HotLips4077

I definitely had a more negative personality while working my first job out of school. Now in my second job, I'm much more positive, partly because I love what I do and partly because I'm so happy and thankful to not be at the first job!

Wait, let me get this straight. You put in a request for leave 5 months ago for 1-2 months from now giving them 7-8 months notice? Did they approve it when you first requested? I'd have a sit down with the director/manager/whoever and tell them that this is not acceptable. You've only requested one week. They can't find any coverage for 3 shifts (assuming that's your schedule)?

Hmmm, we don't have a policy for either. I've actually never thought about how long a pacifier should be good for-I typically just throw it out if it looks crusty and grab a new one. If I'm changing out an isolette, the baby gets all new everything (suction, z-flow, paci). As for the NCPAP, we alternate every 6 hours between prongs and mask, but have no rule on their lifespan. They usually start to lose their firmness after so many days and the RTs just replace them with a new one. You can usually tell when they've reached their time since the mask or prongs won't stay attached to the headgear. Also, most of the time our babies are weaned quickly from BCPAP to high flow or vapotherm as tolerated.

When I started in the NICU 4 years ago almost all of our vented babies were either on fentanyl and versed drips or had it ordered PRN. In the last year, though, our neos have stopped ordering them. Part of the reason for this is because our IVH rates have been pretty high and our unit is implementing a sort of quality improvement project aimed at reducing these rates. Now whenever sedation IS ordered, it's just a one time order that has to be justified. I can't even recall the last time I gave sedation to a vented patient on our unit. Larger kids do sometimes have some PRN's available, but for the most part there has been an overall push to decrease its use across the board. We also rarely give anything for intubation.

10-30 minutes depending on whether its a first hands-on with assessment, weighing, etc. or just a simple diaper change, reposition, and start NG feed. Obviously longer if it involves a bath, PO feeding, or parents' assistance.

Ours are feet to the wall. All respiratory equipment (bubble CPAP, vents, etc) are then positioned toward the unit. It works for us. The only downside i suppose is that hoses/plugs from wall gas source to vent are then strewn across the floor, so if you are not careful, you may trip or unplug something.