Questionable practice???

[RNCFinally]

I am working in a level III Nicu, I was wondering how often do the Dr's and NNP's round on patients in a level III Nicu? I used to work at a teaching hospital and at least once during my 12 hours they would round.... Where I am now, I don't ever see them. Also how common are verbal and telephone orders??

[RainDreamer, BSN, RN]

I work night shift in a big level III NICU and there is always 1 neo on the unit, a few NNPs, and usually a resident. They round one time per shift. We don't take telephone/verbal orders anymore.

[SteveNNP, MSN, NP]

We are never to take phone or verbal orders where I work now... all physicians are required to put their own orders in the CPOE system, from attendings to residents. The last place I worked, a lot of orders were phone/verbals, since we didn't have 24h in-house neo coverage. Here the resident/NNP assigned to the pt usually rounds at least once during my shift, as well as the fellow on call. We rarely see an attending on night shift unless we have a really sick kid (ECMO, bad CDH, cardiac, etc) coming in.

[littleneoRN]

I work in a Level II nursery, but our facility also has a big Level III. We have 24 hour coverage by a neo and at least one NNP. An NNP rounds every morning on all our Level II babies, and the neo rounds in the afternoon. The NNP is the first line of defense on off-shifts, but the neo will definitely come over if something's up or the NNP is busy. On off shifts, if the NNP is relatively busy, we will take TORBs, but VORBs are pretty rare. For meds, we strongly encourage them to enter their own orders.

[carebeth]

I work in a level III NICU. I work nights and rarely see the neo unless there is an admission. They usually sleep throughout the night (one of my petpeeves...)

The team rounds once during the day shift. So other then that, you call the doc/resident if something happens...but beware of calling them in the middle of the night, you might wake them up from there beauty sleep.....grr....

[BittyBabyGrower, MSN, RN]

They round the whole unit in the AM and then do a touch up with the off going fellow to the on coming fellow. We have 2 attendings on each month and they take turns covering eves and nights. Only the fellow is in house all night with the residents and NNP's. We are not allowed to take verbal orders unless it is an emergency and we rarely take telephone orders as their is always someone on the unit.

[preemieRNkate, RN]

Rounds with the whole team in the mornings, between 9 and noon. We have what we call "lightening rounds" at night, usually between 8 and 10, where we can touch base with the NNP and docs and discuss the plan of care for overnight as well as any issues that may have come up. Parents can listen in and participate on rounds on their baby at either time. We have an attending in house 24/7, 1 NNP, 1 fellow and a resident overnight. The attendings usually just do rounds and go to bed at night though. The fellow and the resident head off to bed at some point as well, but the NNPs are no longer allowed to sleep. Most of them never did anyway. We don't really take telephone orders, but we'll call and say and ask if they want certain things, like if the kid looks like he needs a bili level, do they want us to send one? And then we'll just have them write the order when they come out in the morning. More serious things, we'll call and wake their butts up.

[Sweeper933]

We will have morning rounds first thing in the am - all the residents, fellows, and attendings. Then they round again in the afternoon when passing off info to whoever is going to be on at night. Usually the night doc(s) will take a quick walk around the unit around 10pm or so just to make sure there's nothing else that we need them for before they try to get some sleep that night. Depending on the night, we will just have a moonlighter on, a 1st year and a fellow/3rd year, or just an attending. There is always an attending on-call for the night, if there's a really sick baby, or a