PICU Nurses - page 2

Any PICU nurses out here? Where do you work? How is your staffing? How many RN openings are on your unit? How do you like where you work? Let's try to get a dialogue going about PICU issues!:roll... Read More

  1. by   kstinamed
    Hey everyone. I have been a nurse for 6 years. 5 years I worked on the general Pediatric floor and have been in the PICU now for about 15 months. I just wanted to know how long it took everyone to become comfortable in the PICU? How long until I can walk into work and know that I can handle anything that comes through the doors? I am very comfortable with vents and stuff like that but in code situations I feel so completely lost. I thank god for my co-workers everytime that happens. I know that I am a good nurse and while I was on the PEDS floor I felt that I was, but since being in the PICU I feel like I am not such a good nurse because I am not as comfortable in those situations as my fellow co-workers. One co-worker told me it took her a good 2-3 years before she could come to work and know she could handle anything. What does everyone think? Is it going to take more time or am I just catching on slow???? It doesn't help either that lately we have been really slow and having a lot of PEDS overflow kids. Are unit is a 6 bed unit in Detroit and when we are busy we see some really crazy things but during the summer we don't get to use many ICU skills.
  2. by   Grace_RN2005
    Hi, everyone:

    Nice to meet you all.
    Last edit by Grace_RN2005 on Aug 4, '05
  3. by   kessadawn
    i've worked in our picu on and off as a float, and loved it so much i took a full time position! :hatparty: i'm really excited! i should start in the next few weeks, but in the meantime i still float there occasionally. i work in children's hospital in northeast ohio, and we just opened our brand new picu last fall. i think we have around 20 or so beds. staffing on my shift (7p-7a) seems to be 1-2 pt per nurse, depending on the level of care. once in a while we get a kiddo sick enough to get 2 nurses to themselves. nice for nursing care, bad for the poor sick kid

    any seasoned nurses have advice for the new trainee? i have to admit, our orientation time here in my facility is the best, and i'll probably work with a preceptor 2-4 months before i go out on my own. of course, i can still take stable pts on my own, like i do as float, but i like that feeling of security having someone there gives me with the more unstable kiddos right now. the cardiac babies scare the he** out of me!.[/
    font]

    Quote from biscuit_007
    any picu nurses out here? where do you work? how is your staffing? how many rn openings are on your unit? how do you like where you work?

    let's try to get a dialogue going about picu issues!:roll
  4. by   kessadawn
    hey kstinamed, don't fret! i mentioned the exact same concern to the nurse manager in our picu and she said she would be worried if i was totally comfortable with every kid down there! stable post-sugicals, rsv babies, maybe, but the cardiac babies and some of the horrible abuse cases we've seen, she said we should never be comfortable with those kids, and always be ready for anything.[/font]

    Quote from kstinamed
    hey everyone. i have been a nurse for 6 years. 5 years i worked on the general pediatric floor and have been in the picu now for about 15 months. i just wanted to know how long it took everyone to become comfortable in the picu? how long until i can walk into work and know that i can handle anything that comes through the doors? i am very comfortable with vents and stuff like that but in code situations i feel so completely lost. i thank god for my co-workers everytime that happens. i know that i am a good nurse and while i was on the peds floor i felt that i was, but since being in the picu i feel like i am not such a good nurse because i am not as comfortable in those situations as my fellow co-workers. one co-worker told me it took her a good 2-3 years before she could come to work and know she could handle anything. what does everyone think? is it going to take more time or am i just catching on slow???? it doesn't help either that lately we have been really slow and having a lot of peds overflow kids. are unit is a 6 bed unit in detroit and when we are busy we see some really crazy things but during the summer we don't get to use many icu skills.
  5. by   zoxena&Alexis
    I work at Childrens in Dallas, Texas, as a "newbie RN" (graduated in Dec 04 and started in Jan 05) on the Trauma/Neurosurgery floor. I love it. We have a 6 month internship and then they set you free. I feel that I was prepared well, and there are many days I still have so much more to learn. That is what is so great about nursing. As far as comfort level, I wouldn't be comfortable with an ECMO or CVVH kid yet, but they also make our assignments based off of level we are.
    We have 3 split PICU's, one for Cardio, one Level I Trauma/Neuro, and one Medi/SICU unit. I love it here, we float amoung all units so you learn stuff all of the time. We are the only Level I in Texas, so you name it we pretty much see it. We work with all vents and ECMO. Staffing here varies, depending on the census, we can be slammed and then nice and peaceful, but that is usually the silence before the storm. PICU and CVICU here are all so awesome and there is great teamwork. We do have open RN positions.
    Last edit by zoxena&Alexis on Aug 13, '05 : Reason: added info
  6. by   Okiecruffler
    Children's Hospital Oklahoma City here. We run 18 beds but can usually only staff for 16 and that's if they are all 2:1pts. We have 2 top notch cardio surgeons so we see 6-10 hearts a week. We used to see alot of neuro kids, my personal favorite behind trauma, but we've lost our neuro surgeons so that will slow down until we replace them. We do three 12 hour shifts a week with one on call day every other week. Typical nursing is 2:1 except on the fresh hearts and otherwise critical kids. A few of us in the old guard will take 3:1, but only if we're babysitting floor bait. I can't see myself working anywhere else.
    BTW, we just stole 2 of your docs from Dallas, Dr Gormley and Dr Allen, but to be fair, they were our's first.
  7. by   blueinplaid
    Quote from biscuit_007
    Well I have moved. I now work in a 6 bed picu in temple texas. We have 3 intensivists a great staff and loads of patients. We are affiliated with texas A&M medical school. GO AGGIES!


    GIG 'EM AGS! i went to A&M for a few years, but decided to leave to go to nursing school! When I graduated with my BSN, I worked in the PICU for 4 yrs. I MISS MY PICU! I'm from Texas, traveled a bit in NY in the PICU, saw some pretty scary units as far as treatment, doctors, etc. and I left to learn a little about adult medicine as my parents are getting up in years, and am now 7 months in ER. I miss my home PICU! I don't care for pediatrics, just intensive care. When I complete my year, I'm taking my bonus and heading back to PICU!
  8. by   NotReady4PrimeTime
    I work in a 16 bed mostly CT PICU in Edmonton, Alberta, Canada. We have a transport team and an ECMO team as well as providing pediatric code coverage for the whole hospital. Our staffing is generally adequate, although there are times when it's not... those days where we suddenly expand to 18 beds, for example, or we cannulate three kids onto ECMO on the same shift. However, we have a lot (~2 dozen) of very junior nurses who don't receive what I consider to be proper development. They are often thrown in at the deep end because things have changed and there are no appropriate assignments for them. And that would be the time when the people who might otherwise be resources for them are too busy doing their own jobs to help out. I feel very bad for everybody on days like that. We seem to have a lot of positions open at the moment. Make that most of the time. I was hired away from a hospital in another province during the course of a telephone interview. Right now we're going through one of our very infrequent slow periods... it's great!
  9. by   RuralNP4KIDS
    Jeff,
    Hi there. I am in VT and we transfer kids to you. Your director of nursing (Aden) was my assistant NM when I was a staff nurse in PICU at Childrens in Philadelphia. Is that a small world or what?
  10. by   karatenurse
    The PICU is the best place to work! You take care of kids of all ages and with different diagnoses. It's always a challenge, and I am looking into becoming a PICU NP. I work in New Brunswick, NJ, and our PICU is now 20 beds. This winter has been weird so far, as we haven't been busy. Usually we are bursting at the seams! As corny as it sounds, you can really make a difference in the PICU and it is so much more interesting than working on the regular Pedi floor!:angel2:
  11. by   pedseducator
    I have worked PICU for many years and love it. I need some help with concentrations of heparin flushes for either age-wise or weight-based dosing. If anyone can help, it would be greatly appreciated. Need to know what the rest of the world is doing.
    PICU nurses have huge hearts!
    Pedseducator
  12. by   pedseducator
    I forgot to mention that the heparin flushed are for central venous lines
    Thanks,
    Pedseducator
  13. by   NotReady4PrimeTime
    Quote from pedseducator
    I have worked PICU for many years and love it. I need some help with concentrations of heparin flushes for either age-wise or weight-based dosing. If anyone can help, it would be greatly appreciated. Need to know what the rest of the world is doing.
    PICU nurses have huge hearts!
    Pedseducator
    We use commercially available premixed heparin lock solution for most of our patients. It's the 10 units/ mL solution and if it's used properly, we don't have any problems with it. For neonates, we use preservative-free heparin lock solution prepared by our pharmacy. It too is 10 units/ mL and comes in pre-filled syringes. The volume of the flush depends on the volume of the lumen. UVCs only need 1 mL, most short term lines only need 2 mL and the tunneled ones the volume on the port plus 1 mL.

    Now, our pressure lines are a horse of a different color. We use a 1:1 solution for all lines on kids over 10 kg on a pressure bag at 3 mL an hour and 2:1 solution for the little ones, on a pump at 1.5 mL an hour for art lines and 1 mL an hour for CVP, LAP, and RAP lines. We almost never have PA lines.

close