Guyana Nurse Training Program: Lend me a hand...

Today started out nice and smooth. The students all had their babies on skin mode in the isollettes and developmentally positioned...either they are finally getting a routine or they are tired of Kate and I nagging them :) we spent a good part of the morning reinforcing routine bedside care; eye and mouth care, Suctioning, assessments, and feeding. Later in the morning we extubated our 3 rd patient of the week, this one again to bubble CPAP. The little one did great, and provided Randy an excellent teaching time for how to set up the circuit, prongs, and hat with the students.

The afternoon was spent learning how to insert an IV. Since we didn't have the fancy arm trainers, and none of us were willing to sacrifice our hands, I found how to create IV practice hands out of balloons and gloves ( see picture below). It provided a fun, interactive way to learn proper insertion technique and taping.

Back in the unit, we were faced with a decision that most of us in major medical centers rarely face, which is how to divide resources. We had a little one with klebsiella sepsis that really needed to be on a monitor. All 5 monitors ( and may I remind you that there's currently 18 patients) were in use. So who to take one from? Dr.Bixler and I decided on a baby that we just weaned off oxygen today that was doing well. So we get the monitor all set up and find the heart rate to be hanging out in the high 170s. Go to take a blood pressure with one of the new cuffs we brought and found it wouldn't fit the cable, so had to adapt it by cutting and pulling. Go to give a NS bonus and the IV wasn't working, so we insert another one. Did I mention this was all at 4:15 pm, after the students and we were technically all done for the day? But us workaholics love the babies and love the work we do, so at the end of the day, as we are sweaty and tired, we really would have it no other way.