Continuity of care/Routines - page 2

by umcRN 4,801 Views | 15 Comments

I am looking for information about how other PICU/CICU's manage care for their chronic populations. We are trying to get better at this on my unit but are still struggling to a degree. Have a kiddo now who is waiting for a... Read More


  1. 0
    Quote from janfrn
    There are signs up in several prominent places in the unit that indicate that NO child life services (like sibling support, hand- or foot molds, etc) are to be offered to families until Child Life has agreed to provide them. Why bother at all then?
    So sad :-(
  2. 0
    That is so disheartening that your Child Life Specialist isn't doing what she should be doing. Both peds ICUs I've worked in have had amazing CLS and social workers. I was going to suggest your CLS coming up with a schedule (with the parents) and then having every care provider involved in the patient's daily care (MDs, RNs, RTs, OT/PT, etc.) STICK TO IT...but then I saw where you said yours isn't very helpful.

    Our CLS usually meets with the patient or family and comes up with a daily schedule. It is then printed out and made all pretty with pictures, colors, etc. and posted all over the place in the patient's room. Sometimes it is still a struggle to get patients and families to adhere to this, but usually after a few days and some awesome, tough nurses making sure the schedule is mostly maintained, the schedule sticks. Unfortunately, this requires active participation from your CLS. I have found that the parents are usually quite receptive and helpful (especially if they are involved and part of the planning process), but I'm not sure I have any solid advice on your CLS situation...I'm so sorry!
  3. 0
    I have tried so hard to get mom to make a schedule. I even made one for her to look at and edit to her liking. Nothing! They let him do whatever he wants.
    Lets talk about the past 24 hours for instance. Both parents had to go home last night. Mom stayed until he fell asleep then left. He slept ALL night (he hasn't slept in days, he is usually up calling for them hourly and they come running every time). He woke up with a smile at 8:30 this morning. We changed and got right on his play mat, PT/OT worked with him and various people from around the unit and volunteer came to play with him. At 12 he looked sleepy so I told him it was nap time and put him in his crib. He got a second wind and acted awake but I insisted it was nap time, read a story then lights out. He was out cold in 5 minutes (had he acted like that if mom was there she would have let him back out of the crib and up rather than enforcing a nap). Napped for two hours. Was up playing until I left at 7:30 (though definitely looking ready for bed when I left),music therapy came by and his mom was back. Now mind you when mom came back he didnt really want to play much anymore, just wanted water which is his obsession but he aspirates then gags and wretches awful. I had given him 20ml and a pink swab this morning and told him that was all he was getting and he was fine. Mom just keeps giving and giving, can't say no at all. I am super intrigued to see if he sleeps tonight too now that mom is back, even though he was obviously exhausted.

    Anyways I am also super jealous of all these awesome CLS. Please send some to me!
  4. 0
    Child life SHOULD be a great resource for the pedi nurse. If they aren't, then maybe a talk with their department head is in order about how they can better serve your patient population?
  5. 0
    Quote from Janey496
    Child life SHOULD be a great resource for the pedi nurse. If they aren't, then maybe a talk with their department head is in order about how they can better serve your patient population?
    We have tried. Our units CL therapist has been around "forever" and feels she knows "best" how to help our children (which is basically dropping of a pile of toys and leaving). It's very frustrating and something we have been trying to work on but until we get another CLT assigned to us (which isn't likely to happen for a long time) we have to deal with this one
  6. 0
    That stinks


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