Wake Up, Kick Ass, Repeat

As I reflect on our week, this phrase that was a background on Dr. Sarah Singh’s phone was a perfect summary.  It took me a little while to believe that I was really kicking ass though, as my initial reaction to the end of the first week was that I got nothing accomplished because there wasn’t anything tangible to show.  However, when I think about it, there were some really great things that our team did- mostly around education (and a little organization).  

Here’s a little summary of our week:

• Organized the supply shelves in the unit
• Figured out that the suction machines were set about 6-7 times too high, which may be one reason that the infants are developing pulmonary hemorrhage- too high of pressure causing damage to the lungs, nose, and mouth (we reset all of them, and taught the nurses and physicians about the importance of keeping the suction low)
• Started having temperature reviews incorporated into rounds with nurses and physicians- if the trend was not in range, we would move the baby into an incubator (we did this with 2 different babies), or at least get every baby swaddled and with a hat (still working, but it’s a start).
• Started “feeding rounds” in which every baby had a feeding plan by the end of rounds and included getting many babies started on early trophic breastmilk feeds
• Ballard suction catheters were placed on all ventilated patients and education provided to all staff
• Clarification that IV pumps were working and that every small sick baby should have their IV fluids placed on a pump instead of just dripping to ensure proper fluid administration
• Weaning of oxygen on all babies on the ventilator- nurses very involved in this process and often were weaning without us having to remind them
• Engaged moms in bonding with their infants as much as possible (they’re not just milk machines!), and even got one mother to touch her child just 12 hours before he passed
• Reviewed the basics of neonatal resuscitation with the nurses and assisted the OB residents in the resuscitation of an infant after delivery (much education was provided during that session)
• Education of the residents on laboratory principles and blood banking- we discovered a gap in knowledge that babies do not need to have type specific blood- can receive O neg or pos instead (they often wait days trying to get B positive for example when they could just give O positive)- they are going to discuss with the blood bank and get the policy changed so babies are not waiting days to receive crucial blood transfusions
• Got to know the student nurses, new residents, and reacquaint with the other nurses/midwives, PCAs, and physicians in the NICU

When I look at this list, I am no longer plagued with depression about my lack of accomplishment- our team is doing just fine!  Looking forward to another productive week ahead.

Cait and Randy attend patient rounds

Nurse Susan suctioning a patient

Nurse Alicia suctioning a patient

Randy shopping at the Borda Market

Borda Market

Cow crossing outside of Project Dawn (it's like the animal superhighway where we stay, since many farmers allow their animals to graze in the field across from us- we see goats, cows, and horses on a daily basis)