It might be a tough day in the NICU if...

With our unit's booming census over the last few weeks, I've learned a good bit about how to recognize a crazy day. I'm pleased to share some of that here. Can't even make this stuff up.

It might be a tough day in the NICU if...

- Two fundamentalist Christian night shifters are trying to figure out where they can obtain large quantities of liquor at 0700 on a Sunday without being flagged as alcoholics or heathens in general.

- The report for the chromosome analysis on your infant includes the phrase "never before recorded in a living human being."

- The message "We're dying. Clock in and come help when you get here!" is written on the dry erase board in the lounge.

- The entire night shift is standing at a baby's bedside, arms folded uniformly and heads shaking in unison. And of course, it's your baby today.

- As you're checking the assignment board, the charge nurse's comments include the phrases "I apologize in advance" or "Get your roller skates on" or "I don't want to hear any bitching."

- Shift report takes 25 minutes on your first kiddo, then the offgoing nurse says, "Now for the hard baby."

Explained to me with a straight face...

... by a nurse who was telling me about the high rate of "toasterheads" at her NICU, a level 2 center that almost never keeps babies at less than 32 weeks.

"Repositioning is not as much of an option for us. See, those reflective skin probe covers are expensive, so we try to save them. We use clear tape. And the tape sticks pretty well once we get it on there, so we can't go ripping it off the skin every 3 hours just to reposition the kid."