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Blog Posts (44)

  • NICU Nurse Continuing Education

    Empowering Neonatal Care: Unleashing the Power of S.T.A.B.L.E. and ENCCO Dive in with me today on the importance of consistent Neonatal Education and my favorite resources for empowering nurses with specialized Neonatal Expertise. HealthStream is a game changer for equipping all healthcare providers with the essential skills and knowledge to make a difference in NICU care and I am SO excited to share with you two of their amazing partner programs- S.T.A.B.L.E. and ENCCO Imagine a world where the tiniest heroes among us receive the highest level of care from a team of dedicated healthcare providers. In the fast-paced realm of neonatal care, every second counts, and the well-being of these fragile infants relies on the synchronized efforts of a skilled and compassionate team. If you are a nurse, nursing student, nursing assistant or tech, respiratory therapist, pre-hospital provider or a physician, then you NEED to know about two groundbreaking programs—S.T.A.B.L.E. and ENCCO—that are revolutionizing neonatal care and empowering nurses with the knowledge and skills to deliver exceptional care to our smallest patients in the nursery and neonatal intensive care unit (NICU). S.T.A.B.L.E.: Building the Foundation for Safe and Stable Infant Care! S.T.A.B.L.E.’s mission is to provide evidence-based education to help reduce infant mortality and morbidity, improve neonatal outcomes and most importantly, improve the quality of life for infants and their families. S.T.A.B.L.E. targets the majority of problems that will be encountered when taking care of both well and sick infants, with a special emphasis on understanding the underlying pathophysiology of various neonatal conditions. Picture this: a neonatal care program that encompasses six essential components of infant stabilization, forming the bedrock of a holistic approach to caring for these tiny warriors. Let's go over the parts of care and the acronym: Sugar Module Infants require optimal glucose regulation and a nurturing environment to thrive. S.T.A.B.L.E. emphasizes the significance of monitoring and maintaining appropriate blood sugar levels to protect the vulnerable immature brain from hypoglycemia. . Temperature Module Preventing hypothermia and maintaining the perfect body temperature is vital for newborns who are unable to regulate it independently. S.T.A.B.L.E. equips healthcare providers by understanding how heat is lost and how vulnerable babies are to cold stress. These foundational concepts promote the infant’s well-being and reduce the risk of complications. Airway Module Superheroes need clear pathways to victory. Proper airway management is vital for stabilizing infants in need. S.T.A.B.L.E. empowers healthcare providers with the knowledge and skills to assess respiratory distress and support breathing, thus, ensuring adequate oxygenation and ventilation for critically ill neonates. Blood Pressure Module Monitoring blood pressure and perfusion are the secret weapons for assessing neonatal circulatory status. S.T.A.B.L.E. emphasizes recognition of shock and how to treat shock, and guides healthcare providers in promptly recognizing and addressing abnormalities, helping our tiny heroes keep fighting. Lab Work Module Laboratory tests hold the keys to unlocking vital information. S.T.A.B.L.E. educates healthcare providers on interpreting laboratory results, enabling informed clinical decisions and appropriate interventions. With this knowledge, providers can make strategic decisions to help support infants in need. Emotional Support Module Every superhero needs emotional support to conquer challenges. S.T.A.B.L.E. explains the crisis that families face when their infant is sick and in need of care in an intensive care unit. Understanding the emotional impact on families helps underscore the need for compassionate care. Healthcare providers learn how to provide emotional support and guide parents through the challenges of having an infant in the NICU. ENCCO: Guiding Nurses to Neonatal Mastery Imagine a program designed to empower nurses with specialized knowledge and skills in the NICU, providing them with the tools they need to bridge the knowledge gap and provide top notch care in various Neonatal settings- hello, ENCCO! Benefiting from ENCCO: Empowering Nurses in Various Neonatal Settings Nursing is a dynamic profession that demands continuous learning and adaptation. ENCCO recognizes the gap between academic training and the care of critically ill neonates. It collaborates with clinical content specialists and Pediatric Learning Solutions to bridge this gap effectively, empowering nurses with the knowledge they need to succeed. ENCCO offers a tailored orientation program for nurses in the NICU, focusing on refining assessment, planning, and evidence-based implementation strategies. Nurses gain a profound understanding of the complexities associated with neonatal patients, enabling them to deliver optimal care and improve patient outcomes. Bridging the Knowledge Gap in Neonatal Care with ENCCO ENCCO's mission is to enable nurses to evaluate assessment data and develop effective care plans for neonates. Through evidence-based strategies, nurses learn to identify and address the unique needs of critically ill infants. This knowledge integration empowers them to anticipate potential complications and provide timely interventions, resulting in improved patient outcomes. ENCCO places significant emphasis on developing a comprehensive understanding of common conditions experienced by neonatal patients. Nurses acquire in-depth knowledge about prematurity, respiratory distress syndrome, congenital anomalies, and other prevalent issues. Armed with this expertise, nurses can promptly recognize signs of distress and provide the best possible care for newborns. We love this for us! In the fast-paced environment of the NICU, evaluating the effectiveness of care interventions is crucial. ENCCO equips nurses with the skills to assess the impact of their care plans on critically ill neonates. By continuously monitoring and adapting their approach, nurses refine their strategies and improve patient outcomes, emerging as true superheroes of neonatal care. Join the Journey Towards Neonatal Excellence With Healthstream! I hope you feel invigorated and inspired after reading this blog about the impact of S.T.A.B.L.E. and ENCCO in the world of neonatal care. These programs have provided standardized frameworks and comprehensive training to healthcare providers, empowering them to deliver safe, consistent, and exceptional care for vulnerable infants. I can’t recommend them enough for continued education! Working in the NICU we have an amazing opportunity to nurture a generation of tiny heroes who will thrive and flourish against all odds. Explore the power of S.T.A.B.L.E. and ENCCO programs, share this post with others passionate about neonatal care, and together, let's unleash the full potential of neonatal care and create a brighter future of care for our tiniest patients and their families. Will you join me in this mission to make a lasting impact on the lives of our smallest and most courageous warriors? By prioritizing continued education regarding Neonatal Care, we can be the start of change and advancement that our healthcare system desperately needs! More About HealthStream HealthStream understands the challenges that come with navigating an ever-evolving and intricate healthcare landscape. They are your trusted partner in maximizing resources and elevating the quality of care provided by your organization. With HealthStream, your organization gains access to the most innovative and proven applications, content and solutions available in the healthcare industry. They understand the importance of empowering staff to excel in their roles and have meticulously crafted solutions that facilitate operational improvement and efficiency. They shape a brighter future for healthcare, where resources are optimized, staff members are empowered, and the highest quality of care is delivered. Join HealthStream, where they are united with clinicians with passion to make a difference. HealthStream, Inc. (NASDAQ: HSTM) provides workforce and provider solutions for healthcare organizations in the United States. Find out about these programs and more on! To learn more about how ENCCO and S.T.A.B.L.E. can benefit your organization, please visit HealthStream's Child and Maternal page: To purchase S.T.A.B.L.E. for yourself at a 15% off discount, visit HealthStream's NurseGrid Learn page. *Secure your 15% off S.T.A.B.L.E. discount on NurseGrid Learn with this code: TORI15 Tori Meskin MSN RNC-NIC (@nurse.tori_) is a Registered Nurse specializing in NICU care. She has worked bedside since 2013, specializing in neonatal and pediatric critical care. Tori graduated from The University of Arizona (#beardown) with a dual major in Nursing and Psychology. As a bedside nurse, she has worked for Children’s Hospitals and University Hospitals in Level IV NICU, Trauma I centers, and consulting centers. She is trained to work in specialized areas; Small Baby Unit, Body Cooling Team, & surgical NICU (Cardiothoracic, Gastrointestinal, Neurosurgical, & congenital anomalies etc.) Tori has grown and developed her platforms through Instagram, TikTok, and blog where she has developed a community full of support, education, and provides a shiftworker big sister personal sharing her nurse shift lifestyle, nicu nurse journey, nurse tips, and little life hacks. @nurse.tori_

  • Baby Basics Blog

    Whether you are a new mama, future mama, or baby caretaker, this is an up-to-date baby basics blog to help guide you with the best newborn practices! These are a few basic hospital practices mixed with professional practice TIPS to help you in your newborn journey. 3 GOALS To Prepare Before Discharge Home: Research and choose a Pediatrician! Depending on your birth hospital/setting, they may have a list of Pediatricians in network. Create an emergency contacts list including a Pediatrician, Police/Fire Departments, you and your partners’ (if applicable) work/cell phone numbers, and the poison control center. Talk to your discharge planner (MD, Nurse or Midwife) for follow-up appointments. HOT TIP: It is never too early to start getting organized! You will most likely be exhausted and overwhelmed. Start creating a list and calendar to help stay on top of important things such as feeding and medication schedules, well-baby checks, immunizations, etc. You can create a note on your phone with important phone numbers, dates, doctors etc. SAFETY While you can’t anticipate every situation that could arise regarding your infants’ safety, there are some tips you should know and share with others who will be care taking for your baby. A FEW SAFETY BASICS ♡ Properly support your baby’s head and neck ♡ Do not heat breast milk directly on the stove or in the microwave Instead: Place the bottle or sealed container of milk into a bowl of warm water or hold it under warm, but not hot, running water for a few minutes. Test the milk's temperature before feeding it to your baby by putting a few drops on your wrist. ♡ Explain your baby’s needs to older siblings ♡ Lock away all medicine cabinets and household cleaners ♡ Practice crib safety by not using drop-down cribs or putting stuffed animals or pillows in the crib ♡ Practice toy safety (balloons are the leading cause of toy-related deaths) ♡ Maintain a smoke-free environment for baby and install smoke detectors BABY ESSENTIALS FOR FIRST 3 MONTHS Car seat Onesies, or other soft outfits Baby sleepers or sleep sacks Baby socks Newborn hats, depending on climate Disposable diapers or cloth diapers (and detergent for washing) Disposable wipes or 12 cloth wipes Diaper rash cream Waterproof pad for diaper changes Diaper pail or receptacle Baby washcloths Hooded towels Baby sponge Baby bath wash Baby lotion Baby bath tub Baby nail clippers Digital thermometer Medicine dropper Bulb syringe/nasal aspirator Crib, cradle, or bassinet Fitted sheets and mattress cover for crib, cradle, or bassinet Burp cloths Bottles, if you're bottle-feeding and bottle brush A variety of bottle nipples, in different sizes Breastfeeding pillow, nursing pads, and nipple cream Breast pump Newborn Essentials on Amazon SAFE SLEEP "DO'S AND DON'TS" Setting up a safe sleep area for your baby can be done before baby is home. It is recommended that the baby’s sleep area is in the same room, next to where parents sleep for observation. The sleep surface should be firm and flat, such as a mattress in a safety-approved crib, covered by a fitted sheet. For the safest environment, babies should never sleep in an adult bed, on a couch, or in a chair alone, with you or anyone else. When putting your baby to bed, remember to keep soft objects, toys, and loose bedding out of the sleep area and that nothing is covering the baby’s head. Do not use a loose blanket, (to avoid occluding baby's airway and be sure not to over-bundle. A wearable blanket (sleep sack) is great for sleepwear and swaddling is recommended for safe sleep. ALWAYS PLACE BABY ON THEIR BACK TO SLEEP FOR NAPS AND NIGHT SAFE SLEEPS DO'S TO REDUCE SIDS RISK ♡ Always place baby on their BACK to sleep. ♡ Use a firm and flat sleep surface. ♡ Share your room with baby but on a separate surface designed for infants, ideally for baby’s first year but at least for the first 6 months. ♡ Breastfeed your baby if possible for the many health benefits and to reduce the risk of SIDS. ♡ Give your baby a pacifier for naps and nighttime sleep. ♡ Give your baby plenty of tummy time when they are awake and someone is watching. SAFE SLEEP DONT'S TO REDUCE SIDS RISK ♡ Do not smoke during pregnancy or allow smoking around your baby or in their environment. ♡ Do not put soft objects, toys, crib bumpers or loose bedding under baby, over baby, or anywhere in baby’s sleep area. ♡ Avoid products that go against safe sleep recommendations and exercise special caution on products that claim to prevent or reduce the risk for SIDS. ♡Do not use heart or breathing monitors in the home as a way to reduce the risk of SIDS. ♡ Do not let your baby get too hot during sleep. HOW TO PERFORM CPR ON A BABY It is always good to feel prepared in case of an emergency. Here is a great video to help you understand and practice CPR in case you may need it for your baby. This is also a skill to share with other caretakers of your baby (grandparents, family members, sitter etc.) SWADDLING Swaddling is a traditional practice of wrapping a baby up gently in a light, breathable blanket to help them feel calm and sleepy. A swaddle helps your baby feel safe and secure as she adjusts to life outside the womb. Swaddling helps prevent her from flailing her arms and legs, which can trigger her startle reflex and potentially cause her to wake up. A swaddle keeps your baby cozy and warm until her internal thermostat kicks into gear. The idea is that being swaddled will help your little one feel snug and secure, just like in your womb. It’s true that swaddling isn’t entirely risk-free. But the American Academy of Pediatrics (AAP) says that swaddling can encourage your newborn to snooze better — as long as it’s done correctly and practiced in accordance with other safe sleep guidelines. To encourage healthy hip development, the bottom of the swaddle should be loose enough for your baby’s legs to stay bent up and out, like they naturally would in a newborn lying on her back without a swaddle. You'll also want to ensure the swaddle allows your baby to straighten and stretch her legs at will. Wrapping your baby the right way will encourage your little one to sleep more soundly while giving you peace of mind (so you can get some sleep yourself!). Some important swaddling safety tips to keep in mind: Swaddle snugly, but not too snugly. At the top of the swaddle, you should be able to fit two to three fingers between the blanket and your baby’s chest. The bottom of the swaddle should be loose enough so your baby’s legs stay bent and flared out. Always put your baby to sleep on her back. It’s the safest position, whether you’re swaddling or not. Be sure to tuck the bottom of the blanket underneath your baby too. Keep your baby normothermic. Swaddling could cause overheating, which can raise the risk of sudden infant death syndrome (SIDS). Keep the room at a comfortable temperature (between 68 and 72 degrees Fahrenheit year-round). And resist the urge to bundle your baby in extra layers — a pair of pajamas and the swaddle blanket are likely enough to keep her comfy. Sweating, damp hair, flushed cheeks, heat rash and rapid breathing are all possible signs that your baby might be too hot. As a general rule of thumb, dress your baby in one more layer than you would wear. Swaddle for nighttime sleep and naps. Swaddling can help your baby sleep more soundly during the day and at night. If tucking her into a little burrito blanket for hours overnight makes you nervous, know that as long as you stick with safe swaddling and sleep guidelines, swaddling at bedtime isn’t any riskier than swaddling during naps. You’ll also have plenty of built-in opportunities to check on her, since she’s frequently waking to eat. But if checking her swaddle while she sleeps gives you extra peace of mind, feel free to peek more often. Here's a step-by-step guide below for how to swaddle a newborn like a pro, the keys for sticking with safe swaddling techniques. Day to Day Feedings Cues your baby is ready to feed: Rooting (baby turns his/her head when the side of the cheek or face is stroked) Baby demonstrates a good, strong suck on the pacifier Baby is calm and stable during care time Baby is awake or wakes up during care time Baby demonstrates appropriate strength in their body (tone) alone or with swaddling and support, and can remain awake for several minutes at a time. BREASTFEEDING (FIRST FEW WEEKS) Nurse until baby self-detaches (some babies will need to be time-limited due to diagnosis and overexertion). Nurse from one breast to ensure that your baby gets enough of the hind milk. If your baby is still hungry, offer the second breast but be sure to burp the baby when they switch breasts. The breast should feel softer following a feed. You may need to pump after breastfeeding until at least your baby’s due date (NICU) Breastfed babies will have at least 8-12 feeds in 24 hours (every 2-3 hours). TIPS FOR TRANSITIONING FROM BOTTLE TO BREAST The key to a successful transition is to give it time, patience and persistence! In fact, it takes some women several weeks to transition from bottle to breast. I can’t recommend a lactation consultant enough if you are transitioning from bottle feeding to exclusively breastfeeding. They are a great resource, as each situation is unique! BOTTLE Bottle-fed infants will feed every 3-4 hours (which is 6-8 feeds in 24 hours). Like breastfed infants, bottle-fed infants should sleep well between feeds and have 6-8 wet diapers daily. Burp your baby both during and after feeding (or every 1-2 ounces.) The air can cause gas and make the baby uncomfortable. If doing a combination of bottle and breast, breastfeed first, offer a bottle after breastfeeding and pump for 10 minutes (triple feeding protocol). If you are exclusively pumping, pump for 20 minutes both sides 8x in 24 hours. HOT TIP: use your phone. Place a timer on every 3 hours to help keep you on track TIPS FOR PROPER BREAST MILK STORAGE Before expressing or handling breast milk: Wash your hands well with soap and water. If soap and water are unavailable, use an alcohol-based hand sanitizer containing at least 60% alcohol. Mothers can express breast milk by hand or with a manual or electric pump. If using a pump, inspect the pump kit and tubing to ensure it is clean. Discard and replace moldy tubing immediately. If using a shared pump, clean pump dials, power switch, and countertop with a disinfectant wipe. (NICU) BREAST MILK STORAGE TIPS Clearly label the breast milk with the date it was expressed. Do not store breast milk in the door of the refrigerator or freezer. This will help protect the breast milk from temperature changes from the door opening and closing. If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk. When freezing breast milk: Store small amounts to avoid wasting milk that might not be finished. Store in 2 to 4 ounces or the amount offered at one feeding. If you deliver breast milk to a child care provider, clearly label the container with the child’s name. Talk to your child care provider about any other requirements for labeling and storing breast milk. Breast milk can be stored in an insulated cooler with frozen ice packs for up to 24 hours when you are traveling. At your destination, use the milk right away, store it in the refrigerator, or freeze it. Safe Thawing of Breast Milk Always thaw the oldest breast milk first. Remember first in, first out. Over time, the quality of breast milk can decrease. There are several ways to thaw your breast milk: In the refrigerator overnight. Set in a container of warm or lukewarm water. Under lukewarm running water. Never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in breast milk and create hot spots, which can burn a baby’s mouth. If you thaw breast milk in the refrigerator, use it within 24 hours. Start counting the 24 hours when the breast milk is completely thawed, not from the time when you took it out of the freezer. Once breast milk is brought to room temperature or warmed, use it within 2 hours. Never refreeze breast milk after it has thawed. Swirl the breast milk to mix the fat, which may have separated. If your baby did not finish the bottle, use the leftover milk within 2 hours after the baby is finished feeding. After 2 hours, leftover breast milk should be discarded. TRANSITION TIPS FROM A LACTATION TEAM Massage your breasts or hand express to start milk flow before putting the infant to breast. Pay close attention to the position, especially supporting the baby’s head to your breast. Place your baby’s belly to your belly while holding them close for a great deep latch. Ensure your baby has an effective latch by listening for swallowing. Allow baby to self-detach. For example, if baby pulls away from breast after 10-15 minutes of sucking and appears to be content and satisfied. Log the baby’s output during this transition and get frequent weight checks by either your pediatrician or lactation consultant. After baby self-detaches, your baby may be given pumped breast milk if they show hunger cues. Pump after breastfeeding as you may not completely empty. You may need to do this the first few weeks or until the baby’s due date. As your baby matures and becomes more efficient, you will be able to increase the length of time at the breast and the number of feedings in 24 hours. SHOP NEWBORN ESSENTIALS ON AMAZON BURPING While feeding, if your baby doesn’t burp after several minutes, continue feeding, and don’t worry. When the feeding is finished, attempt again and keep the baby upright for 10-15 minutes to prevent spit up. Make sure you don’t bounce baby after feeding. If the baby cries a lot before the feeding, it may be beneficial to burp the baby before the feed or early in the feeding. DIAPERING Let’s talk about diapering your baby, diaper rash and elimination patterns. Start the habit early of checking your baby’s diaper with every feeding. When changing, clean genitals with a washcloth and warm water or fragrance-free baby wipes. For girls, remember to wipe baby from front to back (or TOP to BOTTOM) and for boys to start at the tip of the penis and then wipe the rectal area last. If the baby is uncircumcised, do not attempt to pull back from the foreskin of the penis. After cleaning, lift the scrotum and clean underneath. Keep the skin clean and dry with frequent changes to avoid diaper rash. If a rash does occur, wash with mild soap only after a bowel movement while avoiding wipes with alcohol or fragrances. Expose the bottom to air. (Oxygen can help heal the skin). WHAT ARE TYPICAL ELIMINATION PATTERNS WITH A NEWBORN? Your baby should have 6-8 wet diapers daily, many stool with diapers but some once a day (or every few days). The color and consistency may vary from bright yellow (breast milk-fed infants) to light greenish-brown (formula-fed infants). Monitor the diaper for blood, pus, or diarrhea. Call your pediatrician if your baby has fewer than 6 wet diapers a day or has two dry diapers in a row, has diarrhea, or is constipated for 48 hours. BATHING TIPS Once the umbilical cord or circumcision site heals, you can give your baby a tub bath. Bathe baby 2-3 times a week. Avoid lotions and powders. Bath before a feed or at least one hour after bedtime. Gather all of the supplies you will need before beginning the bath. Never leave a baby alone in a bath, not even for a minute. Babies can drown quickly in a few inches of water. Make sure the room is warm as babies get cold easily. Fill the tub BEFORE you put the baby in it. Water should feel warm, not hot on the inside of your wrist. Ensure your water heater is set no higher than 120F (if you can control the temperature). Never put a Qtip in your baby’s ear. For preemies, bath time can be stressful. Swaddle and wash one area gently at a time. BATHING: WHAT YOU NEED 3-5 baby washcloths 1-2 towels (hooded if you have one) 1 baby sponge 1 bottle of baby bath wash 1 bottle of baby lotion A baby bathtub TEMPERATURE-TAKING AND SUCTIONING I encourage you to ask your bedside RN how to take your baby’s temperature and how to use a bulb syringe! They are there to support YOU and answer any care questions you may have. HOW DO I USE A THERMOMETER? Take temperature when the skin feels warmer or cooler than normal, when your baby is not acting like their usual self and before calling your doctor. (They will want to know the baby's current temperature) Place the tip in your baby’s armpit. Hold the arm in the position for 5 minutes or as long as the thermometer instructions say. For newborns, do not use the pacifier, forehead, or ear thermometers per AAP. HOT TIP! Bring your thermometer into the hospital to practice with the nurse. Practice with it at the bedside to get a feel for the device and how to properly use it. Normal temperature range for baby should be 97.6 - 99.6 TIP: Dress your baby according to how you feel! Use a bulb syringe to suction your baby’s mouth and nose when necessary (stuffy nose, baby vomits, spit up, etc). Sneezing is normal for a baby, but coughing is not. If your baby vomits, remember to suction the mouth then the nose. To prevent gagging place the tip of the bulb into the side of cheek to suction. Clean the bulb syringe after using warm water and mild detergents. BEDDING AND SLEEP NEEDS Whatever bed you choose for your newborn (crib, cradle, bassinet, co-sleeper), it is recommended by the American Academy of Pediatrics that your baby sleeps in the same room with you for the first 6-12 months of life. In addition, bumpers, blankets, pillows, and soft toys are no longer recommended in baby beds. Think minimalistic. BEDDING: WHAT YOU NEED Crib, cradle, bassinet, co-sleeper, or other safe sleep space for baby. If the crib has been used before, make sure it has all of its pieces and meets current safety standards Crib mattress, or a mattress that fits properly in the cradle or bassinet Fitted sheets for crib, cradle, bassinet, or co-sleeper Waterproof crib mattress cover, unless your crib mattress is already fully sealed, or a waterproof pad to lay under the crib sheet Baby monitor DEVELOPMENTAL CONSIDERATIONS There are three common terms when it comes to developmental age (especially for Preemies!) Gestational age is the fetus’ age (calculated as the first day of mom’s last period) Chronological age is counted from the day of birth (baby’s birthday) Corrected age is defined as the chronological age minus the number of weeks or months baby is born early. TO POSITION YOUR INFANT FOR OPTIMAL DEVELOPMENT: KEEP THESE IN MIND ♡ Hold baby with legs bent and arms forward ♡ Avoid leaving baby flat on back for long periods ♡ Wrap baby snugly with legs bent and hands placed close to face ♡ When awake, lay baby on their side rather than on their back with a large blanket roll for body support (only when supervised!) Your baby should start rolling anywhere between 2-6mos old corrected gestational age and sitting up without support between 5-7mos old (corrected age). Make time for tummy time! Tummy time should be when the baby is awake only, and should last 10-20 minutes once or twice a day. Start slowly and work your way up if baby dislikes it at first! You can use a rolled towel or blanket under the shoulders and upper chest to provide support. When should you schedule a time to talk to your doctor about your baby’s development? If your baby does not use one of their arms, legs or one side of body, their legs feel stiff when not actively stretching, they don't roll over or bear weight on legs, or if they don’t sit while supported or reach for objects-make an appointment with your pediatrician. WHEN TO SCHEDULE A DOCTOR'S VISIT Vomits repeatedly or forcefully two feedings in a row. Refuses to eat more than two feedings in a row. Has less than 4 wet diapers-24 hours in spite of frequent feedings. Goes 48 hours without a bowel movement. Has diarrhea or more than 12 large stools/day or has blood in stool. If abdomen is distended and does not go down. If difficulty breathing or makes unusual sounds when breathing. If baby is lethargic and doesn’t arouse with touching or handling. Excessive swelling or drainage around eyes. Blisters or pustules on body. Thrush or patches of white in mouth. Congested cough, running eyes or nose. Drastic behavior changes include extreme irritability, excessive crying without a known cause, extreme sleepiness, or floppy arms and legs. CALL MD: Temperature under 97.6 or over 99.6 and doesn’t change with adding or removing clothes or blankets. EMERGENTLY CALL FOR HELP CALL 911 if blue lips and tongue If you are uncertain or feel urgent care is necessary I hope these Baby Basics help you as you transition to caring for your baby at home! Share these tips with a caregiver who wants to see babies THRIVE through best practices :) REFERENCES: American Academy of Pediatrics (AAP) Centers for Disease Control and Prevention. (2021). Sudden unexpected infant death and sudden infant death syndrome: Data and statistics. Retrieved June 1, 2021, from Shapiro-Mendoza, C. K., Camperlengo, L., Ludvigsen, R., Cottengim, C., Anderson, R. N., Andrew, T., et al. (2014). Classification system for the Sudden Unexpected Infant Death Case Registry and its application. Pediatrics, 134(1), e210–e219. Retrieved May 3, 2021, from,stove%20or%20in%20the%20microwave. Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, and Sponsored Capella University MSN student. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at or

  • NICU Research Ideas & Topics to Consider

    NICU practice and Evidence-Based Research is constantly changing. Many of the practices I have seen over the past 9+ years have changed with updates, new technology, procedures, and treatments, with a movement to push our patient population forward with improved outcomes! Here are a few topics to consider when searching for a research project, paper, or developing an abstract for your project! Many of these are controversial with a lot of different research supporting various outcomes. NICU Research Project Ideas DOUBLE JEOPARDY. WHAT DO WE KNOW AND WHAT CAN WE DO? Common comorbidities of prematurity. Intraventricular hemorrhage Bronchopulmonary Dysplasia Necrotizing Enertocolities Retinopathy of Prematurity Sepsis Congenital heart Disease (CHD) NEC! WHAT FACTORS INCREASE THE RISK OF NEC? Standardization of assessments and treatments, Pneumoatosis, Is Clonic Pneumotosis real?, Treatment and feeding decisions, Guidelines, Antibiotics, Parenteral Nutrition, Vascular Access, Imaging Modalities, Hemodynamics, disease entity, restriction of systemic blood flow, generalized cyanotic state, Congenital Heart Disease (CHD). SMALL BABY STANDARDIZATION OF CARE The formation and focus on standardizing ELBW and VLBW care. Guidelines, standardization, and streamlined care. Feedings, humidity, positioning, weights, lab draws central line management, RDS management, guidelines for incubations/extubations, weaning from isolette to crib, developmental considerations by gestational age. PROBIOTICS! The use of probiotics in practice (to use or not to use them). Gut flora. The pros and cons. Latest research in preventing NEC. Is this a preventative measure? Which probiotic products to consider? Lactobacillus, dual strains, and possible side effects or contraindications. PDA TREATMENT Treatment of PDA. When to treat it and what modalities to treat it with…Indomethacin, PICCOLO PDA closure device, PEEP, etc). Risk vs Benefit. Clinical signs and symptoms. SKIN TO SKIN Skin to skin (myth-busting nicu dynamics when parents can’t hold). Developmental considerations. How to support families during the initial times with inability to hold baby. PAIN MANAGEMENT IN THE NEONATE Anesthesia / Sedation! What is too much? What is not enough? Neurodevelopment perspectives with Gestational age & disease process. Nociceptive stimuli. Neuroapoptosis. Pain consequences with unrelieved pain, sleep, fatigue, and inflammatory response. Pre and Post-op considerations. The first line of pain relief modalities. Benzodiazepines, Opiates, Alpha 2 Agonists (Dexmedetomidine, Clonadine), Sweeties, Positioning etc. BLOOD PRESSURE GOALS & STANDARDIZATION Lack of standardization within the NICU patient population. What is too low? What is too high? Treating symptoms. What line of hemodynamic modalities to turn to? (Epi / Vasopressin / Dopamine) VENTILATOR STRATEGIES Specific considerations for Gestational age, disease-specific treatments. Optimal PEEP, Low peak inflation/TV. Use of surfactant. Surfactant deficiencies (RDS), Corticosteroids, Alkalosis etc. SATURATION TARGET GOALS Optimizing neurodevelopment, Target pre ductal SpO2. Oxygen should be used like any other drug; with potential benefits and side effects. Positioning considerations. PALLIATIVE CARE Multidisciplinary approach. Women facing pregnancies with a diagnosis of complex congenital or life-threatening conditions. Limitations in choices. Support during pregnancy, delivery, post-partum, and beyond. PRETERM INFANTS WITH CHD Congenital Heart Disease issues. Cyanosis (TOF & TGA), pulmonary venous obstruction, (TAPVD, MS), Preoperative care, Preoperative pulmonary vasculature/reactivity (Trisomy 21, post RSV, transitional circulation). Neurodevelopment risk associated with prematurity. Restricted oxygen and insufficient nutrient delivery in utero. BREAST MILK PRODUCTION & BREASTFEEDING INITIATIVES The push for breast is best (doesn’t always work in the NICU). Breast milk production, the latest Evidence-Based Research to support mothers. Hope this list helps you in your NICU Research! These are all very relevant in our NICU care with continued improvements in Evidence-Based Research! The more minds and research we can put to these topics the better. Feel free to drop your suggestions and comments below! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012 and works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey in married life & juggles work, school, and content creation, & brings you top notch Tips & Tricks along the way. Find her at or

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  • Nurse Tori | Nurse Blog | NICU Nurse

    Hey There! I'm Tori Meskin BSN RNC-NIC ​ Nurse. Blogger. Podcaster. ​ Welcome To Tips From Tori. My zesty blog With an informative & trendy side of the medical field. scroll ABOUT ​ ♡♡♡♡♡♡♡♡♡ ​ I am a wife, nurse, self-taught blogger, podcaster, self-care enthusiast, jalapeño margarita mixologist, small-town farmer's daughter, nacho connoisseur, and hold a fierce "put your blinders on" mantra. ​ Welcome to all things nurse life, beauty, lifestyle, fashion, & (yes) fun. Let's get real, there are few places to find support & modern-day insight into the #Real Nurse world. Most current blogs are not nearly the Nurse I feel I am today. So let's spice it up! ​ ​ STALK TORI Here, I am bringing you a bit of my personal & professional life with a bit of zest on the side. You can find my BEST nurse resources, behind-the-scenes snapshots, NICU premium content, lifestyle & beauty hacks, & everything in between. XO Tori Nurse Tori ALL BLOGS Baby Basics Blog Whether you are a new mama, future mama, or baby caretaker, this is an up-to-date baby basics blog to help guide you with the best... 132 Nurse Tori ALL BLOGS NICU Research Ideas & Topics to Consider NICU practice and Evidence-Based Research is constantly changing. Many of the practices I have seen over the past 9+ years have changed with 2,835 Nurse Tori ALL BLOGS Best NICU Nurse Apps!! Modern-day NICU nursing...let's go! I took to Instagram to source the best bedside NICU apps nurses are using. Below I have listed a few of 509 Nurse Tori TORI'S TIPS Stalk my Amazon Storefront My Amazon storefront just got a makeover. It is organized and updated with all of my latest faves! From my all time favorite scrub sets,... 471 Nurse Tori TORI'S TIPS NICU HOLY GRAIL OF PODCAST EPISODES Listen to this holy-grail list of episodes from all aspects of the NICU! These Cellfie Show episodes will give you insight into your most... 892 1/8 Nurse Tori x Elliot Young Elliot Young Fine Jewelry is created on the premise of making an impact while doing what they love! Fine jewelry with a cause! I have teamed up with EY a company founded by two women on a mission to make an impact! ​ Together, we created this small collection of timeless,14K Gold pieces that can be worn in any setting. ​ The Hamsa and an Evil Eye, are protective signs and believed to bring its owner happiness, luck, health, peace, and good fortune. And the Beaded Necklace brings strength, wisdom, power, and energy. The Threaders and Hoops are great everyday lightweight earrings that combine style with wearability. They are fine Jewelry pieces and will maintain their shine through shifts, showers, and daily wear. ​ When you use my IMPACT CODE on these two necklaces and two pairs of earrings at checkout: NURSETORI25 you will get 25% off AND Elliot Young will donate 5% to one of my favorite orgs: Brave Beginnings ​ A foundation which helps support NICUs provide essential equipment to hospitals in need. I hope you wear these with good fortune. Sending you heath and happiness! XO Tori SHOP THE COLLECTION PREMIUM NURSE CONTENT EXCLUSIVE ACCESS to CAREER TOOLS & RESOURCES. THE COMPLETE NURSE INTERVIEW GUIDE. NICU NURSE INSIGHTS & MORE. complete with all of my HOT tips & tricks to land your dream job. TAKE ME THERE To play, press and hold the enter key. To stop, release the enter key. The Cellfie Show weekly dose of sweet and salty Two nurses talking "Off the clock," about healthcare, self care, & the down & dirty in between. Over 800,000+ Downloads. 100 + shows. 500+ 5 star Reviews Together Tori Meskin & Sam Manassero are bringing you the unfiltered side of the medical world. THE CELLFIE SHOW MAXIMIZE YOUR NURSING PROFESSION REAL NURSES. REAL PRODUCTS. REAL PATIENT CARE. Career Rescources 12 HOUR CHEAT SHEET Resources Change of Shift Report Handoff Examples Safety Checks Final Hour Considerations SHOP NOW INTERVIEW TIPS & TRICKS Ebook This 28 page eBook is a digital download that provides you with NURSE PRO TIPS to help you land that dream job! SHOP NOW BRAIN SHEETS Printable Report Sheets ICU. Med-Surg. NICU. PICU. CVICU. SBAR. Nurse Brain Sheets Nursing tested & approved. SHOP NOW EXCLUSIVE NICU FORUM SIGN IN NOW! get the tips I accept terms & conditions ♡♡♡ LET'S DO THIS! ♡♡♡ Tips & Tricks on the Way!

  • Nurse Blog I Nurse Tori I NICU Nurse I Nurse Practitioner

    My Professional Life as A Nurse ♡♡♡♡♡♡♡♡♡♡ Welcome to the most special corner of my website. For over 9+ years now I have been working bedside in the secret gem of a unit called the "Neonatal Intensive Care Unit." (NICU). After 4 years of collecting memories, experiences, & developing my career, finally mustered up the courage to start this blog. ​ ​ ​ scroll NICU Nurse Journey I graduated from the University of Arizona (#beardown) with my Bachelor of Science in Nursing in 2012. I moved home to Los Angeles, CA where I took my NCLEX & obtained my first job as a NICU Nurse Resident. ​ After completing a 22-week nurse residency program I began working bedside as a Clinical Nurse I, turned to Clinical Nurse II, and then Clinical Nurse III. I took on positions within my unit and became a member of several committees, championed many bedside educational opportunities, and trained as a core staff for the "Small Baby Unit," specialized in Surgical NICU, and obtained my national certification RNC-NIC. ​ I have worked as a staff nurse, travel nurse, nights/days, and Per Deim. In addition, I have worked Pediatric Critical Care Float Pool (CVICU, PICU, Oncology etc) and currently seeking my MSN in leadership to become a true leader in this space. ​ I am thrilled to be starting this new journey and to share my experiences along the way. I hope you find this fun, informative, and inspiring! ​ ​ scroll How do I Become A NICU Nurse? This is by far my most asked question. And a very loaded question at that! There are so many ways to become a NICU nurse and I have so many TIPS to offer you. ​ Topics including: How to become a NICU Nurse Interview & Portfolio Tips & Tricks Resources/Websites for hopeful & current NICU Nurses What is it REALLY like to be a NICU nurse? ​ I have created YOU Exclusive NICU Nurse Content & Resources. All of my best modern-day nurse insight & experiences, a collection of Level IV NICU education, curated blogs, with100+ hours of diligent research, podcast interviews, and more. scroll Nurse BloG Your Exclusive Nurse Tori Content I am stoked to bring you this content! These are my PREMIUM posts curated to help you in your Nurse journey! I have compiled all of my BEST content here for you!! TAKE ME THERE Nurse Report Sheets New Nurse Resources Nurse Report Sheets Mommy Labor Nurse EP132: NICU Tips from NICU Nurse Tori Click here to tune in! Listen Here Happy Birthway Podcast Peak into the NICU Click here to tune in! Listen Here Juna Women Podcast Life in the NICU Click here to tune in! Listen Here The WoMed Podcast Navigating the NICU Click here to tune in! Listen Here Baby Basics Blog 58 2 likes. Post not marked as liked 2 NICU Research Ideas & Topics to Consider 1,584 4 likes. Post not marked as liked 4 Best NICU Nurse Apps!! 293 3 likes. Post not marked as liked 3 NICU HOLY GRAIL OF PODCAST EPISODES 705 4 likes. Post not marked as liked 4 11 Things I Wish I Knew Before Becoming A NICU Nurse 1,459 10 likes. Post not marked as liked 10 11 Night Shift Nurse Survival Tips 2,446 12 likes. Post not marked as liked 12 Hot Tips for Nurses Starting in the NICU! 5,986 10 likes. Post not marked as liked 10 Nurse Portfolio 101 1,130 7 likes. Post not marked as liked 7 Top Female Medical Bloggers & Innovators 941 8 likes. Post not marked as liked 8 51 NURSE JOBS TO CONSIDER! 2,243 11 likes. Post not marked as liked 11 20 Things to Know About Nursing in 2021 527 12 likes. Post not marked as liked 12 6 Things Every Nurse Needs 545 7 likes. Post not marked as liked 7 14 Hot Tips to Become a NICU Nurse 10,059 18 likes. Post not marked as liked 18 NICU Nurse Resources! 8,246 19 likes. Post not marked as liked 19 12 NURSE INTERVIEW TIPS & TRICKS! 5,762 17 likes. Post not marked as liked 17 14 NICU Preemie Gifts & Tips 3,496 16 likes. Post not marked as liked 16 9 Tips For Getting Into Nursing School! 700 15 likes. Post not marked as liked 15 55 New Grad Nurse Tips! 3,301 13 likes. Post not marked as liked 13 1 2 Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012 and works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student , & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey in married life & juggles work, school, and content creation, & brings you top notch Tips & Tricks along the way. Find her at or ​​

  • About Nurse Tori

    Tori Servin Meskin BSN RNC-NIC Nurse | Blogger | Podcaster ​ ♡♡♡♡♡♡♡♡♡ I am a Registered Nurse with over 8 years of nursing experience specializing in neonatal and pediatric critical care. I have served as a specialty NICU & Pediatric Critical Care trained nurse serving patients in the Los Angles and Orange County areas providing direct patient care, leadership, consultation, education and patient care management expertise for the complex neonatal & pediatric patient populations. I have worked for Children’s Hospitals and University Hospitals in Level IV NICU, Trauma I centers, and consulting centers. As a new nurse, I completed a 20-week RN Versant Residency Program. I am trained to work in specialized areas; Small Baby Unit, Body Cooling Team, & Surgical NICU (Cardiothoracic, Gastrointestinal, Neurosurgical, & Congenital anomalies etc.) I graduated from The University of Arizona (beardown) with a dual major in Nursing and Psychology. Currently, I am obtaining a Master’s Degree in Nursing Leadership sharpening my leadership skills, enhancing my research expertise, driving evidence-based research forward, and becoming a true leader in this space. ​ Writing this blog, podcasting, running Tips from Tori LLC, and branching into new territories has been such a joy to me and I am so thankful to my amazing "Tipster" community here with me. ​ Here, I share with you, my pearls of wisdom, nurse life, latest tips & tricks, resources, style, etc. From my personal #realtalk posts to beauty, lifestyle, and nurse tips, I hope "Tips From Tori," inspires you, provides useful information, & celebrates what makes you unique. ​ There are few places to find support and information or insight into the #Real Nurse world. And most current blogs are not nearly the Nurse I feel I am today! Therefore, I wanted to bring you a bit of my Nurse world & personal real life fun as well. ​ I hope to bring you a fun, informative, & trendy side to the medical field. Cheers & so happy to be sharing my Little Life Tips with you. JOIN THE NICU FORUM REAL NURSES. REAL PRODUCTS. REAL PATIENT CARE. Nurse Report Sheets Designed Just for you! Now on Sale REAL NURSES. REAL PRODUCTS. REAL PATIENT CARE. Now on Sale Nurse Report Sheets Designed just for you! REAL NURSES. REAL PRODUCTS. REAL PATIENT CARE. Now on Sale Nurse Report Sheets Designed just for you! I began blogging in 2018 and became an ambassador for Brave Beginnings a non-profit organization whose mission is to ensure ventilators and essential neonatal equipment are available to newborns in critical need. I was featured on their 2019 PSA with John Cena to help bring awareness to their mission. In March 2020, I founded The Cellfie Show , a podcast dedicated to sharing all walks of the healthcare space including health professionals, entrepreneurs, innovative businesses, homeopathic practitioners, addiction specialists, therapists & coaches, social media personalities, mental health specialists, patient and family perspectives, people of interest, taboo topics, and sharing life journeys along the way. As a podcaster, blogger, keynote speaker, and social media content creator I present a fun and relatable side of the healthcare world full of education, health, wellness, and motivational topics to my community, organizations, and companies. I am the founder and owner of Tips From Tori LLC, this boutique blog full of education, resources, products, and services to provide value in some small way to you. I love working as a nurse, blogging, podcasting, and time with my family & friends. My husband and I love to ski, travel, spend time at the beach, live an active lifestyle, and living a zesty life! ​ ​ LATEST ON THE BLOG Nurse Tori EXCLUSIVE NURSE CONTENT Hot Tips for Nurses Starting in the NICU! Starting in a new setting, getting to know a very unique tiny but mighty patient population! Not to mention the fact that NICU nurses have b 5,869 10 likes. Post not marked as liked 10 - EXCLUSIVE NURSE CONTENT Nurse Portfolio 101 The job application process can be daunting. Trying to find the job, apply to the job, create that portfolio, interview, and try to land the 1,119 7 likes. Post not marked as liked 7 Nurse Tori EXCLUSIVE NURSE CONTENT 14 Hot Tips to Become a NICU Nurse What a hiring manager deems important is very selective to their needs and what they believe a nurse should be. Frustrating I know!! My advi 10,034 18 likes. Post not marked as liked 18 Nurse Tori EXCLUSIVE NURSE CONTENT NICU Nurse Resources! A neonatal nurse is a Registered Nurse (RN) that works in a Neonatal Intensive Care Unit (NICU) and assesses, monitors, and cares for babies 8,174 19 likes. Post not marked as liked 19 Nurse Tori EXCLUSIVE NURSE CONTENT 12 NURSE INTERVIEW TIPS & TRICKS! After spending much time applying for jobs I have certainly had my fill of Nurse Interviews. Here are some Interview Tips and Tricks! 5,736 17 likes. Post not marked as liked 17 Nurse Tori EXCLUSIVE NURSE CONTENT 55 New Grad Nurse Tips! So, you are a new NICU Nurse! Congrats & welcome the “The Real” Nursing NICU World. Bedside Nursing can be different! Here are a few tips! 3,293 13 likes. Post not marked as liked 13 - EXCLUSIVE NURSE CONTENT NICU Nurse 101...What is the NICU REALLY LIKE? We take care of the tiniest, and often, sickest humans in the hospital. It is important to understand that premature infants are not only... 5,932 15 likes. Post not marked as liked 15 The Cellfie Show Sign in The Cellfie Show Play Video Share Whole Channel This Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied Now Playing Labor & Delivery Nurse, #expertwitness, Clinical Educator, Patient + #Nurse #Advocate 🎙️ 00:55 Play Video Now Playing Sam went #viral, Doggie Prozac, Stalkers, recapping #SuperBowl moments with some #unpopularopinions. 00:56 Play Video Now Playing What You REALLY Need to Know About #Malpractice + #Healthcare Lawsuits. Jen Atkisson #expertwitness 00:56 Play Video ♡ YOUR PREMIUM NICU NURSE CONTENT ♡ Find one that works for you! All Bundles are a one-time payment! BASIC NICU BUNDLE ♡ $ 13.99 13.99$ one time payment Valid for 6 months Sign Me Up ! Access To ♡ 14 HOT Tips to Become a NICU Nurse! NICU Nurse 101! What is the NICU really like? NICU Nurse Resources, Websites, Certifications, Links etc. ACCESS TO NICU FORUM Best Value EXCLUSIVE BUNDLE ♡ $ 27.99 27.99$ one time payment Valid for 2 years Sign Me Up ! FULL Access To ♡ 14 HOT Tips to Become a NICU Nurse! NICU Nurse 101! What is the NICU Really Like?! NICU Nurse Resources, Websites, Certifications, Links etc. 12 Nurse Interview Tips & Tricks: Land that Dream Job! Nurse Portfolio Insider Tips 55 New Grad Nurse Tips! Hot Tips for Nurses Starting in the NICU! ACCESS TO NICU FORUM EXPERIENCED RN PACK♡ $ 21.99 21.99$ one time payment Valid for 6 months Sign Me Up ! Access to ♡ 14 HOT Tips to Become a NICU Nurse NICU Nurse Resources, Websites, Certifications, Links etc. 12 Nurse Interview Tips & Tricks. Land that Dream Job Nurse Portfolio Insider Tips Hot Tips for Nurses Starting in the NICU! ACCESS TO NICU FORUM get the tips I accept terms & conditions LET'S DO THIS Thanks for joining the squad! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student , & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at or ​

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