Quote from Wrenslove
I am not new to nursing, but new to PDN. Hospital nursing have set routines laid out throughout the day for cares and checks. Can you let me know what your routine for a vent case is like-- starting from-- when you walk in the door. I know it sounds silly, but I am super new at this and just want to do well.
I've only been doing this for about three months but have two non-responsive, vent-dependent cases that I see routinely. I'd imagine that having a responsive vent patient is a lot different. However, I've finally gotten a basic routine down:
go in, take a visual of the patient to make sure he's not blue or anything, check the Sa02 monitor and the vent settings (the vents we use have very touchy PEEP settings and a wrong PEEP setting can seriously mess up your shift.) From there, it's kind of a decision-tree. If the sa02 isn't where I want it, I get that up - repositioning and oral/nasal suctioning before I mess with trach suctioning, cpt, etc - usually while taking report from mom or the evening nurse if there is one. If the Sa02 is fine, than I get report, do a quick lung/heart/diaper assessment and then sit down to read nursing notes and get started on my own notes.
I don't know if this is because I work nights with both these patients or what but both kiddos have pretty specific patterns for how the night will progress. I have one who desats like clock work around 3 am and again around 5 am. (But mornings always produce more secretions so...) The good part about a usual day, even with a vent patient, is that the day is tailored around the patient's needs/behaviors/patterns. The hardest part about pdn is figuring out how those days work.