The LEAST critically ill kid you've cared for in PICU :) - page 2

So last night I admitted an eleven-month old fro the ED into a PICU bed for acute asthma. The floor doc declined him due to his 'instability' and 'acute distress'. The first HOUR this kid spent in the PICU was spent jumping... Read More

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    Quote from Janey496

    For what its worth, In my PICU, I find that when kids don't get transferred out, it's more often because the doctors don't want to, not the nurses.
    Exactly! Not many ICU nurses want to keep that screaming 10 month old who just wants to be held and entertained 24/7...
    dirtyhippiegirl and marycarney like this.

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    Aaah, sorry, didn't mean to offend. I guess I should have added the caveat to my original post that I was mostly frustrated with the politics surrounding my particular hospital's PICU, of which I don't want to get too in-depth for fear of outing myself to the wrong people.

    The ability of a sick-sick or sick-stable child to crump suddenly is one of my unit's biggest collective fears since we've become overflow (we do pediatric burns, big burns in theory but in practice anything big and under 14 years gets life-flighted to Shriner's so), so I do *understand*...I was mostly just using this topic to inappropriately vent about a particular situation. I'm sorry!
    hikernurse and NeoPediRN like this.
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    Quote from dirtyhippiegirl
    Aaah, sorry, didn't mean to offend. I guess I should have added the caveat to my original post that I was mostly frustrated with the politics surrounding my particular hospital's PICU, of which I don't want to get too in-depth for fear of outing myself to the wrong people.

    The ability of a sick-sick or sick-stable child to crump suddenly is one of my unit's biggest collective fears since we've become overflow (we do pediatric burns, big burns in theory but in practice anything big and under 14 years gets life-flighted to Shriner's so), so I do *understand*...I was mostly just using this topic to inappropriately vent about a particular situation. I'm sorry!

    Inappropriate vents are our FAVORITE kind!!!! No worries!
    DizzyLizzyNurse, WoosahRN, canoehead, and 1 other like this.
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    My new standards of "You do NOT need a PICU bed" is this: Anyone who can eat chicken fingers and ranch dressing, coke and fries? No PICU bed for you!
    KelRN215, WoosahRN, hikernurse, and 4 others like this.
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    at my hospital all pre-glenn cardiac cath patients have to stay overnight in the CICU for observation. I admitted one today, big fat chunky 4 month old who w/in the first 30 minutes of waking up from anesthesia ate SEVEN OUNCES of formula, thats almost unheard of for a cardiac baby. Once he was allowed to not be flat (6 hrs post cath) he was dressed and strolling around the unit in the wagon flirting with all the nurses.

    Very very sick obviously
    KelRN215, fashionistaRN, hikernurse, and 3 others like this.
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    The PICU I worked in was generally very high acuity, so we shipped off kids to the floor as soon as we could...except when politics came into play.

    One of the surgical attendings had a daughter who had CF...the mildest case I've ever seen. Even on her sickest days when she came in for a clean out, there were kiddos up on the pulmonary floor who were in much worse shape than she was. She never went to pulmonary, always to the unit to be cared for only by certain nurses. After her clean out, she would be discharged home. When I would do my charges she always came up as a 1:3 care...which means she needs to go upstairs. It never happened.

    Only certain beds were acceptable. Bed 8 was her favorite. Bed 1 was okay too. Don't even think about Bed 11-16. Bed 25 will do in a pinch, but it was only temporary. Mom (an RN) and Dad did most of the care...all the PDs, meds, treatments. All I had to do was chart and occasionally do a little nursing here and there. She was a sweet little girl, although she was a bit spoiled. She would always say "Please and thank you", but expected to get what she wanted when she wanted it. Taking care of her required not so much the skills of a critical care nurse, but as a successful waitress and/or cruise director.

    Other nurses complained, I just played the game and enjoyed a very easy assignment/break whenever I took care of her.
    KelRN215 and hikernurse like this.
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    Quote from meanmaryjean
    My new standards of "You do NOT need a PICU bed" is this: Anyone who can eat chicken fingers and ranch dressing, coke and fries? No PICU bed for you!
    And yet if they have obstructive sleep apnea from all these chicken fingers and need bipap at night...they will be found in my icu, because the floor can't do bipap
  8. 1
    Our floors do Bipap (if the kid is a home bipap) but will not take home vents - no matter what. So we get every home vent kid who comes in for T&A, scolis, heel-cord lengthening......
    anon456 likes this.
  9. 0
    Quote from meanmaryjean
    Our floors do Bipap (if the kid is a home bipap) but will not take home vents - no matter what. So we get every home vent kid who comes in for T&A, scolis, heel-cord lengthening......
    Same here about the vents! (clearly if the floor won't do home bipap, they won't do vents) Except i'm in cardiac ICU but if an old MRCP PH-er comes in for hip surgery it's us that's got him! And all the other cardiac home vents, but the picu is the same of course, they get all the non-cardiac home vents
  10. 0
    I worked in a PICU that took every pt that had a VP shunt not just malfunctions. If a pt coming in for an t+a or appendectomy etc had a VP shunt they had to stay in PICU through discharge. Apparently due to a sentinel event but it seemed silly to have kids who were fine hooked up to monitors all the time in a PICU bed.


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