Last night was my first night in senior practicum. I'm in what's called the grad NICU at PSL. It's the NICU where the babies go once they are more stable but still unable to go home. There's potentially still a lot of risks involved with them but the critical care aspect isn't as high as I was hoping it would be.
The staff at PSL is incredibly welcoming! They all welcomed me in and treated me with wonderful courteous-ness from the beginning. My preceptor is incredibly smart and knowledgeable and is a mom herself, so brings a mom-like quality to the table yet still expects performance from me.
The night went rather smoothly. We had as assignment of three small babes. Each one of them was getting antibiotics which meant they all had peripheral IV's. We do "cares" every 3 hours, which include taking temps, changing diapers, flushing lines, quick assessments, and feedings. The night stayed pretty busy due to this but also due to having to replace each one of the little babes IV sites.
Babies have tiny tiny veins to begin with. Add in their smaller size and then trying to get a PIV started is almost ghastly. Really to the point that on the 2nd baby I got queasy and had to step away (also might have had something to do with getting incredibly hot from standing under the warming light). What really killed me was the number of pokes done to each child before help or use of evidence-based practice was used.
We are taught, and it has been shown to be remarkably more effective, that with babies with such small veins doing a thorough search using the little illuminators works very well for finding and getting a vein. Not to mention warming up the site to make the veins pop, etc. Very little of this was done and the babies were poked up to 6 times before someone from the level III NICU (the more critical babies) was called in to also attempt. 10 pokes on one baby to get an IV when probably half, or well below half, of that could have been attempted had a little more time put into the extra measures.
Or perhaps that's just my opinion.
And then there's the whole doubt in my mind over sucrose and whether it really eliminates pain, or just overwhelms the babies system. I'm not a huge believer in the sucrose for pain relief. Then again I haven't worked with neonates for many odd years like these nurses have. It did help to calm the babies down, but I'm not sure I would call it a pain reliever.
A few ethical concerns while there but then again that's to be expected, I knew that going in.
Overall a really great night and really exciting start to the next five weeks of my time there!! By the end Tami wants me taking care of a 4-baby assignment. Think I'm ready?! We will sure see.