advice requested= track to PICU

So, how did you answer that one? Nursing students don't often have the opportunity to be involved in the care of truly critical patients, but perhaps you spent sometime with a post-MI who could have gone either way? Or someone with respiratory distress... Always remember your ABC's and tailor your answers accordingly.

Panel interviews can be very nerve-wracking. (How well I know... I had many of them when I worked Level 2 neonatal.) Again, ABC's. Some sense of what drugs you might need in a code situation (atropine, epinephrine, bicarb, calcium chloride, sedation and neuromuscular blockade for example). Look at my and AliRae's previous posts to Canadian_Nurse. But because you're a new grad with no experience to fall back on, they aren't likely to ask you anything about in-charge decisions. They will expect you to know what you're getting into and what kind of nursing care you're going to be expected to provide. Think about this: Why do you want to work in PICU? They WILL ask you that, or a variation on it. Have a knock-their-socks-off answer ready. Good luck!

Thanks for the reply!

The nurse recruiter asked this question specifically relating to a pediatric patient. And, honestly, i had NO critical patients on a regular peds floor. The closest I came to a good answer was an 18 month old baby who had nephrotic syndrome (which i actually said he had "nephritis"...holy heck was i nervous, i couldnt remember anything), and was losing lots of protein, was on all sorts of medications, including high dose steroids, and was s/p renal & liver bx. I did tell the NR that, although this patient wasn't considered "critical", i told her that i felt it was important to monitor his status closely because (based on his labs and history) had a lot going on. My plan of care was exactly that...to monitor him closely for changes, keep precise I&Os, and follow up on his labs. Perhaps i wouldnt have hired myself at that point, but she may not have been listening very closely...either way, i was invited to take the pediatric pharmacology exam and was told to expect to be called for the panel interview.

The sad part of it all was that i have had the incredible opportunity to be involved in several pediatric emergencies. I have worked as an MA for the last 5 years at a pediatric cardiology practice, and witnessed kids having tet spells, post pericardiotomy syndrome, cardiac failure, respiratory distress, etc...i had one kid was on the verge of death. BUT, this is a good indicator as to how nervous i was...i did not think to draw on ANY of my experiences, because the way she asked the question related to my experience in nursing school. I'm sure i could have had an excellent answer. But i blanked.

Their peds pharm exam had TONS of drugs in it, and my way of preparing for it was to try to memorize as much as i could. Atropine, epinephrine, bicarb, lidocaine, and verapamil where on the list, so i'm pretty comfortable with them.

The thought of this next interview makes me so nervous. But i want to be prepared. THIS is exactly what i have wanted to do.

Why do i want to be PICU nurse? I think of this very often, especially while driving, for some reason...i'm going to think it through (i know in my heart that this is what i want to do, but i need to convert that into words), and come back to answer that. Perhaps you can tell me if you'd hire me...

thanks again!

Kids with nephrotic syndrome can become critical in the blink of an eye. I'm sure you could be forgiven for calling it nephritis. Their high-dose steroids can cause some interesting changes in their lab work, like hyperglycemia. Knowing that has saved many of my patients who are getting hydrocortisone for hypotension from ending up on an insulin infusion. The bxs are also something important to consider, because of the potential for significant bleeding. If the kid had hematuria, how would you know which was causing it, the nephrotic syndrome or the bx? Then there's the fluid retention they experience. They need frequent position changes and scrupulous skin care. They can have respiratory symptoms because of it too, due to increased intraabdominal pressure. Lots of things to consider and monitor.

It's too bad you weren't able to slip in anything about your out-of-school experience at that first interview, but you have a second chance now. Develop a script in your head for the interview, practicing describing a couple of memorable situations that will put you in the best light possible. Talk about what happened, what you did and what you would do now that you'd be in a more responsible role. You can practice it on me if you want.

If you give good answers to the clinical content on the interview and have a stand-out reason for wanting to work in PICU you can't lose. Puleeze! Don't fall back on cliches, like "I really want to help people" or "I love kids and can't think of anything more rewarding than looking after sick ones." My answer usually falls along the lines of "pediatric intensive care being an extremely challenging job with a lot of stakeholders, and providing the best care possible to a family in crisis is a very important part of it. There's a wide variety of problems seen in the population served and I like to be challenged to learn and grow my skills." That sort of thing.

Let us know how it goes.

Hi all!

I received a call just before suppertime today from the nurse manager in PICU...you were right Jan...I was offered the job! Of course, I accepted the offer! I do have to meet with her in the next couple of weeks after her vacation and go over some fine details, but it sounds like we're both excited about things. I know I am! Thanks for all the support and encouragement. I'm sure I'll be here lots as I go through my orientation and preceptorship periods, asking tons of questions.

Gotta run, back to work in the morning!

TTFN!!

:hatparty:CONGRATULATIONS!!

What she said. =)

I'm so useless with smilies that I'll let Jan's party up there suffice. Congratulations! And let us know how the world of PICU treats you, kay?

This is a great thread!!! I'm also going into my last semester in June and want to work in PICU. I'm crossing my fingers for my last semester internship to be in PICU here at a local hospital and then moving off to Fort Worth, TX and hopefully go to a PICU there!!!

Congrats on your graduation from school!

Let me say first and foremost that as a new grad, the most important thing to know is where you are- not just clinically, but emotionally. I did my senior practicum in a large PICU and literally ran out the doors when I finished my last day. I have always known I wanted to do peds, but knew I was not emotionally ready to deal with the tragedy we deal with daily in the PICU. I am so glad I took a step back and did general peds for a few years after graduation and then stepped it up to peds ED/ urgent care after that. Finally, at 30, I felt I was ready. And I have been in the PICU since.
I have said that teachability and enthusiasm are two of the most important characteristics of any new grad. If you carry those things with you, you can be successful in any area you pursue. The very fact that you feel 'called' to peds tells me you sense a purpose behind your career. That sense of calling will carry you far, as long as you accept the fact adversity will accompany your calling. Sometimes your job will be helping a child die with grace and dignity. Sometimes it will be helping a family let go. These things are a part of being a PICU nurse.

Good luck and Godspeed!

I have an interview Friday with the PICU at Cook Childrens in Fort Worth and I am freaking out...but I was glad to find this post...lots of good information. This is the DREAM job, so I'm thrilled to be interviewing for it before I even graduate!!!

hi,
i have been a peds nurse for say 18yrs now.Have worked in different children's hospital where i had some rotation shifts in general peds and ICUs..but the last 8 years of mine expeience,kinda lost my critical care
opportunities.Am a traveller,..and because ive had previous PICU/NICU experiences,been asked to try the areas too.But the thing is,i dont think m confident to start back on it as this is just my 2nd month in the country....not really sure what diffrences/changes should i take into consideration in view of knowledge and management skills...practices and policies
any advice if would there be like any refreshers course that may be i could
undergo...to help me gain back my confidence/.......????