A close friend of mine gave birth at 28 weeks (almost 3 months early) yesterday. Rauri weighed in at a whopping 1 pound, 7 ounces, which is small for her age. Rauri is doing well in the NICU and already showing a strong personality.
This family is going to be spending the next 8+ weeks traveling to see their daughter on a daily basis and I'd like to make their load lighter by feeding them on a regular basis.
Will you please comment with links to your favorite fail-proof, somewhat-healthy, freezable entrees/casseroles/meals? I seem to have about 4 that I make over and over again and I'm sure they'll quickly get tired of them! ;-)
Thanks!
Showing posts with label NICU. Show all posts
Showing posts with label NICU. Show all posts
Friday, May 04, 2012
Wednesday, February 23, 2011
Follow-up to "Changes"
Changes
I wrote the post "Changes" back in November when my work-place went through a re-bid and lay-off process. I was reading Leah's blog today and realized that I never updated you guys on what happened.
First and foremost, I want to thank you all for the encouraging thoughts, positive messages, and prayers you sent my way. That was a very low time for me and you definitely lifted my spirits.
Prior to the re-bid, I worked 8-hour night shift and a 0.8 FTE, which means I worked 80% of full-time employment, or 32 hours per week. I worked my shifts all in a row, 8 nights on and 6 nights off.
The re-bid didn't affect us as much financially as I was expecting it to. Based upon my (very) low seniority, I received a position that was better than I expected. God is so faithful! My new position is now 12-hour night shift and a 0.75 FTE. This means that I now work 5 12-hour shifts in a 2 week period.
Change can be good! For me this means more nights at home, sleeping in my bed with my husband. Fewer days of fuzzy brain, and that dreaded so-so physical feeling. Many days I was used to feeling a light hangover from lack of sleep. NOT ANYMORE! Now, I go to work for 5 nights straight, then I flip back over to a day-time schedule and enjoy life for 9 days. We are eating better because I have more time to cook, the apartment is much cleaner, and the laundry isn't back-logged, plus I have more time and energy for exercise and relaxation with my friends. Which sounds a bit like I'm not too far off from some of my 2011 Goals.
Many of my co-workers did not fair as well, but we are all rallying together. The mood has brightened in the unit, and of all the people laid off only 2 are still without employment. Which is better than anyone expected in this economy.
Again, thank you for your support! You are all much appreciated.
I wrote the post "Changes" back in November when my work-place went through a re-bid and lay-off process. I was reading Leah's blog today and realized that I never updated you guys on what happened.
First and foremost, I want to thank you all for the encouraging thoughts, positive messages, and prayers you sent my way. That was a very low time for me and you definitely lifted my spirits.
Prior to the re-bid, I worked 8-hour night shift and a 0.8 FTE, which means I worked 80% of full-time employment, or 32 hours per week. I worked my shifts all in a row, 8 nights on and 6 nights off.
The re-bid didn't affect us as much financially as I was expecting it to. Based upon my (very) low seniority, I received a position that was better than I expected. God is so faithful! My new position is now 12-hour night shift and a 0.75 FTE. This means that I now work 5 12-hour shifts in a 2 week period.
Change can be good! For me this means more nights at home, sleeping in my bed with my husband. Fewer days of fuzzy brain, and that dreaded so-so physical feeling. Many days I was used to feeling a light hangover from lack of sleep. NOT ANYMORE! Now, I go to work for 5 nights straight, then I flip back over to a day-time schedule and enjoy life for 9 days. We are eating better because I have more time to cook, the apartment is much cleaner, and the laundry isn't back-logged, plus I have more time and energy for exercise and relaxation with my friends. Which sounds a bit like I'm not too far off from some of my 2011 Goals.
Many of my co-workers did not fair as well, but we are all rallying together. The mood has brightened in the unit, and of all the people laid off only 2 are still without employment. Which is better than anyone expected in this economy.
Again, thank you for your support! You are all much appreciated.
Friday, November 19, 2010
Changes
Sorry for the brief hiatus. My world has been in a topspin of late and everything is off-kilter.
2 weeks ago today, a vicious rumor came out at work that lay-offs were coming. Mandatory staff meetings were already scheduled for Tuesday and Wednesday, where my boss completely blind-sided (despite the rumors) the entire staff with a complete re-bid for our positions as RNs in my unit. Oh, and they are taking away 8-hour shifts. Which doesn't bother me, but we have a lot of nurses who prefer 8's and some who can't work 12-hour shifts due to medical reasons.
This re-bid has spun out of control and a black cloud has settled over my workplace. Which, despite being NICU, is usually a happy place. And it is bringing out the best and the worst in people. Many nurses are banding together, and trying to have good attitudes, the doctors are bringing treats to us, etc; but others are so upset that they are acting like 3rd graders: only wearing black scrubs, wearing witch hats into work, dropping by my boss's office just to let her know how they feel, inappropriately.
My husband pretty much had to talk me into going to work all week long because I was having a really hard time handling all of the negativity. I am generally a happy person, but negativity effects me greatly and really drags me down.
Things are a bit better now, the shock has worn off, and management has heard our concerns and has agreed to compromise on a few things.
The process: A full re-bid essentially entails that a seniority roster and list of available positions is given to everyone. Management is offering fewer positions than we currently have people on the roster. The positions are nearly all 12-hour shifts, and the number of hours per week being offered may cause some financial strains for many of our staff, myself included. All part-time positions (anything less than 60% of full time) are being eliminated.
So, number 1 on the roster chooses her position, gets it, and it goes on to number 2, and so on and so forth until all positions are filled. Some people are choosing to leave, this will result in fewer lay-offs. I am safe from being laid-off based upon seniority alone, but I am pretty far down the list, so the positions that are left and available to me may not be enough hours or might be a terrible schedule.
I AM GRATEFUL TO HAVE A JOB. Hear me on this. I AM GRATEFUL TO HAVE A JOB.
I just had a higher sense of security because healthcare is generally a safe field to be in, especially as a nurse.
My heart goes out to my co-workers who will not have a job at the end of this, and to those who this change is putting a huge strain on their families.
2 weeks ago today, a vicious rumor came out at work that lay-offs were coming. Mandatory staff meetings were already scheduled for Tuesday and Wednesday, where my boss completely blind-sided (despite the rumors) the entire staff with a complete re-bid for our positions as RNs in my unit. Oh, and they are taking away 8-hour shifts. Which doesn't bother me, but we have a lot of nurses who prefer 8's and some who can't work 12-hour shifts due to medical reasons.
This re-bid has spun out of control and a black cloud has settled over my workplace. Which, despite being NICU, is usually a happy place. And it is bringing out the best and the worst in people. Many nurses are banding together, and trying to have good attitudes, the doctors are bringing treats to us, etc; but others are so upset that they are acting like 3rd graders: only wearing black scrubs, wearing witch hats into work, dropping by my boss's office just to let her know how they feel, inappropriately.
My husband pretty much had to talk me into going to work all week long because I was having a really hard time handling all of the negativity. I am generally a happy person, but negativity effects me greatly and really drags me down.
Things are a bit better now, the shock has worn off, and management has heard our concerns and has agreed to compromise on a few things.
The process: A full re-bid essentially entails that a seniority roster and list of available positions is given to everyone. Management is offering fewer positions than we currently have people on the roster. The positions are nearly all 12-hour shifts, and the number of hours per week being offered may cause some financial strains for many of our staff, myself included. All part-time positions (anything less than 60% of full time) are being eliminated.
So, number 1 on the roster chooses her position, gets it, and it goes on to number 2, and so on and so forth until all positions are filled. Some people are choosing to leave, this will result in fewer lay-offs. I am safe from being laid-off based upon seniority alone, but I am pretty far down the list, so the positions that are left and available to me may not be enough hours or might be a terrible schedule.
I AM GRATEFUL TO HAVE A JOB. Hear me on this. I AM GRATEFUL TO HAVE A JOB.
I just had a higher sense of security because healthcare is generally a safe field to be in, especially as a nurse.
My heart goes out to my co-workers who will not have a job at the end of this, and to those who this change is putting a huge strain on their families.
Friday, August 27, 2010
Patient Satisfaction
What does the term "patient satisfaction" mean to you? Anything? To those in the medical field, patient satisfaction scores can be a huge nemesis. When people leave the hospital a survey follows them home. Most people who fill out surveys are either extremely happy or extremely unhappy. Very few people who have an average or neutral experience fill them out.
In my hospital these scores determine managerial level bonuses. Which means that if the doctors and nursing staff can make the stay pleasant for the patient, the manager(s) of the unit get a monetary bonus.
My hospital takes the surveys and anonymously publishes the comments bi-weekly. I love to read them for my personal growth as a nurse, so that I can provide a better experience for my families, and for a good laugh.
In my unit, the surveys often come back with the same themes:
A) the nurses spend (too much) time in personal conversations
B) the families do not see the doctors enough
C) the parents write a review against a particular staff member
I always rebut each comment/theme in my head that I find ridiculous or do not agree with. It's quite amusing.
A) Nurses love to talk, it's a part of our profession. We spend 9-13 hour days with each other. When parents come in and participate in 45 minutes of care and then spend the next 2 hours and 15 minutes sitting next to the isolette watching their baby sleep or holding their baby, they can't just expect us nurses to not talk to either them or the other nurses. In my unit, we are all in one big open room with 1/2 walls serving as privacy partitions, but you can still see everyone. We nurses are aware that you hear us, and do keep our conversations appropriate, but we do talk.
B) I agree, our families do not see our doctors enough. But, all they have to do is ask (and they know this from day 1). As the nurse I am constantly asking the family, "would you like to speak with the doctor?" Our doctors work 24 hour shifts and do their exams early in the morning (3-6 am). They examine all the babies at this time because there are fewer interruptions--they can do the exam and then go transfer their thoughts immediately, which results in safer medicine.
C) The "we hated nurse X" just kills me. You don't have to love your nurse. Personalities do not always gel the way we want (it's fabulous when that happens!). Was your baby properly cared for? Yes. Then that should be enough. Because you know the "we hated nurse X" comments are always personality based, never based on the care given.
My personal favorite comment doesn't fit into one of the above categories, but is pretty funny. My hospital is located in a so-so area. I feel safe, but don't want to go walking around outside at 3 am by myself. The community and the hospital have built a partnership and purchased an old apartment building across the street, maybe a 1/2 block away and turned it into free and low-cost parent apartments for families who want to stay close by their children while hospitalized. It's an awesome program that we are able to offer. If parents are leaving the hospital late at night, we often will arrange a security guard to escort them to the apartments. Well my favorite comment stems from this. The parent complained that the security guards were too slow and that the hospital should provide a shuttle to escort them to the apartments. WTF? Really?! We're giving you a free place to live and you can't walk 1/2 a block?! Give me a break! Be grateful.
Do you ever read what gets put in the comment box at your job?
In my hospital these scores determine managerial level bonuses. Which means that if the doctors and nursing staff can make the stay pleasant for the patient, the manager(s) of the unit get a monetary bonus.
My hospital takes the surveys and anonymously publishes the comments bi-weekly. I love to read them for my personal growth as a nurse, so that I can provide a better experience for my families, and for a good laugh.
In my unit, the surveys often come back with the same themes:
A) the nurses spend (too much) time in personal conversations
B) the families do not see the doctors enough
C) the parents write a review against a particular staff member
I always rebut each comment/theme in my head that I find ridiculous or do not agree with. It's quite amusing.
A) Nurses love to talk, it's a part of our profession. We spend 9-13 hour days with each other. When parents come in and participate in 45 minutes of care and then spend the next 2 hours and 15 minutes sitting next to the isolette watching their baby sleep or holding their baby, they can't just expect us nurses to not talk to either them or the other nurses. In my unit, we are all in one big open room with 1/2 walls serving as privacy partitions, but you can still see everyone. We nurses are aware that you hear us, and do keep our conversations appropriate, but we do talk.
B) I agree, our families do not see our doctors enough. But, all they have to do is ask (and they know this from day 1). As the nurse I am constantly asking the family, "would you like to speak with the doctor?" Our doctors work 24 hour shifts and do their exams early in the morning (3-6 am). They examine all the babies at this time because there are fewer interruptions--they can do the exam and then go transfer their thoughts immediately, which results in safer medicine.
C) The "we hated nurse X" just kills me. You don't have to love your nurse. Personalities do not always gel the way we want (it's fabulous when that happens!). Was your baby properly cared for? Yes. Then that should be enough. Because you know the "we hated nurse X" comments are always personality based, never based on the care given.
My personal favorite comment doesn't fit into one of the above categories, but is pretty funny. My hospital is located in a so-so area. I feel safe, but don't want to go walking around outside at 3 am by myself. The community and the hospital have built a partnership and purchased an old apartment building across the street, maybe a 1/2 block away and turned it into free and low-cost parent apartments for families who want to stay close by their children while hospitalized. It's an awesome program that we are able to offer. If parents are leaving the hospital late at night, we often will arrange a security guard to escort them to the apartments. Well my favorite comment stems from this. The parent complained that the security guards were too slow and that the hospital should provide a shuttle to escort them to the apartments. WTF? Really?! We're giving you a free place to live and you can't walk 1/2 a block?! Give me a break! Be grateful.
Do you ever read what gets put in the comment box at your job?
Thursday, August 19, 2010
Day of Hope
Working in a NICU, I do my fair share of grief and loss tending. It is so important to remember the littlest souls are truly members of the family: very much loved and very much missed.
Don't be a part of the taboo or add to the stigma. It is ok to talk about the deceased and to ask how the family is doing. They want to know that you care and are sticking by them through their (and your) shared time of sadness.
Today, my heart goes out to all of you who have suffered infertility, miscarriage, infant loss, still birth, death of a small child: sibling, friend, child, grandchild. That soul was loved and is truly missed.
Saturday, May 01, 2010
March for Babies!
My region's March of Dimes walk "March for Babies" is today. I really wanted to participate this year, but have to work. Boo! Looks like it's going to be a nice day for it, and I have to stay inside sleeping. (Yes, I have to miss watching the Kentucky Derby too.)
Many of our graduates and their families turn out for the event, so it's like "old home week," but better. It is just so awesome to see our little itty-bitty 24 weekers running around as 4 year olds!
Not being able to go walking today makes me really want to see the new movie, BABIES.
Enjoy the trailer! The baby/goat bath made me giggle!
Happy May Day!
Many of our graduates and their families turn out for the event, so it's like "old home week," but better. It is just so awesome to see our little itty-bitty 24 weekers running around as 4 year olds!
Not being able to go walking today makes me really want to see the new movie, BABIES.
Enjoy the trailer! The baby/goat bath made me giggle!
Happy May Day!
Wednesday, March 03, 2010
A Night in the Life of a NICU Nurse
5-6 pm- wake up. Cross my fingers that we have something I can throw together for dinner. Do a happy-dance when I remember that I put something in the crock-pot at 7:45 this morning when I got home from work.
6-10:45 pm- spend time with J. Clean up the place, watch some tv, shower, prepare for work.
10:45 pm- leave for work. Pray there is parking available in the employee garage at the hospital.
10:56 pm- clock in, begin 3 minute finger-tip to elbow scrub, lop off any nails that are too long. Find out assignment: am I in the NICU or the Intermediate Care Nursery? 2 babies or 3? Tonight: NICU & 2 babies.
11-11:30 pm- receive report from evening shift. Get interrupted umpteen times and answer a bazillion alarms. (Well, it just seems like it...)
11:30 pm- safety checks: Are monitor limits correct?, Ventilator settings correct? (if vented), Bag & mask at bedside?, Bulb syringe at bedside?, When are leads & feeding tube due to be changed?, When is crib due to be changed?, Is suction working?
Quickly chart safety checks and scan most recent notes in chart-MD, NNP (neonatal nurse practitioner), Social Work, etc for pertinant information. Answer alarms.
11:45 pm- head to "milk station" and mix up the formula or breast milk concoctions needed for my shift. Our recipes often look like this: MBM + HMF = 24 + 1/4 tsp BP/100 ml = 24 cal/oz. This translated is: Mother's Breast Milk (20 cal/oz) + Human Milk Fortifier = 24 cal/oz + 1/4 tsp BeneProtein = 24 cal/oz. Essentially, preemies need extra calories and protein when compared to healthy term infants. So we fortify MBM to give them the extra needed calories to grow. Stop 4 times to go answer alarms.
12:00 am- begin "care time" on baby #1, if parents are present teach/assist them. Wash hands. Assess IV (if has one). Draw labs, get blood pressure, take temperature, feel skull for fontanel (soft spot) and suture lines, listen to heart, breath sounds, bowel sounds, listen for placement of feeding tube in stomach. Is belly soft & pink? Check residual (how much undigested food is in the stomach from the feeding 3 hours prior). Look over skin for any rashes, bruising (from birth), pustules, area of breakdown (diaper rash, tape removal). Change diaper, weigh diaper. Wash hands. Redress, swaddle, & comfortably position baby. "Drop" feed via feeding tube (for a baby too little/weak to suck from a nipple). Wash hands. Turn off lights. Chart about baby. Answer alarms.
1:00 am- begin "care time" on baby #2. See above.
2-4:00 am- Go to break for an hour at some point in this time period. Catch up on reading the charts. Help other nurses with their babies if necessary-- help with linen changes, assist with an IV start, draw labs, fold laundry, track down formula that we're almost out of from distribution, hold babies still for ultrasounds, rock babies that need some extra loving, re-stock supplies. Answer alarms.
3-4 am- if baby #1 eats every 3 hours, do care at 3 am. If they eat every 4 hours or do not eat at all, do care at 4 am. Ditto with baby # 2 except at 4/5 am.
5 am- get MBM from freezer out to thaw for day shift. Work on updating each baby's care plan. Give updates on babies to Team Leader (charge nurse overseeing both NICU & ICN). Answer more alarms.
6 am- Baby #1 has care time again if 3 hour feeder. Otherwise, X-Ray is here! Don fashionable lead dress, do x-rays on own babies and babies of pregnant co-workers.
6:30 am- last minute "clean-up" for day shift. Enough diapers at the bedside for the next shift? Is the MBM thawed enough for me to fortify it for day shift? Did I get everything charted? Do I need to leave a note for the MD or NNP about anything?
7:00 am- Thank God day shift is here! Give report, while answering many alarms. (Babies really like to alarm, plus our alarms are very sensitive and we get lots of "false" alarms.)
7:30 am- clock out, scrub out, get out!
6-10:45 pm- spend time with J. Clean up the place, watch some tv, shower, prepare for work.
10:45 pm- leave for work. Pray there is parking available in the employee garage at the hospital.
10:56 pm- clock in, begin 3 minute finger-tip to elbow scrub, lop off any nails that are too long. Find out assignment: am I in the NICU or the Intermediate Care Nursery? 2 babies or 3? Tonight: NICU & 2 babies.
11-11:30 pm- receive report from evening shift. Get interrupted umpteen times and answer a bazillion alarms. (Well, it just seems like it...)
11:30 pm- safety checks: Are monitor limits correct?, Ventilator settings correct? (if vented), Bag & mask at bedside?, Bulb syringe at bedside?, When are leads & feeding tube due to be changed?, When is crib due to be changed?, Is suction working?
Quickly chart safety checks and scan most recent notes in chart-MD, NNP (neonatal nurse practitioner), Social Work, etc for pertinant information. Answer alarms.
11:45 pm- head to "milk station" and mix up the formula or breast milk concoctions needed for my shift. Our recipes often look like this: MBM + HMF = 24 + 1/4 tsp BP/100 ml = 24 cal/oz. This translated is: Mother's Breast Milk (20 cal/oz) + Human Milk Fortifier = 24 cal/oz + 1/4 tsp BeneProtein = 24 cal/oz. Essentially, preemies need extra calories and protein when compared to healthy term infants. So we fortify MBM to give them the extra needed calories to grow. Stop 4 times to go answer alarms.
12:00 am- begin "care time" on baby #1, if parents are present teach/assist them. Wash hands. Assess IV (if has one). Draw labs, get blood pressure, take temperature, feel skull for fontanel (soft spot) and suture lines, listen to heart, breath sounds, bowel sounds, listen for placement of feeding tube in stomach. Is belly soft & pink? Check residual (how much undigested food is in the stomach from the feeding 3 hours prior). Look over skin for any rashes, bruising (from birth), pustules, area of breakdown (diaper rash, tape removal). Change diaper, weigh diaper. Wash hands. Redress, swaddle, & comfortably position baby. "Drop" feed via feeding tube (for a baby too little/weak to suck from a nipple). Wash hands. Turn off lights. Chart about baby. Answer alarms.
1:00 am- begin "care time" on baby #2. See above.
2-4:00 am- Go to break for an hour at some point in this time period. Catch up on reading the charts. Help other nurses with their babies if necessary-- help with linen changes, assist with an IV start, draw labs, fold laundry, track down formula that we're almost out of from distribution, hold babies still for ultrasounds, rock babies that need some extra loving, re-stock supplies. Answer alarms.
3-4 am- if baby #1 eats every 3 hours, do care at 3 am. If they eat every 4 hours or do not eat at all, do care at 4 am. Ditto with baby # 2 except at 4/5 am.
5 am- get MBM from freezer out to thaw for day shift. Work on updating each baby's care plan. Give updates on babies to Team Leader (charge nurse overseeing both NICU & ICN). Answer more alarms.
6 am- Baby #1 has care time again if 3 hour feeder. Otherwise, X-Ray is here! Don fashionable lead dress, do x-rays on own babies and babies of pregnant co-workers.
6:30 am- last minute "clean-up" for day shift. Enough diapers at the bedside for the next shift? Is the MBM thawed enough for me to fortify it for day shift? Did I get everything charted? Do I need to leave a note for the MD or NNP about anything?
7:00 am- Thank God day shift is here! Give report, while answering many alarms. (Babies really like to alarm, plus our alarms are very sensitive and we get lots of "false" alarms.)
7:30 am- clock out, scrub out, get out!
Monday, January 19, 2009
First NICU IV start!
I did it! I started my first peripheral IV on a baby the about a month ago.
In my NICU this is a rite of passage as we use UAC/UVCs (IVs in the umbilical cord stump) and have a special PICC (IV) team. This means that many nurses do not have the opportunity to start PIVs, as we don't use many.
I got it on the 2nd poke! The baby is a former 25.3 weeker (now 27.6), who is vented on the high-frequency oscilating ventilator. This all means that she is tiny! and that her body was shaking while I was trying to start the IV.
My mentor was super-ecstatic for me. She, my Charge, and a bunch of others made me this sign and did a "hip-hip-hooray" chant for me!
My co-workers always make for a lively night!
Author's note: this all occurred about a month ago, I didn't post it earlier due computer issues. But we're good now, and I've since started about 4 more!
Saturday, October 18, 2008
bad names
Jayme + Marci = Jayci
At least they didn't name her "Navaeh" (heaven spelled backwards).
Or "Zamiracle" because "she'z-a-miracle."
At least they didn't name her "Navaeh" (heaven spelled backwards).
Or "Zamiracle" because "she'z-a-miracle."
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