PEDS in Adult ICU

[PHOEBE RN]

The unit I work in is also Pediatric ICU.(a rare occurence...) Recently we have had to take overflow pedi general care patients with RSV. Imagine taking care of a 24 day old with RSV, a 56 POD#2 CABG and a vented post-op???????? Or even 4 patients under the age of 2 when you are a nurse trained for adult patients. We are told that because we have PALS, we can take pedi patients. My mantra has been,"If I wanted to take care of Peds, I'd be working on their unit."

[P_RN, ADN, RN]

I've never worked the unit, but I'd say this is a ridiculous situation and dangerous as all get out.

My hospital decided kids 3-12 would be just fine on adult ortho......we managed-just.

You can understand having to use a buretrol for 30 mi of antibiotics on a 40 pounder isn't as easy as setting a pump for 8 hours of IV fluids on a LOL with a total knee. That's with caring for 9 other patients who are age 80 and above. The ones making these decisions are only looking at the bottom line. I'd say keep the occurrence reports handy.

[christianRN]

We are a general ICU, and we take kids if they're too sick to be on the peds floor but not sick enough to be shipped. Mostly if they probably took some pills and need to be monitored, or chronically ill trach-vent pts.

Never non-ICU kids, though, we would only take our standard 1-3 pts depending on the acuity.

I would definitely not be comfortable functioning as a regular peds nurse, especially the situation you described!

[Floridanurse]

If you are taking 3 ICU patients with one being pediatric. I would say this is very dangerous and I believe that the ratio of pediatric ICU nurse/patient is a mandated issue. Check the peds boards for more info on that.

I would have to find somewhere else to work and somewhere else to take my child to be cared for if it were my child.

[Bizzo]

I'm not yet a nurse, but I work in the ICU as a CNA, and we get kids when they are too sick to be on the Peds floor. We only have a general ICU also, so its really the only option. I can see your point however, becuase I'm not really a "kids" person. Taking care of kids is a whole different situation, especially with the families.

[bethin]

Sounds very dangerous. I know if I was a CABG pt. and I knew my nurse was taking care of an RSV pt. I would not be happy. I don't blame you, but administration for putting you in this position. Also, if you have a pre schooler in an adult ICU they may see things that don't need to be seen by a child. I'm assuming your unit is either open or curtained off. A child can hear the code being called, the people running, etc. What if they see the deceased pt. being wheeled out? That can be very scary to a child. Like you said, if you wanted to work with peds you'd work there.

Do other nurses feel the same way you do?

Where I work we have an adult ICU so if a kid is sick enough to need an ICU, they are transferred. If it's an extreme emergency, we have a helicoptor on standby for those cases.