[janfrn]

There's no such thing as travel contracts in Canada. I'm not sure there ever will be either, because our health care system doesn't lend itself to that kind of arrangement. The fact that all provinces have nursing unions bargaining for all acute care and most long term care facilities' nurses makes it unlikely. Boy are we ever far off topic here. Sorry Kim for hijacking your thread.

[AliRae]

...now back to your regularly scheduled thread...

[JazzyRN]

I agree with Ali. Those near drowners are so hard to deal with. Completely normal healthy kids that quickly go down the tubes. The families deal with alot of guilt and its always very emotional and unexpected. Ive seen a couple of these kids actually make a neurological recovery but die anyway because the injury to the lungs was too great. It gets me everytime.

[WarEagle4Life]

Honestly, the absolute worst for me is the "non-accidental" trauma. We've unfortunately had a run of several babies, all male, about the same age, with shaken baby. One died (parent has been charged with murder), the rest are devastated neurologically.

The death of our chronics is very hard - it's hard to pull back and realize we are "doing to" instead of "doing for".

Stick around the PICU awhile. What keeps us going is seeing "the fruits of our labors." When the kids come back in that we gave no chance for living, for having a "normal" life are doing great - WOW!!!! Seeing "our" kids up walking, talking, smiling - that's the best feeling in the whole world.

We do make a difference!

Cindy

[RNNPICU]

I agree with Janfrn about the kids that we put through so much even though they will not survive. Or the kids that are chronic kids who we do invasive procedures on only because we can, not really to improve quality of life.. I have heard one family member tell me that she did not want a DNR for her child because the child's body, physical presence was the most important thing. This kid was GT, trach/vent dependent, no spontaneous movement, no tremors, nada. The kid was on Dopa of 20 epi of 1, and was not going to recover. That wa hard.

[stefaniePICURN]

the toughest for me are the abuse cases.. these kids arent even sick, and yet they die. i admitted a trauma in my unit almost two months ago, a toddler who was thrown around by his babysitter. he herniated 5 hours after admitting him, it was horrible. it breaks my heart.

[heelgal]

What a difficult question to ponder. For me, it is the kids who actually speak to me before they crump before my eyes and die violently while we try to save them, pounding and sticking. This has happened a few times. Recently I had a 5 year-old girl flown in for presumed septic shock. She was still alert enough to be scared and said so. She also had enough spunk to yell when I put a mask on her face and to ask for her mommy. Who knew she would be dead 90 minutes later- full blown meningicoc sepsis. Awful, simply awful.

[MistyBlue]

BCS kids are usually the hardest for me. You get what was a perfectly normal child now on their death bed or damaged for life and it is heartbreaking.

The beauty of PICU is when a kid who shouldn't be alive comes back to visit and you get to see a miracle right before your eyes.

As emotional as working in the PICU can be I often find that it is easier than dealing with certain foolishness that I have encountered in the adult ICU world. When you have a pt who has had CABG twice and is now post angioplasty and is still smoking two packs a day and is fussing about still being in the icu not able to smoke drives me crazy.

Hang in there. It does get better!