Jerico

A professional nurse does not get intimidated by management making threats. A professional nurse does not work without pay. A professional nurse does what she needs to do ON THE CLOCK. Nursing personnel who cower and bend to intimidation ALLOW management to suck the blood out of nurses. YOU have a license you must keep, use it. Report illegal labor practices and intimidation.

Management has just begun a requirement that all nurses clock in and out for our 30 minute lunch, and if we do not take lunch or take a short lunch we must fill out a discrepancy form. I am working in an NICU, and in order for us to take lunches, we all must coordinate with our baymates to leave for our now MANDATORY unpaid lunch in the breakroom on the floor. This leaves TWO nurses for 9 critical babies....on vents and such. I do not feel comfortable leaving other nurses who already have hands full with my THREE babies. Management says this is so "all nurses get their much needed lunch". We NEVER get breaks, we are supposed to get 2 15 minute breaks, over the course of our 12.5hour time in the unit. Any thoughts?

Am SO glad you had a great orientation/preceptor experience. I FINALLY got a good orientation/preceptor experience in the THIRD NICU I worked in, and it will KEEP me at this NICU. Sometimes I think they STICK people as preceptors and the preceptor takes it out on the new nurse! I have had THREE terrible preceptor experiences, and left each place that claimed to have a "great" NICU educator(s) and "great" orientation experience. Some NICUs lie. Trust me. Am so happy to hear about good orientations.

I too absolutely love babies, always have. I have four of my own! I love being an NICU nurse, I like doing what is best for babies - advocating for them. I would never be any other kind of nurse. My heart does not get torn up when one gets angel wings, as I just assume God needed him or her back for some reason...I just do my best for them while they are in my care and let God take care of the rest.

If I saw a doc attempt such, I would report him. That is how wrong this seems to me. Circ under anesthesia while having something else done, well, that would be an intelligent thing, I would think....lol

My questions for you current NICU RNs are: (1) Do you do this rinsing with formula? No (2) Do your coworkers do this? Not that I have seen. (3) Has your hospital educated RNs about avoiding formula exposure in breastfed infants? Yes, is a most excellent NICU. I've been in three previous to this NICU and it is a breath of fresh air. (4) Do many NICU moms ask about avoiding formula so they can exclusively breastfeed? A few, but we encourage EBM and DEBM. (5) Is anyone using donor breast milk (from a certified human milk bank) in NICU? Yes. Our NICU attempts to use EXCLUSIVELY breastmilk; we have fantastically up to date neos who hold the staff to high standards. I have not seen a case of NEC in this NICU (65 bed); and in ALL the others I saw NEC and the others did not hold breastmilk at a premium. The policy of breast milk or donated breast milk is a GREAT policy, in my opinion. :up:

ALL new hires in our NICU for the last four years are required to have a BSN. We are a large NICU and it is the FOURTH NICU I have been in and it is the BEST hands down for it's standards.

I just want to know the barebones UNLESS the baby is less than 24 hours old; or it is a highly critical baby (just short of circling the drain....) : Problems the baby has had during the shift: As&Bs? How many times has the baby needed blowby? IVs and lines? Can't get a good peak on the UAC? What is running into the kid, how fast, any changes? When was the last suction? What kind of vent and settings? Are you getting pee? Feeds: NPO or NOT? What, how much and how often, how tolerated? Elimination: Does the kid possibly have belly issues? What Meds and what time and for what reason? What tests and what time? Social train wreck or not? Basically, I want to know what I need to know to keep the kid away from Heaven for another 12 hours.:redpinkhe I don't CARE if the kid had a PDA....all kids in an NICU have a PDA pretty much!

Changed career at age 47 to become NICU Nurse. Second bachelor's RN/BSN, from good school = very important to get into good NICUs. My goal was to be an NICU RN by age 50, met goal. Will likely still be in the NICU when I am 70.

I was in a dr office one day and the recept told me "the nurse" is going to discuss your procedure with you (colonoscopy). So "the nurse" takes me into a business office area, sits me down and starts to discuss the procedure. I start asking technical questions, things an informed patient would ask...and she could not answer the questions. Not only that, she never even introduced herself. SO I said: "Are you a nurse?". She said: "Yes". I said, "Where is your ID tag?". She says, "Oh, it is in my desk". I said: 'May I see it?". She takes it out of the drawer and it has her name on it but no professional designation. I said, "Where is the RN or LPN identifier, as I was told I was going to speak with a nurse, to give me my procedure information and discuss...". She says, "Oh, I'm not that kind of nurse....". I stopped the conversation right there and asked to speak with an office manager. I informed the office manager I was an RN, and "Your officer personnel are calling themselves nurses, I think you need to take care of that, because they are not licensed nursing personnel...I AM...and I don't think the BON of Texas would approve". She was falling all over herself apologizing. I left, and needless to say I did not use these GI docs for my procedure. A week later I got a letter of apology from the office manager telling me she sent out a letter to all her employees requiring they NOT call themselves "nurses" if they were not RN/LPNs etc.

:twocents:My daughter just finished her first term, at Frontier got a 4.0 and found it not too difficult.

Thanks so much. It helps to know I am not the only one who felt this way! Now I think I can go in this knowing I CAN do it, I just need to delegate and at least appear to know what am doing...I think my hesitating signals to others I need help. Am perfectionist type and when I don't think I have something down "cold" I tend to avoid doing it. Appreciate the great input.

Thank you. :redbeathe I will do try that. Also, there does not seem to be any sort of "list" of what to do when the baby arrives and when I am stressed anything I remember goes right out the window. If I had a list or at least a outline of a routine as to what comes first, and is most important, etc. For example: Check bed for set up, equipment etc. When baby arrives- 1) attach leads, ox probe, temp probe 2) start IV line.... 3) draw ABG... Could you elaborate? It is about the time the IV needs to be started that I kind of collapse, because I am so still so slow at starting IVs on itty bitties...and then someone will kind of shove me over and grab everything. It all seems very rude to me, but it happens that way... They get impatient. So perhaps I should just have a "partner" start the IV and I do everything else?

BSNs get first pick of jobs as most employers prefer BSN educated nurses. Supply and demand.

I've been an NICU RN for two years. I love NICU III and am technically very competent except other than a problem with emergency admits. I know this sounds stupid, but when emergent admits happen and all the personnel in the NICU "gather" and "take over" what is supposed to be my baby to admit...how do I get near the baby to LEARN to do this??? Now, admittedly this happened twice at a teaching NICU, so docs & NNPs get in the way because they all want experience, learning. BUT I need to LEARN, too!! People won't get out of my way, or they shout things at me way too fast that I don't understand (due to my inexperience and need to confirm for safety issues...) what do I do? I tend to just freeze up and back away, in tears as I get so frazzled and intimidated at all the confusion, as no one seems to be in charge, and everyone gets so impatient and won't SLOW down. I realize a baby needs all these things done quickly, but when I get near all the hub-bub I tend to shut down and begin to panic, as I get very intimidated. Any suggestions? I have helped resusitate a baby with one or two people helping and that does not bother me...but when there gets to be a crowd around and I don't know half the people, I just want to run away and hide! It is a terrible feeling and I haven't the guts to pipe up and say: "Go away! Because I am not sure who I may need and who I may not need. I do FINE working alone, or with one or two people, but when a crowd gathers and crap is flying everywhere, I just shut down. I need tips...

Oh, my. Hope you are OK. As long as you are not under 6 or over 66, you will probably do fine.

Ask regarding: Percentage of time you will be in Level II and Level III Ask if they have neonatal pharmacy specific pharmacy services Ask if they have dedicated neonatal RTs, if they are round the clock. Ask if they have dedicated neonatal nutritionist. Ask if they have round the clock neonatologist in house. Ask how much of your training will be didactic (book as opposed to clinical experiences). Good luck. I went straight from nursing school to NICU. Been great.

Came on duty tonight in the Level II. Mom and Dad came in, baby born at 0400 - 20 hours ago. Dad arrived while mom was in labor, directly here from Iraq he got to see his baby son born! He hadn't seen mom since she was about 3 months pregnant... Totally awesome to watch these two with this baby boy. Made my heart sing to know this very young man made it back from Iraq AND got to see his son born AND got to see his wife again. Baby OK and beautiful, just monitoring him.

Photo Atlas of Nursing Procedures by Swearingen & Howard ISBN 0-8053-8789-7 This book should be purchased the DAY you begin nursing school and kept in your personal career library. This book took the "scariness" out of procedures for me.

Am pro uniform/color code for a couple of reasons: 1) So I can tell who is who on a unit. Esp if a travel assignment. 2) As a pt I LOVE be able to figure out who is who. Often the staff do not change the name/title on the room board anyway. 3) I think it helps with unit cohesion. 4) I think it distinguishes the RNs and that is good IMO.

Am a believer that you can look things up anywhere and why waste my time memorizing trivia? I don't even know my work number... Having said that DA is good for mathematically challenged, agree there. Just write down the conversions on a card, laminate it and carry it everywhere you go and look at it at each stoplight, line you're waiting in....and MEMORIZE the things WRITTEN on the card, the IMAGE not the facts. Then when you need to come up with them VISUALIZE the card in your head as if you are looking at a photo - and you'll see the conversions written down on the paper. It works. I never could remember lab values, still don't. I carry a card in my scrub pocket. I don't care if anyone thinks I'm silly or stupid...I just want to make sure I've got it right.

I agree with the $60K a year to clean up feces post. AND the one who posted "I like to inspect the skin of my patient post". I like DELEGATING to be honest, and then I inspect the skin and tell the CNA "GREAT job on the BIG job!!". There is something humbling about cleaning up a helpless person.... BUT I cannot take the smell without vomiting.

Lamazeteacher: You post is most excellent. You put a lot of thought into it and I can see from where you come. I do not disagree that INSURANCE is out of line in this country. Medical insurance has become extremely expensive and perhaps a question we should all ponder is WHY? I have worked in health care administration (policy and planning) since the early 80s. I have worked in long term care policy and planning just about as long. On ONE hand you have hard working, INDEPENDENT minded Americans who are essentially HEALTHY. They may see a doctor or dentist ONCE a year. They wonder "why do I have to pay $265.00 a paycheck for insurance?". The reason they pay it is to CROSS-SUBSIDIZE the uninsured high cost persons: those over 50, the very young, the mentally ill, and the young OB patients. The WAY the healthy cross subsidize the others is by a special cost accounting that hospitals do. Example: A tylenol tablet is $5.67 on the insured person's bill. This is the ONLY way a hospital can bill an insurance company at a level which will help cover the "charity" or "self-pay/no pay" patients. Either that or the hospital is a 401C3 and they must serve a poor population in order to have tax breaks, financing benefits. This form of cost cross subsizing must stop. The insurance MIDDLE man must stop. Insurance companies hire nurses to review medical records and cases to approve or disapprove services according to physician/manager guidelines. When a patient falls out of those guidelines the case/issues is declined, unless the patient/physician of the pt asks for a review; in many cases the decision is reversed to keep liability at a minimum - but the process for reversal is designed to frustrate the consumer into just "giving" up. The typical American does not know how to navigate the system, it isn't complex, but it is built to be a frustration. My proposal is that military medicine become the "universal medicine" in America. There are several reasons I feel this: A) Wars/conflicts/disasters will never cease. We need a strong health care system that is ready for immediate use anywhere in any manner. B) The US needs a mandatory military/public community assistance/obligation time and a military/public health system based health care system would provide a MULTITUDE of jumping off points for young people who need age 17-24 guidance. Young people could work in the system for either 1,2,3,4,5,6 year committments in exchange for educational dollars or they could stay in the system as a permanent worker. Those that took the longer committments could move on to be the RNs, CRNAs, physician assistants, physicians, tech based professions within the system they "grew up" in since high school. C) A universal system could EMPHASIZE healthy lifestyle. Preventative medicine being the mainstaple. D) There need to be restrictions in reasonable health care expectations. E) People need to be able to choose and buy in to the system that is proposed because buy-in means greater acceptance and compliance. Sorry this is rather jointed..but am on a time crunch at this moment and have to sign off. Am writing a proposal but I don't think either candidate is listening. Cheers. J Oh, and THANKS for saying I am a "Typical American"...I think typical Americans are GREAT. Regardless of what others say...

We already have that so why change the best democratic health system in the world to socialized medicine for all?

Sorry about your SM but: If she worked for Humana for decades, she should have realized what her coverage was; perhaps she didn't want to have more coverage all along. CHOOSING to save the house for your father, etc was a CHOICE. I think taxpayers should have a CHOICE in who deserves taxpayer paid healthcare. Do we INCLUDE breast aug? Cosmetic dentristry? Hair implants? Br reconstruction? Super expensive "SAVES" only to see someone on disability for 50 years? WHO is going to play the "GOD" who decides what to RATION to WHOM? I'd predict what happens is that the high income taxpayers will pay MORE taxes for minimal coverage for ALL and then have to go out and get their own coverage ANYWAY so they can have a CHOICE. People decide how important their health is to THEM. Health isn't so important to EVERYONE...that is why I don't want to be paying for the smokers, drinkers, high riskers. They want to smoke, go ahead and buy your own insurance and it SHOULD cost you more than others who pay attention to their health needs. Punish the good and successful. REWARD the stupid choices people make.