Q& A!!!! @thenicudoc and I asked each other a bunch of questions!!! What do I love being told on rounds??! Do we care about RESIDUALS?!! Which ventilator do we choose for which patients and WHY??! I asked him a few questions too!!!! To view the rest of these: head on over to Dr. Fort’s channel: http://www.youtube.com/thenicudoc --------------------------------------------------------------------- Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded! --------------------------------------------------------------------- Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist. ----------------------------------------------------------------------------- Music: www.bensound.com (royalty free with credit) Music: https://www.bensound.com/free-music-for-videos License code: BMROMRG5TJNGOMUS Music by https://www.bensound.com/free-music-for-videos License code: NXQX4U6RSEPN1YSV ---------------------------------------------------------------------------- *Disclaimer*: This video is intended for educational purposes only and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.
Hello! Today, NICU docs and I are going back and forth answering a few questions that you've asked
us in the past on this channel. We hope you enjoy it. My next question is, if you were a nurse and
you're rounding with Dr. Tala, what would you like the nurse to present to you? What kind of
information do you want to know on rounds? This is such a good question and one that we've been
asked multiple times on our channel. So what I would like to hear from the nurses during rounds
is stuff that I may not have picked up from the electronic medical record or the flow sheet
or stuff that just isn't on there. So for example, things like the IVs aren't lasting as long. So
obviously that might make us kind of make a decision to go a little bit faster with the
feeds or something or get central access. Or that the baby is having more events that aren't
necessarily needing stimulation. So aren't actually going onto the chart or the baby's
taking a little bit longer to come up after each event or desatting more, but really kind of not
bad enough to actually record it. Maybe in the last 24 hours, the baby had really good urine output,
but the nurse might tell me, by the way, the last two diapers were completely dry. Or for example,
I see a massive weight change in the baby's weight. The nurse might tell me, by the way,
we used a different scale to weigh the baby this morning. So just all these kind of little things
that aren't necessarily in the chart, which might really help. The other thing that would really
help is stuff that may be in the chart, but I haven't necessarily picked up on. So for example,
I may look at the heart rate today and it's kind of 160s to 170s. I go to the bedside and the nurse
tells me, by the way, Tala, the heart rate yesterday was kind of in the 130s. The heart rate
has slowly been creeping up over the last 24 hours. That might be clinically relevant. Or the
baby's sleepier. The respiratory rates are a little bit lower. The baby's acting a little bit more
lethargic. Maybe the nurse tells you, by the way, the events are happening right before the caffeine
dose is due. So maybe we should think about doing caffeine BID or whatever. Like all those objective,
but also a lot of subjective things that can really, really help at the bedside.
On the complicated patients, I like to run through the whole system with the nurses. So literally
we'll start with neuro and we'll both be like, okay, cranial ultrasound is next week. So we're
on the same page about that. And then for example, she might be like, oh, I'm having to give more of
the PRN fentanyl doses. And then we'll talk about that. Like, is the baby in more pain? Why is the
baby in more pain? And it just really helps us all get on the same page. The other huge part of
the equation that we want to know from the nurses is all about the social situation. As everybody
who's watching this knows, we can get very, very different views of the families sometimes. And
this has definitely happened. The families can be like really short and abrupt with us. And then
the nurses tell us that they're at the bedside sobbing and they're having a really, really hard
time with, with the whole situation. Other times parents are sweet and happy and trusting with us.
And then we find out that they're being extremely aggressive with the nurses or just angry and,
and not trusting them at all. That's obviously really important for us to know so that we can
give the help that these families need. Okay. So those were our questions and answers. If you
liked this video, then please press the like button and subscribe to this channel. If you're
interested in neonatal education and of course to Dr. Fort's or the NICU Docs channel as well.
Lots of great, great tutorials on there as well. In the meantime, if you do write to us, then please
comment on where you're from. We love hearing where the viewers are from, but also ask us which
questions you'd like us to ask each other in the future. We're kind of hoping to set this up as a
continuing series. Thank you again so much for being here.
