itsybitsy

We typically don't feed on high flow. We regularly feed on low flow as long as that's the only issue. We don't feed if respirations are greater than 70 breaths/minute.

Slow flow nipples are not all that?? What is that suppose to mean? That they don't work or what? If you're trying to say the practice is being outdated, you're sorely mistaken. Slow flow nipples are very heavily supported by evidence, and continue to be. You mention your SLP using a premie Dr. Brown nipple, which is a slower flow nipple than standard. So you would follow the MD orders to use a standard flow, because it's risker to use a slow flow than a standard flow in a baby with mild PPHN? What?!? It's risker to slow the flow of milk, than it is to possibly aspirate, stress the baby out, and worsen the PPHN? Where is the thinking that a baby will become stressed by eating from a slow flow nipple?! And really, you really should feed every baby left-side down for two reasons. One being that if they are on their side, the milk will not pool in the back of their throat but their cheek, lessening the chance of aspiration. The second reason for specifically left-side down is the anatomy of the stomach. The larger part of the stomach plunges to the left side of the body, meaning that intake will collect at the very bottom of the stomach if left-side down, rather than the flat part of the stomach on the right side. This allows a baby to continue eating without feeling full faster and will reduce reflex. You want them upright as well to reduce reflex.

I'm sorry, but this is so wrong. This is just asking for aversion after aversion. "Spilling milk out of her mouth" is anterior loss. It's showing that the baby is not tolerating the flow of the feeding. The feeding is coming out of the nipple too fast, the baby is pushing it out. It's also a sign that that feeding should cease. If it continues, the baby is eventually going to get worn out and aspirate, because it will be too exhausted to push it out any longer. Secondly, arching, crying, pushing away from the nipple, falling asleep, etc., with a feeding are also signs that the baby is done eating. That baby is cueing that the feeding is no longer wanted... I wonder why. The faster flow is probably stressing the baby out more, probably exasperating the PPHN. This is a 25 weeker, who is 42 weeks, on oxygen, and have mild PPHN. If we are even going to orally feed this kid, it BETTER be slow flow, probably with a thickener. ALL of our premature babies are fed with a slow flow nipple, and most term kids are as well, all the way to discharge, and we send parents home with a slow flow bottle and nipple, to continue using. ALL of our premature babies are held in a left-side lying position, elevated. Many of our kids are paced, if it's needed. The order needs to be deleted from use. The kid is in the NICU for a reason, and doesn't need to aspirate, in which case they are at higher risk for if they have had any respiratory problems. The few kids that could probably use standard flow nipples are the chorio kids that just need some antibiotics and haven't had any respiratory problems. The SLP is not educated on neonatal feedings, obviously. I'd rather not have a kid that has mild PPHN to aspirate, thanks. Slow flow nipple is NOT harder to get out of the nipple, it's to literally SLOW THE FLOW. These kids SHOULD eat slower, so they DON'T aspirate. If the baby is worn out, then the feeding is done. If the baby isn't meeting their full feeds, then you need to tube feed, to meet those requirements. Obviously this is an ongoing problem, seeing as the baby is 42 weeks, in which case, I wouldn't be surprised if the baby needs a button to go home. My suggestion - Lobby for a SLP full-time in the NICU that knows what they are talking about.

I would do whatever you feel is right for you. Whether that be having a concealed carry or not. Whether you want to leave it in your car or carry it on your person. I understand you when you relay that you aren't worried about your patients, rather the areas where your patients live. Which is why you might want to just leave it in your car. I wouldn't worry about it getting stolen unless you are leaving it in plain sight, in your vehicle. So many "what ifs" could happen and none of them justify limiting your ability to protect yourself where you feel is a threatening area. Pepper spray and blunt objects won't do you any good if a gun is pointed at you. Carrying on your person, into a patients home, is legal, as long as the patient/owner of the home doesn't have signage posted that firearms are not allowed. Yes, your employer probably doesn't "allow" it, if it's even discussed in your employee handbook. Your employer probably also doesn't allow many other things, such as cell phone use in patient homes. Obviously the latter wouldn't get you fired, while carrying concealed probably would, but it's not against the law. The point of concealed carry is that no one knows you have it, so your employer shouldn't and wouldn't know, even if you did, properly. The only time they SHOULD find out, is if you had to use it, in which case, if you saved yourself and your employer fires you for protecting yourself, within the limits of the law. In which case, I wouldn't want to work for said company. If you are found out to conceal carry, by accident (as in a patient saw it, as it wasn't concealed properly, and reported you), and you are fired, that is a risk you must decide if you want to take, in which you can mitigate that risk by concealing properly, 100% of the time.

Neonatal NP's work 3, 12 hour shifts. Some even work 24 hour shifts.

From article: I see where you got your one liner. Except you decided to use conservatives instead.

As requested, I'll stick to the topic at hand. I think as a group, we have concluded that the CDC banned the words, not President Trump. I see the title has changed to "per White House", which is still false, per CDC statements. So I guess that is where I'll end it for this forum. I'll be finding the Donald Trump forum in the break room if you'd like to join me. And if you copy your comments there, I'll be happy to respond.

Twice I have been berated because I apparently said "Christian terrorists don't exist". I didn't say that, the opposite is true. So here it is, in big bold letters, what I said. Maybe read the posts before making a comment.

Sorry, I must have been exhausted trying to keep up with all the posts. Don't get your panties in a wad, I'll respond now. It's hard being the only one on the right against so many who are vehemently against our sitting President and his policies. They are looking at their e-mails? And doing what? It doesn't say. If they are using government e-mail, I don't know why they are surprised. My hospital can look through my hospital e-mail anytime they want. It's their property. I know if I don't want my hospital to see something, I won't use their e-mail. I never said Christian terrorists don't exist. I'm sure they do. I did reply to someone else about the KKK earlier, so feel free to look over that response. As far as Eric Rudolph, his motives that HE described were anti-gay and anti-abortion, saying, "the purpose of the attack on July 27 was to confound, anger and embarrass the Washington government in the eyes of the world for its abominable sanctioning of abortion on demand. The plan was to force the cancellation of the games, or at least create a state of insecurity to empty the streets around the venues and thereby eat into the vast amounts of money invested." Some sources suspect it was motived by Christianity, since he frequently quotes biblical verses and had conversations with some Christian extremists, however Rudolf himself denies it had anything to do with his religion. Either way, again, it does exists, but not even close to the number of times you have heard of Islamic extremism happen in the past decade. I never said it didn't exist. Just simply it didn't happen as often. I did read a couple similar articles, and responded to them, about the event you are referencing. The conclusion, if I remember right, was that the conference was not an EPA conference and so the researchers, themselves, didn't show their findings, as you have shown through your paragraphs. So I'm not sure what type of evidence this is. That the EPA didn't present because it wasn't an EPA conference? Okay? So where do they go from here? How can we jump to conclusions that it was a direct attack? I'm not denying evidence, because their really isn't any solid evidence given. It is all presumptions and assumptions. There is no gingerbread trail to the exact reason without doubt.

You are living under a rock if you think this is the first instance of this happening. It's not. It won't be the last. It's probably the first time it has gotten airtime, because it's Donald Trump. But since I really don't have any proof to show you otherwise, because this stuff usually doesn't matter, because it's not President Trump, I guess you can continue to believe this never happens.

Yes, yes he did. Obama Bans Islam, Jihad From National Security Strategy Document | Fox News I didn't say Muslim in the post you quoted. Islamic means relating to Islam. It doesn't mean mainstream Muslim beliefs. You can be Christian and hold different religious beliefs from a Catholic, but both are still Christian. The term "Islamic terrorist/extremist" is a person, I, along with the rest of the world, views as a follower of Islam, following to the extreme, as far as carrying out acts of terror in the name of their Prophet because of their interpretation of the Quran. No one is saying Islam is extreme. But those who profess one must fight or kill those who do not believe in Allah, yea, that's an extreme form of Islam.

I don't have a bias for anything. I have my own viewpoints. I don't know what you think I downplayed. I stated my opinion on the matters presented and provided rationales for everything on why I think what I do. And what President hasn't had things served to them on a silver platter? Who cares. The CDC wanted to do that, which was their own decision, and have probably done it numerous times before, just no one cared until now. You as well; I cannot help it if you do believe it. I don't care if you think President Trump is "waging a war on science", you're entitled to believe whatever you want. But I am listening to you. I read your link and replied to it on what it had to say, which was pretty much nothing, except they were unsure why these things were supposably happening. You can continue to use "whataboutism" as your fallacy scapegoat, or you can actually have a debate without pointing out false fallacies and refuse to reply with any intellectual content. Again, read the definition of your "whataboutism". Here, I'll make it easy: Whataboutism - Wikipedia "attempt to discredit an opponent's position by charging them with hypocrisy without directly refuting or disproving their argument" ...which I did, I directly disproved that President Trump banned words and that President Obama did ban words. The hypocrisy is in the outrage on hindering freedom of speech and ideas. Here's a source: Obama Bans Islam, Jihad From National Security Strategy Document | Fox News From reading this source, it does point out the number (50) of scientists that arbitrarily resigned who worked on climate based projects. It also says that scientists were "afraid to utter the words 'climate change'". I can see how some people might take that as trying to dismantle science. However, those who resigned, either forcefully or voluntarily, are still free to work for a privately owned company to continue their work openly. Also, (I can see it now, you guys are really going to think I'm a nut, but feel free to take your jabs) not every scientist backs up the "climate change" we know, with their research. Yes, climate change is real. We all know this, it's a fact, and has been occurring since the beginning of Earth. The issue is, climate change is sold as an event that is going to have devastating effects on the Earth in the next few decades. I err on the side of that isn't true, which is what many scientists, mentioned above, describe as what climate change isn't. Climate change is slow and won't be noticeable in our lifetime. It is ever occurring whether we all drive around Hummers or not. Hummers are not going to speed up climate change. It doesn't have a large enough effect. The volcano eruption in Bali on the other hand, DOES change the climate, more significantly than anything an entire first-world country could do in 100 years. There could be many reasons press releases are wanted to be vetted before reaching the public. I'm not interested in playing the guessing game. This is again, more of less money, less hiring, rationale that science is being silenced. It brings up that certain chemical that can cause disease and cancer were ignored when setting regulations. Not ideal to have these chemicals in products, but why would anyone care if you used one chemical versus another. I doubt the administration cares as they have bigger fish to fry. They didn't include their actual research on the product so how would anyone know if the risk was substantial or minimal. There is a risk with virtually every product, and we just don't know about it. The Paris Agreement is a different story. I'm glad we got out of that. We can do all the things the Paris Agreement set forth to decrease emissions and the like but won't have to pay for other countries to have high-tech equipment. I'm not about sending money everywhere else but home. Additionally, the actual Agreement made U.S. to agree to all of these terms while allowing China to continue their normal protocols for the next decade. Sure a deal was made, but why would the U.S. agree to something we can do ourselves without using our money for other countries? I'm not saying the articles are false, but don't you see? I want solid proof. Big, fat, stinking proof. Not "well these things happened and we think it's because of this person". Undeniable proof.

You keep saying this without anything to back up your statements. (I replied to your link below, still doesn't back anything up.) I don't have a "thing" for President Trump, he is my President, plain and simple. I voted for him based on his policies and ideas, because the majority I agree with. I also haven't denied anything he has supposably done. You keep imposing that President Trump is silencing scientists without any real sources. If you don't provide any evidence, why would I have any reason to agree with you? The one thing I have said is false is the supposed banning of words for the CDC, which IS false. You're right, there is no comparison. Each other have very different takes on different subject matters, as do the people. Why is that wrong? Again, no evidence President Trump is "hiding science". You can say he "chose to use more accurate words" but he distinctly banned certain words from ANYONE using them in U.S. Homeland Security documents. Also, one of the banned words is "Sharia". How is that in anyway not accurate of "Sharia Law" no matter who you are? If you want to say "Christian terrorist/extremism", be my guest. It's not offensive if accurately displaying what a person is based on their actions and motivations. Again, if you are referring to the CDC debate, we already concluded that President Trump and his administration, nor the GOP, had any part in what the CDC wanted to submit for their budget proposal. I don't know where you're getting that the majority of American's don't like President Trump. Yes, he lost the popular vote, but not everyone votes. If you are referring to the pollsters, you can probably remember how polls are always or anywhere near correct at times. As in, the polls leading up to election on chances of winning. They weren't correct in the slightest. In my opinion, the polls were biased, like the many other things from mainstream media. There is no way to prove that unless I worked for those polls, so I will leave it at that. I am not brainwashed at all. I have done my own research instead of mindlessly listening to talk shows to give me information. I also am not overlooking any "scandals" that may have happened, but honestly, they don't matter to me whether they happened or not, as I am very skeptical of many things that "have come out" anyways. I wanted a President with solid policies that weren't going to drain this country even more than before, and Donald Trump was the perfect candidate. I also don't need to "defend" President Trump. He does a good job of that for himself. I am correcting false narratives and explaining my position. Did you even read what you posted. Okay, it's a list of everything the Trump administration has supposably done to "silence science". 1. No conclusion on why the speakers didn't present. They were either not at an EPA conference or the EPA and Fire Service said they did not attend because of travel-funds. No evidence that anyone silenced anyone from talking at these events. There were multiple, how would anyone have time to keep up with all of them and telling specific people they cannot talk at these small events? 2. This is the same situation at the CDC one. The person restricting language is an EPA employee, not part of the Trump Administration or GOP. 3. The administration wanted to stop covering birth control under ACA insurance. Apparently, the article, which gives no source, says the "administration claimed scientific evidence supported their decision". No further information. That doesn't mean the administration silenced any science. 4. The article states an analysis was dropped from the Department of Treasury's database in order to deceive the American people from realizing what a tax cut would really do to the economy. This seems more of a mathematical hypothesis, not really science based as there is no way to "research" something that has never happened in a certain economy. So it's solely based on possible numbers of what COULD happen. 5. This one itself chalks the cancelled trips up to the event being in Russia and the topic being nuclear energy. An obviously touchy subject for both countries during the time the conference was scheduled to take place. There continues to be a never-ending "list" of everything our "horrible" President has done to keep scientists from speaking or attending. I am not going to read through every single one. I read the first 5 and all of them stated in the articles other reasons or no conclusion at all on why things happened. No solid proof or evidence of it being President Trumps doing. If you would like to read your own source and provide specific example, I would be more than happy to read.

So, to you, all conservatives in the current administration and GOP are dumb?

What exactly has he attacked from the organizations? The CDC has come out saying that President Trump did not ask for these words to be banned, censor, or otherwise avoided. That it was the CDC themselves who are self-censoring. What more do you need to eliminate President Trump from the beginning equation? Furthermore, no one knows if those words would be censored with a different President, that is an assumption. To add to that, if it weren't these words with President Trump, they would be different words had we had a different President. The difference is, there would be absolutely no media covering it, meaning no hysterical outcry that "TRUMP BANNED WORDS!", because it wouldn't be Donald Trump. Edit: I do understand the last sentence is an assumption as well, but let's be honest, it probably wouldn't get the coverage it did had Donald Trump not be President. Not whataboutism. I distinctly disproved the argument that President Trump banned CDC from using certain words, including a source. Yes, it is hypocrisy, but you are forgetting the second part of whataboutism. Maybe you should look up the definition. From my stance, I am not so much upset over the banning of the words, such as "Islam", as I am about the blatantly obvious bias of and incorrect reporting going on and havoc following suit solely based on who may or may not have said what. No one is condemning the Islamic community as a whole. That is not what "Islamist terrorists" or "Islamic extremism" means. The two phrases describe those who practice the religion of Islam to the extreme, enacting terrorism. Some believe it to be because the interpretation of the Quran, and the scripture enforces that to be the purest devotee to Islam you must participate various acts, where some of the terrorism comes into play. To them, they are just being a good Muslim, following the Quran, in their interpretation. To everyone else, it's terrorism. Not every Muslim believes these things that "Islamic extremists" profess to be from the Prophet, written in the Quran, and not every Muslim is a terrorist. I've never read the Quran, so I'm not going to list the acts the Quran says, as again, the interpretations can differ. No one says "Christian terrorists" because when a Christian commits terrorism, they are not doing so in the name of their God. I'm sure there are a few cases of Christian terrorists that do do it for their God, but how many can you even find a link between - as in this person is a terrorist because Christianity? When you have Muslim's yelling "Allah Akbar" when committing terrorism, the two ARE linked and this happening is weekly. ISIS has made numerous videos about how the crimes they commit are in the name of their God. That's what "Islamic terrorism/extremism" is. Don't believe it to mean every Muslim is a terrorist, because that's not what it is, nor what it ever was. Again, I'd like to know what he is "doing to the science community"... I think we are going through a fantastic presidency. If you think only this presidency, as opposed to past presidencies, thinks political opinion matters more than scientific facts, I don't think you've been paying attention.