Tcom,what to report

[Jd0817]

I am a prn nicu nurse, have been for 2.5 years. Our census was super low when I came off orientation, so I went and oriented and picked up shifts in our ED for 7 mo before getting my first nicu pt. I got stuck with a lot of feeders and growers, piccs/IV's, Cpap and a few intubated. Ive never had a jet/osc vent baby.

My question is regarding Tcoms and what you would report to the dr or NP, or what you would look for. I havent had a tcom baby since orientation.

Also in general, what would you report? Obviously increased or decreased temp, increased A/B spells or longer recovery time, increased 02 needs, increased residuals, etc.

Ive had an epi drip baby and wanted to report and decreased mean bp. It got down to 25 or so and I was told that wasnt worth reporting. What mean bp would you report or closely watch? On a drip and off a drip?

I want to fine tune my assessment skills but when I more often than not have stable babies, it makes it hard. For example, my last shift, I had 3 babies, all in isolettes, 3 pounders, all 3 on 02 (2 ram can's 23-26% 02, and a hfnc on 4L), all ogt feeders. I am great with that type of stuff, but want to familiarize myself with things an experienced nurse would observe for, be suspicious of, report, etc.

Thanks in advance!

[BittyBabyGrower, MSN, RN]

What to report is related to the patient and parameters set by the team. A MAP of 25 on a 25 weeker is fine, not so much on a full term kid.

Take a look at policy, protocol and procedures too, we have some of the parameters in ours.

We don't use tcoms anymore, but we had parameters set in our orders.