[climberrn]

We have a new PICU with nurses without PICU experience. They received an accelerated didactic with OTJ training once we got our first patient. I'm trying to think of topics for bedside learning to help cement what they learned in class but I'm drawing a blank as to what were the things I found hardest when I first came to PICU. Any ideas?

[janfrn]

Just off the top of my head, I can think of a few things you could go with. Basics of hemodynamic monitoring: how we do it, what we use to do it, what steps are followed for ensuring accuracy. (We're currently having a difference of opinion in our unit about how often transducers need to be calibrated. Our educator, who is new to the role, is telling people that they need to zero EVERY time they reposition the patient. Tell me how that will affect the atmospheric pressure! Level - yes, zero - no!) Modes of ventilation, their advantages and disadvantages. Hand-ventilation: practice with both Jackson Reese and Laerdal bags. Suctioning ETTs and trachs. Basic blood gas interpretation. Fluid management: calculating maintenance, deficit or overload, restriction and replacement. IV med administration and how to decide how much diluent is needed (central vs peripheral). Effects of vasoactive drugs. Shock states. Assessing sedation and pain. Complex dressing changes. Central line care. The list could go on and on!