How to ACE the NICU!!// 10 facts to learn now!// With @TheNurseNook

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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.
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REFERENCES:

Riskin A, Erez A, Foulk TA, Kugelman A, Gover A, Shoris I, Riskin KS, Bamberger PA. The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics. 2015 Sep;136(3):487-95. doi: 10.1542/peds.2015-1385. Epub 2015 Aug 10. PMID: 26260718.

Riskin A, Erez A, Foulk TA, Riskin-Geuz KS, Ziv A, Sela R, Pessach-Gelblum L, Bamberger PA. Rudeness and Medical Team Performance. Pediatrics. 2017 Feb;139(2):e20162305. doi: 10.1542/peds.2016-2305. Epub 2017 Jan 10. PMID: 28073958.
(THIS IS STUDY ON HOW RUDENESS IN FAMILY AFFECTS TEAM PERFORMANCE- wrongly referenced in video)

Mürner-Lavanchy IM, Doyle LW, Schmidt B, Roberts RS, Asztalos EV, Costantini L, Davis PG, Dewey D, D'Ilario J, Grunau RE, Moddemann D, Nelson H, Ohlsson A, Solimano A, Tin W, Anderson PJ; Caffeine for Apnea of Prematurity (CAP) Trial Group. Neurobehavioral Outcomes 11 Years After Neonatal Caffeine Therapy for Apnea of Prematurity. Pediatrics. 2018 May;141(5):e20174047. doi: 10.1542/peds.2017-4047. Epub 2018 Apr 11. PMID: 29643070.

Innate Immunity of Neonates and Infants
Jack C. Yu1*,  Hesam Khodadadi2,  Aneeq Malik2,  Brea Davidson1,  Évila da Silva Lopes Salles2,  Jatinder Bhatia1,  Vanessa L. Hale3 and  Babak Baban2*

OI:10.1177/0973217920080207 Corpus ID: 56906776
Prevention of nosocomial infection in NICU P. Joshi Published 1 June 2008
Medicine Journal of Neonatology

FROM THE AMERICAN ACADEMY OF PEDIATRICS| CLINICAL REPORT| NOVEMBER 01 2021 Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant 
Margaret G. Parker, MD, MPH et al.
SPediatrics (2021) 148 (5): e2021054272.

FROM THE AMERICAN ACADEMY OF PEDIATRICS| POLICY STATEMENT| JUNE 27 2022
Policy Statement: Breastfeeding and the Use of Human Milk 
Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; 
 Lawrence Noble, MD, FAAP, FABM, IBCLC; 
Pediatrics (2022) 150 (1): e2022057988.

Jasani B, Patole S. Standardized feeding regimen for reducing necrotizing enterocolitis in preterm infants: an updated systematic review. J Perinatol. 2017 Jul;37(7):827-833. doi: 10.1038/jp.2017.37. Epub 2017 Mar 30. PMID: 28358382.

Grunberg VA, Geller PA, Hoffman C, Njoroge W, Ahmed A, Patterson CA. Parental mental health screening in the NICU: a psychosocial team initiative. J Perinatol. 2022 Mar;42(3):401-409. doi: 10.1038/s41372-021-01217-0. Epub 2021 Sep 27. PMID: 34580422; PMCID: PMC9145720.

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***TIMESTAMPS***
01:40 BE NICE
05:07 Caffeine is great
07:24 Work Together as a team
10:32 Sepsis
13:25 When is my baby going home?
17:22 Mother's Milk
19:21 Standardized Care
22:57 Lowest point in parents' lives
24:55 Noise levels in the NICU
27:39 Do Less
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License code: HIDRBFRRQEFMODOL

Music by: Bensound
License code: HIDX7AB2C4WXTOGU
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*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.

[milliehummer]

Wonderfully informative! I have been a NICU RN for 43 years & I agree with everything said! Especially about being nice! I have been yelled at too many times by co workers & doctors. It’s NEVER helpful.

[dawnlizmc]

How do I as a grandparent let my concerns about noise be known. I feel almost, if not all, the nurses talk informal voi es over the incubator and when it's open. They talk loudly at times and LOL often just feet away. It seems they are just in the bad habit of not trying to be quiet. Our baby was next to the break room door...in ou in ou in out all day..WITH A LOUD CREAK! all the noise of rolling trash, laundry, instruments, etc...I feel it is hazardous noisy and it hurts my heart to witness it. My son and daughterinlaw are afraid to offend for fear of their child's care...they don't get that the noise is detrimental to his well being. I've left many times in silent tears and prayers. He was born at 24-25 weeks.. has a significant large PDA. He is now 31 weeks gestation with no improvement. He was able to go to the NAVA CPAP. Just seeking a bit of advice for coping here.

[raniasham]

No no I don’t appreciate that comment about older nurses being more rude you should see the younger nurses how they are with their patients 😢

[Chris-dinl]

Omg such a gret vid. I'm only a year in to NICU nursing and people are way too loud in every room so Idk how to tell my senior nurses I think they're too loud. I might suggest that decibel tracker to a manager >.<

[summerrejmankova]

I always love your book recommendations. Thank you so much!

[Harryify]

Hi Dr Tala,
Always enjoy your video. Like you, I believe in team work and I emphasis this to our students and new colleagues- I want to instill a culture of kindness and helpfulness on the unit, If I see a nurse with long finger nails when coming to clinical area, I will tell her outside the patient bay quietly. Our babies can weigh as little as 500 g so we need to be very vigilant. Infection control is vital.
On a different note, can you do a video on how to interpret the monitor ECG waveforms? Obviously the monitor displays numbers of vital signs but how can we utilise the graph information to detact any issues for example, with potential electrolyte inbalance etc, this requires a skill in recognising the waveforms. We use 3 leads probes for babies attached to B850 carescape monitor that displays heart rate, resps; of course there are also BP, Sats leads attached as well. A video on all waveforms, what they mean will be useful. I teach parents not to fix on numbers as there are instances when the leads or probes are not even proply attached to babies. Thank you very much in advance.

[royal_furn]

Dr. What you're teaching is priceless.

I am studying a postgraduate degree in Neonatal Nursing in Ethiopia🇪🇹🇪🇹🇪🇹. Your friendly and professional lectures gave me a real conceptual understanding of complex cases, and helped me know practical tips of NICU.

Thank you so much Dr. Tala and your colleagues.

[medweb]

I work as a travel nurse and am currently in NYC. I agree that conforming to the culture is vital; however, at this particular hospital I’ve had to educate countless residents who seem to write me off because I’m “just a nurse”. I refuse to do things that I know will give rise to potential harm. For example, pushing to bottle feed an infant on a PEEP of 5 or even 6. There is no IVH protocol for the most extremely premature, it’s frightening. I abide by the culture where I can and try to have a positive outlook on educating other staff on the many NICUs I’ve worked within and even learn a few things myself.