kidsccrn 964 Views
Joined: Sep 7, '01;
Posts: 15 (7% Liked)
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Thanks everyone for the info. Keeshadawn,don't get me wrong I never trust a parent to be responsible for an intubated kid but a lot of parents flip out if the kid moves at all (and scream for a nurse) so that can be helpful to at least know if the kid moves while I am in with another kid. I to am an oldie who works nights and loves it when the parents go out to the waiting room or to RMH to sleep. I'm just getting too old to climb over people to get to their child!! When they park in front of the IV pumps or monitor. I would love to have 1:1 on intubated kids with our staffing levels that will not happen. We use fentanyl gtts some versed gtts. Mostly use PRN versed/ativan and vecuronium for the wild ones,ARDS on high PEEP and ventilated fresh trachs.I'm glad to heard I'm not the only one nervous about private rooms. I love the open unit with curtains so I can see all the kids. Just one more change we will have to deal with I love the kid that very quietly sits up with an ETT. What a way to get the adrenaline flowing!!!!! We now have a very low self extubation rate I want to keep it that way.
What do you do with parents during rounds? I work in a teaching hospital.
Just a question for all you PICU nurses. We will be moving to our new Children's Hospital soon, the setup is scarey to us oldies. The unit is all individual rooms no windows between rooms (parent group did not want any). Of course the nurses are nervous it will be a big change. We now have an open floor plan with 2 isolation rooms but have a window between the 2 rooms. We will have a nurses "mini station" between two rooms which will have windows to visualize from the hallway. Our concern is what happens if you are in with your other patient and the other kid is intubated and tries to bolt etc.
I'm trying to stay optimistic so my question is does anyone else have this setup? (It will be a 15 bed unit ) How do you guys sedate ventilated kids drip/prn? I think it will be ok on days because the parents will be awake at the bedside. What about night shift when the parents are sleeping? Parents will be sleeping in the room on a pull out bed.
I'd appreciate any ideas and what is working or not working for you. Thanks
Yes it should be a felony and in NY it is.
I was assaulted by a pt.(17 yr old high on cocaine) a little over 2 yrs. ago.
I was out of work for almost a year. He tore the ligaments in my wrist of course my dominant hand. I was covered by workers comp. I did press charges!!!
The biggest problem I have is PTDS I left the ED (Peds) because I would have panic attacks if anyone started yelling etc. I still live in fear because his mother threated to come back with a gun and take me out. Security said not to worry she was just blowing off her mouth!
I went back to my safe home PICU and feel much better. But I still watch my back.
I can't believe I'm actually writing this but I'm hoping it may be therapeutic for me.
I am the victim of an assault by a pt. I have been out of work since the day after christmas due to a torn TFCC which I just received approval from comp. for surgery. My MD told me I have a permanent injury that he can only try to make it functional enough to work, the next step will be some kind of ligament transplant. Oh did I also mention this is my dominant hand!!!
Anyways this was a 17yo punk who swallowed a bag of cocaine while being arrested. He arrived in custody but was then given an appearance ticket because the police did not have the evidence and did not want to wait for it. After they left the fun began, mom arrived demanding to take him home. To make a long story short CPS got involved d/t his age and said we had to keep him. 6 security officers took him down put him in 4 pt leathers I went to give him sedation IV he broke out of the restraint grabbed my arm threatened to kill me I went to the floor hanging by my twisted arm! The mother threatened to come back with a gun to take me out, and told me to watch my back. Oh did I mention he is a gang member and has been shot 3 times.
I am scared to death to go back I did press charges and asked for a restraining order (which I still have not gotten). The hospital has not been at all supportive as a matter of fact they put me in the float pool!!! I have been a nurse for 30 years at this hospital and I have never been so scared to leave my home as I am now.
Until admin. wakes up and admits we are always in danger and take these threats seriously this is going to continue. I called EAP they talked to me on the phone and said I need to see a councilor at my expense- I know the drill what I need is a safe working environment! I know I have PTDS who wouldn't I thought he was going to kill me and would have if security had not pulled him off. I think we should be allowed to tazer (? sp.)!!!
So what I say to all nurses take every threat seriously and report it to have a record of it. It is a felony to assault a health care worker.
Please protect yourself from the crazy people out in the world.
Sorry this is so long
I'm not sure where to start but here goes.
I have been a peds nurse for 26 yrs. NICU, PICU, Peds ED and homecare.So I have seen a spectrum of reactions with parents of a special needs child. Don't try to analyze how parents react it is so individual just listen- that is worth more then any advice you can give.
I am also the mother of a now 23 yr old (ex-premie ) who is disabled both mentally and physically. She is ambulatory but uses a wheelchair for long distances. At 16 she had complications from a nissen fundoplication and now has G-Tube fdgs at night and nursing at night. She is a beautiful young women and is loved by everyone she has contact with but will always be dependent. I have run the spectrum of emotions and everytime we had to add some kind of support it was a greiving process, you see to us it is just another way we have failed. I still greive for the beautiful women she could have been. I do not want someone telling me how to feel or tell me that I should be over it by now. Every milestone has been a triumph but it has been a long road. I am tired and I now have people to help me but it has taken me a long time to get to that point. I now accept the fact that no matter how much we do she is never going to be "normal" what ever that means.We love her unconditionally and we are blessed to have her, but I also have a right to feel cheated, angry, sad and happy.
Sorry this is so long but you need to know there is not a book of etiquette for parents to follow when they are being told there child has CP etc. Everyone is an individual just listen even if it doesn't make sense. The next day things might seem different after they have a chance to let it sink in.
Here's a few of the many Obvious, Knowledge, Female (pronounced fa-mal- e)(she said the nurses named her),Ya Jealous, one bright one wanted to name her baby Clamydia she thought it was a pretty name she was talked out of it!!!!!!!!!! Thank God.
I feel sorry for these kids what are these people thinking?
I'm 49 I've been a RN since 1977 always a bedside nurse and love it! I can't think of another profession I would rather be doing. Kids are great to work with!
Does anyone have a written policy/procedure for arterial draws on peds patients? We are trying to institute the procedure but the only written policy is for adults. I'd be forever grateful!
The residents are butchering the poor kids just like they do for IV's so the director wants us to start doing them.
I have been trying to get on the site also to no avail anyone know what happened
Hi Fran Hazinski's is still the best out there. As a matter of fact I was just looking something up in it today! Good luck! Lynn
sorry if people took my previous post the wrong way. What I am trying to say is that 99% of the families are ok it's the 1% that is a pain. Beleive me I have asked parents to leave due to inc. ICP and they can't keep there hands off the kid! I strongly believe in 2 people at the bedside at a time. It is hard enough to get around the bed without triping over people. The problem is when one nurse lets the whole gang in the nurse that enforces the rules is the bad guy. And what about siblings visiting the PICU I love it when they sneak them in with snotty noses or call the next day to say Johnny has the chicken pox. I spend the time explaining why we have restrictions in the PICU the parent are very compliant then the next nurse doesn't and the circus starts all over again. When a child is dying we have open visiting for that pt. with as many people as the family wants. (of course then the other families whine "why can they have so many people". I can't remember who said you tell a family something and 2 mins later they ask the same question- I was that way when my daughter was in the NICU the nurses finally figured out when I had that spacey look I was overloaded and they would stop trying to give me info. Nobody ever said life in an ICU would be easy.
I have been on both sides of the bed let me tell you it's not easy! First my daughter was born in full arrest and then spent 8 weeks in the NICU. She has had many admissions and I am always there! Second my father-in-law was diagnosed with AML on a routine pre-op lab for a valve replacement (he was not at all sick the murmur was found at a routine physical) he died within 2 weeks of induction of chemo! Was I at the bedside, you bet, did I break the visiting policy, you bet because I was the only one he felt secure with. Everytime I left he would go into resp distress, I'd come back and he would settle down. The one night I left because he was intubated he arrested and died. I still feel the guilt that I left. As far as being a pain in the nurses eyes I probably was,however the care was less then even adequate. He was scared and there were several mistakes made like the wrong amphotericin was hung (it had another patient's name on it when I questioned it she said we do that all the time if his didn't come up we use another pt's) 5 mins later she came back to say it was the wrong dose!!!!!!!! Most of the time I spent holding his hand and letting him sleep. I was always out of the way of monitors, pumps etc. I very seldom asked for anything except ice chips.
I have been an PICU nurse for 21 years are there difficult families YES but 99% of the time it is fear. They are afraid to be left alone with the pt. for fear they are going to die. Kindness and information works wonders.
For the other 1% nothing you do is right or ever will be, they are usually the people who sit in front of the pump and when it alarms just sit ther and are annoyed when you ask them to move.
As for family prescence in a code I am very torn, if there is someone assigned to just be with the family fine but if the family is there with no staff to explain what is being done and support them I DO NOT AGREE WITH THEM BEING THERE. During a code it is stressful enough for the staff if you have a hysterical family there it makes it worse. I personally do not think I would want to be present I do not think I want to see my love one being pumped on, stuck, chest opened etc.
Sorry for the long post but families are a part of our job, not just caring for the pt.
I agree with alot of the posts. The biggest problem I have is with people making judgements about depression who have never been there. I have been on antidepressants for about 5 years now I wish I had done it sooner. I come from a dysfunctional family of which I will not bore you with the details. I also come from a strong family history of depression and suicide. It's takes alot of strength to go to therapy and face your demons and I do not appreciate people making fun of people who are in therapy. If you have never experienced depression you have no idea what it is like, to get to a point that taking your life seems like it would be better for your family then watching their mother unable to function is frightening. I got to the point I could no longer put on a happy face and fake it. I am so much better now but it took a lot of therapy and meds before I got back to living. So cut your coworkers a break that are being treated for depression it's a long and lonely road back. I wish I had time to do something for myself but between work and taking care of my family which includes a daughter with special medical needs I DO NOT HAVE THE LUXURY OF TIME TO MYSELF
Hi I just left a unit where they do a fair number of norwoods. The surgeon is also doing the RV to PA shunt instead of the BT shunt. I'm not sure it's any better these poor babies still go though hell and many just up and die. We just had one going home the next day arrested and died, another ( actually 2 ) were found dead by their parents in the AM. I am very torn about this procedure are we really giving them quality of life or just prolonging the inevitable?
Best of luck. I just left the PICU after 20+ years. I left not because I didn't like it, I loved it, but the administrator and I just don't have the same values. I love each and every child I take care of as if it my own. In my eyes saving money is more important to her than patient care. I have transfered to the Peds ER and I'm liking it, the staff is great and very family/kid oriented. All procedures are as pain free as we can make it, we do a lot of conscious sedation. I hope you love the PICU and always remember you are being entrusted to take care of someones child. No matter how you feel about that kid, deformities,injuries,disabilities and all, the parents love that child unconditionally. Man this was deeper than I thought I would be. I love PICU nursing. If that person ever leaves I would seriously think about going back. Good Luck
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