megatronRN

1. Neobars are secured by the RT at delivery. Even with drying and correct placement, adhesion can be an issue. On our tiniest babies (23-25w), we still use cloth tape to secure ETTs. 2. We use a thin piece of clear tape to secure the NG to the ETT. a. I don't believe we have an issue with increased tension. c. We also standardly use NGs unless there is an indication not to.

It's interesting that you said nasal intubation is the way forward, as on our unit it has been completely phased out due to facial/sinus trauma and septum breakdown. A few of our doctors still nasally intubate, but only if an infant has a history of self-extubation.

Push for the sicker babies and continue on your path. When I want a particular assignment, I try to get to the unit earlier than normal and speak to the Charge Nurse. I'm not sure how your unit functions or does assignments, but this usually works for me. Also, do nurses on your unit take primary patients? Why not take a small and/or sicker baby as a primary patient? Finally, speak to the nurses that usually do assignments and explain your situation. Sometimes you really need to push for what you want and be vocal about it. Nurses (especially NICU nurses) can be protective of patients and place the sicker kids with experienced nurses without giving it much thought. Speak up about your desire for more experience. There is a ton to learn in a level III unit.

If you have any desire to continue your education in the near future, go ICU. Yes it is stressful, yes it is a lot to learn, yes it is difficult, but overall it will benefit your career more and you will be able to move along faster than you would be able to coming from an oncology unit. I don't know what your career plans are, but if you want to continue your education I'd recommend jumping into ICU. Although it can be terrifying (I've been there), it will be worth it. Also remember, while ICU is scary, you will have a long orientation and there will be other nurses around to guide and assist you. Also, while ICU is mentally stressful, floor nursing can be physically stressful. From my experience, ICU nurses enjoy their jobs more. More critical thinking, more opportunities, less patients to split your attention between. I don't know what your future plans are. If you feel connected to oncology and could see yourself staying there long-term, that's awesome. But, if you want to advance your career within the next few years and/or go back to school, go for ICU.

Many NICUs do not use CNAs anymore. I'd imagine you will be restocking, answering phones, gathering supplies, setting up equipment, etc. You'll be functioning more as HUC/equipment aid. A wonderful opportunity and great experience if you have any interest working in the NICU after graduation. Any exposure to the NICU is good experience.

For the plethora of free food in the break room, obviously.

Hi! I am currently working in the NICU. I love it, but it is extremely unit specific and I couldn't see easily transitioning into PICU. As a level III NICU, the main diagnosis you work with is prematurity. Neonates are a different beast all their own. If you're serious about PICU, I'd think Peds Med-Surg would give you much better experience. You'd see more diagnoses and work with different ages. I'd go that route. That's my two cents :)

Hi All! I'm curious if anyone else has insight into this issue... I began working in a level III NICU five months ago. I'm enjoying my role and learning a great deal. Most of the experienced nurses are very helpful and great teachers, however, the unit is experiencing a great deal of turnover at this time due to retirements and FTE changes. Seniority and seniority ONLY determines which nurses get to move to day shift. More new nurses are being hired (all for night shift positions) and I worry this will only exacerbate the issue. I'm concerned about working in such a high acuity setting with no one that has 5+ years of experience on our shift (this has happened with staffing in the past). Has anyone else dealt with a similar situation? Our unit manager has been made aware of the issue, but thus far has made no changes.

I've never hesitated to use the ordered "comfort measure" drugs in a dying patient. If the patient is actively dying, it seems much more ethical to lessen their pain and make them comfortable through the experience. Most families agree with this practice. If death is imminent and the patient appears to be in distress, give the medications and allow them (and their family) a peaceful transition.

livi66- It was the Women's Health Unit.

One of my applications switched from "Under Review" to "Applicant Not Selected". It's good to know they are moving on in the process! Has anyone heard anything about Labor and Delivery?

They called me for ortho/neuro, but I expressed my top choices were L&D and Oncology. No one should get discouraged, it sounds like they have a lot of applications to get through and a lot of HR people working on it!

I got a call Wednesday from SMCA for my third choice unit. She said she was going to see if I was a candidate for my first choice and get back to me about interviews. Hopefully soon! She did mention that for the first interviews they try to connect applicants with their first choice unit. All nerve wracking!

Just got all my applications in finally! Good luck to everyone! This thread has lots of good info... thank you to those who posted! Hopefully someone hears something soon regarding an interview.

Sameee