Curious...any of you guys considering Peds/PICU/NICU? - page 4
I am a NICU/PICU/Peds RN, and have been out of school for almost 2 years in the legendary "real world." I have had the chance to precept several guys in nursing school over the last year in PICU and... Read More
Apr 13, '08My dream is to work PICU or NICU. I've been in both as a dad and I've just got such a heart of compassion for those kids and their parents.
Jun 8, '08I'm leaning toward newborn nursery/NICU/PICU. The birth of my grandchildren is what led me to considering it. I start my pedi/ob rotation in August, and hope things go well there.
Jun 8, '08my wife's 4 year old niece had a heart transplant at st. louis children's, just a couple of days before christmas 2007. we went up there, and i was amazed by the nurses and doctors in the cardiac-picu. their compassion and professionalism was a sight to behold, and really impressed me, a 2nd level adn student.
Quote from kckstrti absolutely love pediatrics. i loved my clinicals in peds and am doing my internship at st. louis children's hospital emergency department. i am truly drawn to emergency peds.. .i may consider nicu or picu upon burn out...
Jun 9, '08I enjoyed my peds rotation but haven't done high acuity rotations yet. I would certainly consider PICU/NICU if the rotation is a positive one. My greatest frustration during my Peds rotation was trying to educate parents who simply couldn't be bothered to appropriately care for their chronically ill child.
Jun 11, '08Well here is an update from me so far...i have posted on this thread twice before in the past year...
Well i got into Brenau University up in Gainesville, Ga. I just finished up my first year and i'm going into my senior year starting in August. I'm also half way through my Nurse Externship in the NICU of a local hospital and i absolutely love it!!! Even though i'm still one year away from graduating i'm lining up my ducks in order to work in a NICU when i graduate and get into NNP school as soon as i possibly can...probably after two years since most require at least that in order to qualify. I can't wait!!
Jun 12, '08Quote from SteveRN21Wow, that's incredible...Well, here's a brief "day in the life" in NICU....
I get to work and get report on my assignment of 1-3 patients. These can have any number of diagnoses including cardiac anomalies, sepsis, respiratory distress, meconium aspiration syndrome, etc... Let's say I get a 24-weeker, a "feeder-grower" and 1st admit. (we rotate admissions where I work) I set up a "giraffe" bed for admission, a 30k bed that converts from a closed isolette to a radiant warmer in 15 seconds. I assess my 24 weeker, who is around 600 grams in weight, assessing VS, fontanelles, color, tone, lungs, his umbilical or peripheral arterial line, PICC/IV lines, chest tubes, ETT. I make sure his dopamine/dobut gtts, along with hyperal, lipids and fentanyl gtts are running without problems. I check out his High-frequency oscillator ventilator, which is a special vent that pulses 600-800 puffs per minute, "shaking" o2 into his lungs while holding his alveoli open at a controlled pressure. He's already gotten a few doses of surfactant down his ETT to help "ripen" his lungs. His assessment's complete, so I change his diaper and bed linen and reposition him. Doors shut, light off....on to feeder grower... Assess, especially abdomen, checking to be sure he's tolerating his feeds, IV's are intact, especially the 26ga one in his scalp we placed after 4 attempts. Bed linen's changed, NG tube's patency checked, BG fed q3hr formula. Back to bed... ok time to chart... meds due on 24 weeker: Claforan and Vanco, Bumex too... L&D calls for a 35 weeker vaginal delivery. I go with one of our unit's 3 RT's, manage the baby in the delivery room. No resuscitation needed, just a little blowby o2. Back to nicu, more meds and an ABG to get on 24 weeker. Feeder screaming for more food. It's time to feed again. This time I attempt to PO feed with a bottle, slowly teaching the baby how to pace his sucks and breathing. He's slowly getting it...I teach mom and dad how to give him a bath and change him. We also go over discharge paperwork for later this week. ED calls, sick kid, can't get an IV. I go down with another RN. Get the IV in and come back. More VS, ABG's, feeds and meds. My 24 weeker's Hct comes back 24. I start a PRBC transfusion, right before L&D calls again. This time it's a 30 week abruptio placentae. The kid comes out blue, apneic and with a HR in the 40's. the RT intubates as I start compressions and draw up epi. 0.2ml down the ETT...cpr continues. The kid comes around, and we rush him back to nicu to admit him. So now I have 2 vents...another RN picks up my feeder....don't have to worry about that, now. I'm caught in a mad rush. the new kid goes into SVT,,,,I grab the neonatologist and some adenosine, push it. He converts. I hang his and the 24 weeker's IV fluids and chart....more meds due...labs due. Luckily we're a great team and help each other out. Finally it's 7pm. I report off to the oncoming RN before finishing my charting. I've already seen the new kid's family, oriented them to the unit and answered all their questions and gotten consents signed. IV's are in, meds given and labs sent. I'm exhausted, but done for the day.
Some other things I do in NICU:
PICC line placement
Assist with surgery, central line, Chest-tube placement.
I can intubate, place PICCs.
I really enjoy the high-technology and fast pace, including delivery room resuscitations. But I also love taking time to teach and counsel parents, and even just sit for a while and feed a baby,.....It's hard to explain. I hope the above scenario wasn't too scattered, but it's pretty much what happened today at work....
You really can't even compare PICU/NICU with adult ICU. Peds diagnoses are usually not chronic. We get a lot of traumas, including gunshots, ATV accidents, DKA, Asthma, RDS, RSV, etc. You see a lot of the same drugs and treatments, such as vents, chest tubes, central/arterial lines, etc, but not stuff like COPD, Heart disease, ESRD, etc.....
I'm starting up my BSN this Fall, and I've wanted to work peds/nicu since I decided I was going into the medical field six years ago.
Jun 12, '08I'm considering it. I worked Pediatrics when I was a Hospital Corpsman in the US Navy. It was one of the most rewarding jobs I've ever had.
Jun 20, '08I am a RRT of 10+ years and am currently enrolled in an accelerated nursing program. I specifically went back to school to become a NICU/PICU nurse. The only real challenge that is of concern is staying out of the all the social drama that tends to come with NICU/PICU units. Do you have any suggestions for this?
Jun 24, '08I'm still in school, but i have been way interested in peds. There is something about working with kids that i love. I think a lot of it is my little niece has turners syndrome. she has been in and out of the hospital her whole life. She was sent one time to primary childrens medical center here in utah, and the nurses that worked there where so impressive, they really knew there stuff, and they where so caring to the sick children all around. It actually kind of inspired me to go into nursing.
Jun 24, '08uhm this semester im going to be rotated in the pediatric ward and the operating room... any advice guys??? thanks..:spin:
Jun 25, '08In the OR, make friends with the anesthesiologist/CRNA, and you can have a birds-eye view of what's going on, as well as get to see the anesthesia side of it.
Peds: Be cool. Play, have fun. Sick kids are still kids. Study developmental levels ahead of time so you can interact with all age groups. This is one thing from nursing theory that I actually used, and made sense after I graduated.
Jul 1, '08I def. want to go into peds. Right now am doing a summer internship in peds oncology but might want to pursue a career within peds ed/icu