on. If you have a routine, you will not miss stuff, and have to bother the baby again. If any of your findings are not normal, it will slow you down--a lot. I wish you all the best. I know you will do well.
  6. prmenrs

    Reasons for an unplanned extubation

    Visualize the length of the trachea below the cords. How much wiggling would it take to maneuver the ET tube out? Some babies are even strong enough to "tongue" it out. Part of your assessment is how slobbery the tape and tube junction are. If it's precarious, snag a RCP to help you clean up and retape it. That will save you a lot of hassle should the kiddo slip out of their breathing apparatus. Some kids even manage to get their hands on the tube and p-u-l-l. Like Pooh Bear and the honey pot? And, since doing this hurts, they scream as loud as they can [while intubated].
  7. prmenrs

    Positioning an older, chronic lung baby

    These work well. And they have a variety of styles to fit different cribs/incubators, etc. https://tucker-sling.myshopify.com/
  8. prmenrs

    When Nurses Dream...and Have Nightmares!

    I had repetitve nightmares for years. Most involved blank charts @1830. I retired in 2002; as of 2015, I was still having them. Certain staff members featured in them, some positive, more not positive.
  9. prmenrs

    Flu Shots

    I always seemed to be in line behind the needle phobic customer. So I would hold their hand and try and keep them calm. Don't go w/the hip--no one has time for that! Positive attitude: this is going to keep folks healthy and at work, not home wishing they were dead. Flu hurts. Not to mention that @ some HCFs, it's more or less mandatory, esp. if working w/immunocompromised clientele. For those folks, they really could die if they get the flu. If some people claim "they always get the flu after they get the shot"--they were likely incubating it @ the time of the injection.
  10. prmenrs

    No more lifting

    As a NICU nurse for many years, the patients may not weigh a lot, but, the equipment is another story. And, when you lift a baby who has a couple chest tubes, an ET tube, and pacemaker wires so someone can put a clean blanket under him/her, you feel it in your back. Then there's the acrobatics needed helping a mom breastfeed her baby. Don't know how that would affect your situation. See if you can find a spot that involves a desk?
  11. 30 or 40 years ago, TB was "on the decline" also. Then, along came AIDS, and, whamm-o, TB was back, better than ever. Don't trust it. Having been one of the people who unwisely thought we had the beast cornered, and was soooo wrong, I think we shouldn't ever take TB for granted. It's been around longer than we have. jmo.
  12. prmenrs

    Ever forgotten to feed a baby?

    Aug 6, 2018 by llg, PhD, RN llg has 40 years experience as a PhD, RN and specializes in Nursing Professional Development. 639 Likes; 13,085 Posts; 58,214 Profile Views I also dreamed once that a very little one that I was caring for (with lots of tubes and wires) had managed to crawl out of her incubator porthole and was dangling there like a marionette. That one was kind'a creepy. This did happen to a baby in our unit: I turned around, and here's this little thing who had wriggled off the mattress, and was stuck against the plexiglass, hanging on for dear life to his/her ET tube. One of the very rare occasions I actually gave out w/a little scream. It was hard getting the hood open w/o losing the kiddo completely, but, we won out, and didn't even extubate him/her in the process. Back in the 70's we had an open warmer w/metal sides and a foot--no head of the bed. We used a monitor similar to Fetal Heart monitors--it put out reams of paper recordings, so they rigged up a basket to catch the output. One of my colleagues was walking past a bed, heard a rustling sound, and found the baby--in the metal basket. Even w/the head of the bed up, baby manage to travel up and over. It may seem like we were awfully careless w/our patients, but, I had a 40 year career, so...
  13. prmenrs

    Nurse as a Patient?

    Scared and angry. And taking it out on you, and everybody else. Suggest a Team conference and team approach. Charge nurse and/or supervisor should stop in periodically just to chat. Head off the complaints @ the pass. Within her dietary restrictions, bring her a "treat" from the gift shop. Not saying that bribery works, but---it does. Best wishes on your challenging patient.
  14. prmenrs

    How to get NICU job without experience?

    This is a great idea. Not only will you get experience w/"normal" newborns, you will learn a LOT about breastfeeding. That's a really useful skill set.
  15. prmenrs

    Is it time to stop? Adult to Neonatal.

    I have often said that neonates are like a whole 'nother species. While some of your ICU skills are useful, your whole ability to look @ a pt. and "know" something is off is just---gone. And, no one should expect you to have that skill for @ least a year or so. They should expect you to say, every once in a while, "look @ this kiddo. Is s/he ok?" to a more experienced nurse. If s/he thinks something's off, ask what they see. It takes time. Think while assessing: what am I seeing, and how does it fit? You will get it, and it will feel great.
  16. prmenrs

    Wise One Liners

    My signature line: Never, ever trust a 35 weeker.