boomerang12

boomerang12 specializes in NICU, Pediatrics.

boomerang12's Latest Activity

1. 

   Does your unit often utilize HFNC?

   boomerang12 replied to boomerang12's topic in NICU

   Thanks for your response. That is definitely interesting. Are you finding the kids need much for Os while on the vapotherm? The rationale for leaving the CPAP on for so long is actually to avoid using any oxygen to keep their sats within range (88-93). The idea is that the use of pressure from the CPAP rather than oxygen for support optimizes FRC while reducing oxidative injury and might improve pulmonary outcomes. So when they are on CPAP the goal is to wean them down to +4, 21% with sats in range ~90% of the time. Then when they meet those criteria and are 33 weeks we try to wean them to nasal cannula, usually 1L 21%, but these kids often fail (and often fail more than once), so this is where I'm wondering if using high flow more often might help us.
2. 

   Does your unit often utilize HFNC?

   boomerang12 replied to boomerang12's topic in NICU

   Thanks for the response. Just to clarify when I say "regular nasal prongs" I mean prongs at a flow of 1/4 - 1 LPM and blended O2. Our high flow systems are heated/humidified, able to be blended and generally use flow rates > 2 LPM. It sounds like you guys are much less quick to go back to CPAP than us. How much do you find you're upping the Os on these kids when you wean? (We aren't allowed to go up at all, if we have to it's back to CPAP). I can't believe you have 28 weekers on room air! We will keep babies who were brought to us from L&D on room air (generally those 30-33 week kids) on room air until they prove they need more support, but as soon as they go on CPAP it is staying until 33 weeks. Thanks again for the response, it's so interesting hearing about what other units do.
3. 

   Does your unit often utilize HFNC?

   boomerang12 posted a topic in NICU

   Hi everyone, i was hoping to hear how often/in what circumstances everyone's unit utilizes high flow nasal prongs. I'm especially interested in hearing about anyone whose unit utilizes it when getting babies off of CPAP. My unit has fairly strict guidelines regarding taking a baby off of CPAP (must be +4, 21% all the time and >33 weeks) and is quick to jump on putting babies back on CPAP (failure is any increase in A/Bs, any oxygen requirement - even just a 1% increase, decreased interest in oral feeding, any change in WOB). We will keep babies on CPAP up to 38 weeks if they continually fail to come off. However we rarely utilize HFNC (just use regular nasal prongs instead) expect for babies who are still failing regular nasal prongs at 38 weeks. I've had trouble finding any studies comparing HFNC to nasal prongs for the purposes of weaning babies off of CPAP. Most of the literature I have read on HFNC compares it to CPAP as a primary mode of support or post extubation and the outcomes appear to be fairly comparable. I would love to hear if anyone else has any experience with this. I don't necessarily think we need to change our approach at my unit, however it is so hard for parents to watch their babies fail to come off of CPAP over and over again, so I'm wondering if this is something we should be utilizing more. Thanks for for any input you might have!
4. 

   Overseas volunteering for nursing students?

   boomerang12 posted a topic in Volunteer

   Hi! I am a third year student and I was thinking about doing some travelling on my break between spring and summer semester. Once I started thinking about it a little more I realized that a volunteer trip was what I wanted to do. Just was wondering if anyone knew of any volunteering opportunities abroad that are specifically for nursing students, as it would be awesome to do something relevant to nursing! A little more info... I am open to going almost anywhere, but my time frame is fairly limited (2ish weeks at the end of April is all I have to spare). If you know of anything let me know! Thanks :)
5. 

   Knitting during class: ok or not?

   boomerang12 replied to BusyBee91's topic in General Students

   My policy is generally to ask myself the question, "Is this person's behaviour affecting my ability to hear what the prof is saying in a significant way?" If the answer is no, then it's none of my business. They paid to be here just like me and how they choose to spend their class time is not my concern. Things aren't always what they seem anyways... Students who take notes all class might end up learning nothing, while students who seem lazy because they aren't might pass the course easily. I have seen this happen more than once. Having said that, I might be biased as I'm not at all a note taker, I don't find I need to as I absorb new information really easily without taking notes, but I am quite a doodler sometimes....
6. 

   What has been your favorite clinical experience so far?

   boomerang12 replied to AlwaysLearning247's topic in General Students

   I think maternity is just hard not to love, it's generally a very happy floor, everyone is excited about the new addition to the family and it makes it a fun place to be. Plus as another poster said the babes will just melt your heart :) as for surprises I was shocked by my dislike for medicine. I did not find it enjoyable at all and I thought I would. And then surprisingly I actually enjoyed surgery which I had been dreading post-medicine rotation thinking it was likely to be similar.
7. 

   What has been your favorite clinical experience so far?

   boomerang12 replied to AlwaysLearning247's topic in General Students

   Maternal/child and pediatrics were probably my two favourites. Also had a good rotation on labour and delivery. I had great experiences, I wasn't surprised by that as I want to work in NICU, I'm definitely a baby nurse at heart :)
8. 

   Just curious

   boomerang12 replied to Julesmama28's topic in General Students

   Ours is about 450 hours over our first two years (4 semesters) which is the minimum requirement for us to work as undergrad nurses and then another 600 or so hours over the next three semesters, plus 350 hours in senior preceptorship. Our preceptorship placements work that we get to pick three specialties and who gets their placement of choice is determined by availability and random draw -- which I think is a terrible system but that's another story.
9. 

   Nursing school

   boomerang12 replied to pall24's topic in CA Programs

   My program has hardly any unfortunately. You will need a basic knowledge of chemistry for A&P, pharm and microbiology (especially micro lots of people struggled with the biochemistry section). My program is one of the more highly respected ones in my province so I would expect that other programs are similar but I could be wrong. There are a few nursing programs that require a year of pre-req type classes and that may include a first year level chemistry.
10. 

    "Nursing is my fallback plan"...for medical school

    boomerang12 replied to The Lady Kate's topic in General Students

    As someone who has really considered the medical school option (I always thought I could graduate, take a couple bio/chem courses while working and then go, but lately I've been really interested in eventually going the NP route instead as I love the patient interaction nursing provides, plus it would put me in way less debt lol), I can say I don't think it's a bad plan at all, where she is going wrong is not taking her schooling seriously. Getting into med school is difficult, especially with a nursing degree as it is often not their first choice for undergrad degrees, so you need to get good grades, do volunteer work and interview well and still it's very possibly you won't get in even having done all that. Honestly, most students really can't afford to get a biochem degree, not get into med school and have no job prospects. Nursing is also a job where you can work prn shifts during your first few years of med school, which once again helps with the financial burden. While you may not necessarily agree with it, it is a route that a lot of students go because it makes sense. And I really don't think there's anything wrong with it. It's not necessarily that these students don't enjoy nursing, most of the ones I know would be perfectly happy nurses if they didn't get in, thus why they chose to get their undergrad in nursing. Also most of them are very intelligent and have great critical thinking skills so I think they will be great nurses if they stay in the field.
11. 

    How have you changed since starting school?

    boomerang12 replied to missmollie's topic in General Students

    I would say the only things that have really changed (other than nursing knowledge obviously) are that I am more of a communicator; less shy and easier to talk to than I used to be, and I definitely care a lot less about other peoples judgements of me; the only thing I really concern myself over these days is doing the best I can for my patients and whether or not I'm going to be a good nurse when I graduate. Other than that I think have more just solidified the kind of person I want to be. I know more now about what I value and the things I am or am not willing to compromise on. Some of that is just growing up, but I will attribute at least part of it to nursing school. -- And as an addition to what the OP poster said about nothing grossing her out, I'll say I've lost my sense of what will gross other people out. Lol.
12. 

    One thing I learned today is that honesty will get you nowhere in Nursing School.

    boomerang12 replied to guest08/05/2014's topic in General Students

    I feel for you. I had almost the exact same thing happen to me in my first year. Made me absolutely sick to my stomach and was so frustrating and stressful. Mixed up the time of the shift I was working at my job the next day with the time of my exam. I arrived what I thought was early but I was actually half an hour late. They wouldn't let me make it up either, and I offered to do an extra assignment to help make up for it but no dice. The worst part was that the exam was mandatory for entrance to clinical so I still had to take it, but still received a zero. It was worth 20% of my grade so it was really upsetting. I did stick it out though and I got a B+ in the class, so it is possible to bounce back if you work hard. I would stick with it if I were you. It was very stressful to me, but I am glad I did it and didn't end up behind. It was a harsh lesson for me but I bounced back and I have been doing well in nursing classes ever since. You did the right thing being honest, and as long as this isn't a regular habit your instructor was wrong to suggest it's evidence you should drop out. Mistakes happen, take it as a tough lesson learned and prove to her that you have in you. Good luck :)