PICU Nurses

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!

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?

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!

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

I forgot to mention that the heparin flushed are for central venous lines
Thanks,
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.

Hello all...
I started out my PICU career in 2001 at Childrens Hospital of Oakland. I loved it there and miss many of my old friends.

After not being able to afford a good home in the bay area, my wife and I decided to move north the the great pacific west. What did we find? RAIN RAIN RAIN.

I am currently employed at a Portland based childrens hospital and have been here for the past 4 years. The people here are incredible also. My only gripe is that we do not have 24 hour in-house coverage. Working 7p-7a can put a lot of stress on RN's with no doc in house.

No place like the PICU!!

Great dialogs. I no longer work in the PICU (miss it )but it's been fun reading these posts. Keep it going

I work at a PICU in pennsylvania. I typically have two kids, if they are both "stable." We have great teamwork here and are planning on building a new childrens hospital so that should be nice. Right now we are a twelve bed unit, and we need about 20-25! Welcome

I have been in the PICU in connecticut for the past 6 months, I transitioned from the adult world to the pediatric world and still do both, but LOVE my kidders much more than my adults. We are an 18 bed unit that takes med/surg, cardiac,neuro,and trauma so a lil bit of everything. We have some 36hr nurses and some 40 with the option of picking up extra as we still have a few positions to be filled. We have A LOT of new nurses, there are times when the most experienced nurse, besides the resource nurses, only has 2-3 years of experience. However, we are really growing and making great strides in pt care. Our pt care ratios are usually 2 pts to one nurse, unless we have a sick cardiac or very serious kiddo then they are 1:1, occasionally we will triple our lil ones that are heading out to the floor or are chronic vents that need vent checks and daily care.