"one thing you know, in faith you find...something to stand on or you will be taught to FLY..."

so this whole experience has been a leap of faith, and i'm not sure if i'm flying or if God's given me something to stand on yet...but i definitely know His hand is here.

Sunday was my first full day in the unit. rolled out of bed around 5 and was on the road by about 5:45. got to the unit a little early (i know, all of my Lubbock people are shocked) and found my place. had one of the same kids i had on friday plus two cardiac babies. my preceptor's name was Cat...and she was hilarious. great about teaching (and picking on me) and gave me the twin that we had to take care of for the day. i did all care (with a little help) and all of the charting (with a lot of help!). got nicknamed "sparky" by one of the transport nurses, because i told her i want to eventually be able to do everything in the unit (ECMO, take care of head cooling babies, transports, and cardiac--only certain nurses take care of cardiac babies) and that i love to be involved and get really excited about stuff. first feeding went off without a hitch. got baby changed and assessed and such, and cat gave me a crash course in incubators. one of the really cool things is that if you have to open the doors or take down the side, there's a button you can push and it creates a "heat wall" between baby and the outside of the incubator to help prevent the cold air from getting in. kind of like that wall of air you meet with at the grocery store to keep the bugs out. *thanks for the analogy, beth! :)* in addition to the servo temp (set temp for non NICU people) and the baby's temp, the environment temperature is also displayed. got little one's feeding started (it's all over a pump here...usually 30 min to an hour) and then went to the computer. got as much done as i could without help, and then cat came over. "did you do your abdominal girth?" nope...didn't know i was supposed to. how often do we do it? "every shift." sure, got it. will do it at noon. we looked at the assessment, meds (the MAR is also computerized...no sheet to print out, and we don't doublecheck routine meds...still the narcs and serious stuff though), feeding assessment...it was really amazing. nice to be able to go back and edit if i needed to, but definitely slower than just whipping out my pen and writing it down, although some nurses will write things down throughout the day and then put everything in at the end of the shift.

the rest of the day went pretty well...i spent my time exploring the chart (which is much smaller because a lot of the charting is online) and playing with the computer system. the nurse who dubbed me sparky came to me about 10:30 and asked if i wanted to go on a c-section...of course! then she stood up for me when the nurse practitioner stated that they already had plenty and i would probably be in the way. "it's okay, she's not going to do anything, she's just gonna watch." mostly the same setup for deliveries, except the warmer in L&D stays there if baby has to come back to us. we have a couple of carts with an isolette and a transport bag set aside just for deliveries, and baby comes back in those.

now...for the things that are a little different...for starters, pretty much all babies in the unit feed every three hours. blood pressures are with every feed (on every baby) and we do abdominal girths every shift. the incubator was not as big a deal as i thought it would be. i could do pretty much everything i needed to with just the windows open, but i did have to take the whole side down to turn baby prone. another big difference is the developmental aids...they use something called a Z-Flo here. it's like a whole mattress that's a semi-solid material that can be formed any way you want and it will stay that way. you just squish it around with your fingers and form it the way you need it to be, and it has two straps (kind of like the snugglies) that you can sort of hold baby in with. i get the feeling that the nurses don't like them so much...they think they're a pain. also, they are trialing something called Prolacta with some of their babies...it's like HMF, only liquid, and i think it's got protein in it that HMF doesn't or something. so you have to thaw the stuff out (they have a milk thawer...that's cool) and then you add a certain amount of breast milk (10 cc prolacta+40cc breast milk). there's four different concentrations depending on what you want your final caloric intake to be. we also use donor breast milk that comes from the milk bank in austin. it has a lot number and expiration on it and has been pasteurized. when you take one out, you just have to log the lot # and expiration on a log kept on the baby's clipboard. very interesting.

so the day was relatively uneventful...i learned a lot and it was a good day. i'll be out of the unit for a week because i have new nursing orientation on tuesday/wed/thurs and then i'm off the weekend because friends are coming in and i'm going to SEA WORLD ON FRIDAY!!! cool!!! i haven't been since i was like 8 or something. can't wait!

on a different note...i emailed my narrative of my whole moving experience and photos to my original contact at Nationwide today, and I should have my claims stuff in the mail by the end of the week. for your viewing pleasure, i will be posting the letter and photos on here...get excited! hopefully i will actually get something out of this for all the work i've put into it...

okay, gotta go to bed so i'm not falling asleep tomorrow. much love to all!