Nurse Kelly’s Notes

01/03/2026

Hi, everybody! I’m so glad that you’re here! Let me tell you a little bit about myself…

• My first name is Stephanie! I’m originally from Pennsylvania but now live in the Washington, DC area with my husband, two kids, and our cat.
• I’ve been a nurse for over 14 years and have spent most of my career in the NICU, including 3 years as a Nurse Educator. I’m currently a NICU nurse and member of my unit’s PICC team.
• My Masters degree is in Bioethics!
• Nurse Kelly’s Notes was born after I left education to return to patient care. I missed creating education and my colleagues thought that I should sell the notes that I created while studying for certification exams and for classes in NNP school — which I attended for a year, but ultimately left because I loved working at the bedside.
• One of the fonts in my products and posts is actually my handwriting, which I turned into a font because so many people thought it was a font!
• Fun fact: I can solve a Rubik’s cube and bring one with me to work.
• My favorite types of self-care include exercise, sleeping, and spending time outside. I’m a Peloton addict!

Do we have anything in common? Share it in the comments below!

12/28/2025

Top 5 meme posts of 2025! Which one could you relate to the most?

12/17/2025

In my almost 15 year career as a nurse (with almost 14 of them spent in the NICU), I’ve been “fired” from taking care of a patient one time. I share this not because I’m proud of being fired (I’m not), but because I feel like I was the unfortunate scapegoat for a NICU patient’s off day during my first shift ever caring for her. I felt a range of emotions when I heard that the family didn’t want me to care for their baby again, and as a people-pleaser and type-A NICU nurse it took me a fair amount of thought and discernment to feel okay with what happened. At the end of the day, I feel so privileged to be trusted with the care of NICU babies and their families and I realize now that — even though babies have off days — they’re lucky to have me, too.

12/04/2025

NICU Nursing UNWRAPPED: Your 2025 in review! You spent a LOT of time at work, caring for small and mighty in the 2nd and 3rd trimesters, swaddling hundreds of patients, and hearing the sweet sounds of alarms everywhere (accompanied by crying from the babies and occasionally the stressed out NICU RN).

11/26/2025

Tips and tricks for IV insertion in the NICU! Taking the time to set up and prepare your patient is integral in increasing your chances for success!

First, I set up all of my supplies before doing ANYTHING to my patient. Regardless of whether or not I can visualize a site with the naked eye, I’ll use my to further assess. I love that my Firefly is wireless, rechargeable, and has multiple light intensity settings. It’s also got a studded surface to facilitate having a good hold on the patient to prevent veins from rolling.

Other tips and tricks:
✨ I don’t hesitate to use a heel warmer on the extremity of my choosing, especially if perfusion is poor or the extremity is cold.

If you haven’t invested in a Firefly to enhance your IV insertion skills, you absolutely should and now is a great time to do it! You can use code NurseKelly to take 10% off your purchase. AND starting this Thursday, you can bundle and save Firefly and Nurse Kelly’s Notes products for Black Friday, saving up to 20%. Stay tuned for more information!

11/18/2025

Managing pneumothoraces and chest tubes can be daunting for ANY NICU nurse, especially new RNs! Luckily, the Neonatal Intensive Care Nursing Bundle has the information that you NEED to boost your knowledge and confidence about caring for patients with a pneumothorax and chest tubes — it includes pathophysiology, evidence-based interventions, and rationales for over 70 commonly seen conditions affecting babies in the NICU!

Get yours by tapping the photo here, or shop on my website or Etsy at my link in bio!

11/12/2025

I’ve had TWO CBCs clot on babies in over 4 years, and it’s not because I’m lucky. Proper technique and good preparation are key in avoiding any NICU nurse’s most dreaded phone call from the lab. Share your tips and tricks to avoid having CBCs clot in the comments!

1. Put a heel warmer on your patient. Depending on my patient’s perfusion, I’ll sometimes add a second heel warmer and place it on the calf, or I’ll place the foot with heel warmer inside of a diaper.

2. Use gravity to assist you by angling the head of the bed UP, with the feet lower than the chest. I’ll swaddle or restrain my patient if necessary as well, to avoid being kicked during the procedure and to comfort them, and offer a pacifier or sucrose.

3. Use an appropriately sized lancet to puncture the skin on the outer aspect of the heel. You should never have to upsize your lancet to keep a specimen from clotting.

4. Work with gravity and the flow of blood, not against it. A common mistake that I see is that people will raise the head of the bed, but then they also inadvertently pull the patient’s leg up in the air, too.

5. Avoid scraping the specimen tube against the patient’s skin to avoid having skin cells mix in with my sample, which can cause clotting. Let big drops of blood fall into the tube without squeezing the lower extremity. The more scraping that you do, the more likely that you are to have your specimen clot. If bloodflow is slowing, pump the leg back and forth or briefly massage the calf.

6. The purple top tube that we use to collect CBCs has an additive called EDTA. EDTA is an anticoagulant, and it works by binding to calcium ions in the blood. EDTA inhibits the coagulation cascade, but it doesn’t affect cell counts. Overfilling and overshaking your tube actually increases the chances of hemolysis or clotting. Instead, gently invert your tube 8 to 10 times, end over end, to ensure that the EDTA mixes to prevent clotting.

11/08/2025