New Hire at Pulmonary Progressive Unit

Mary C, MSN, RN, APRN, CNM · Oct 9, 2008

I will respond to myself many months ago!!! This is just my :twocents:

Learn every way oxygen can be delivered. Learn all you can about COPD. Learn the difference between Pressure Control, Volume Control PRVC, CPAP (weaning modes)... Learn Tidal Volume, PEEP, Fi02... Review breath sounds, lung sounds, even the funny named ones!!! :jester:

Most importantly, find a nice respiratory therapist. They can be your absolute best friend and angel!!! Ask them questions. Watch them do procedures. Watch their technique. Ask for tips. Volunteer to help them. Ask for warning signs to look for. Know when to page them. Be nice enough to them that if you page them for a really dumb reason, they can laugh and explain what happened and what to do next time!!!

But most importantly, know what to do if a patient decannulates!!! And always always always remember that if you can't figure out what the heck is wrong with the vent, ambu bag ambu bag ambu bag!!!

If the vent looks like it's broken; If the tidal volume is really low; If the vent screen is blank; If the pt is inexplicably desatting while on the vent on 100% O2 and has been suctioned (& all connections appear to be in tact); If there's a major air leak ... Please just BAG THEM!!!! :nurse:

PageRespiratory! · Oct 10, 2008

"Pulmonary Progressive Unit"...........is that a weaning unit? What kind of vents are you using? You liking it so far?

Mary C, MSN, RN, APRN, CNM · Oct 10, 2008

"Pulmonary Progressive Unit"...........is that a weaning unit? What kind of vents are you using? You liking it so far?

In theory, yes. We get patients directly from ICU (our next door neighbor). Normally it's more "we gotta make a bed opening in ICU" and we get some pretty unstable patients not ready to wean. But in theory, it's supposed to be a step down. Word on the street is that we're merging (we're cross training in critical care classes currently) with ICU to be either a Pulmonary ICU or a trauma ICU (vents).

PS I LOVE THE NAME PAGE RESPIRATORY. LoL i say that several times a shift.

nerdicus · Apr 13, 2009

I'm interviewing this week for a position in a Pulmonary PCU. Now that you've been there awhile are there questions you'd wished you asked during your interview?

I'm reviewing my vent settings, and the other recommendations you made...

Thanks

Mary C, MSN, RN, APRN, CNM · Apr 14, 2009

Yes, I would have asked what the Nurse to Patient ratio is! You need to have no more than 3 or 4 in order to give adequate patient care-- ventilator dependant patients are normally coming with a complex myriad of other health issues and often lack mobility. Make sure that it's a manageable patient load.

I would have also asked about the training for the unit-- how much time you spend training-- how much is classroom and how much is working with a preceptor nurse?

Finally, I'd want to know if you get to hang out much with RT's. Like I said, I learned SO much from them.

I actually had my last week in Pulmonary last week, and got my dream job in Labor & Delivery. Pulmonary was a very interesting unit and I learned SO much.... I think I might actually miss my patient having an airway and I may miss wound care!

nerdicus · Apr 15, 2009

Well I finished my interview, and asked many of the questions recommended here. Unfortunately it sounds more like a normal med/surg floor than it does a Pulmonary PCU. In fact the nurse manager even said, "It really should be a called multi-system PCU". And with a 5:1 ratio, no ventilated patients at all, and "lots of our patients are bariatric patients as well" it sounds closer to a normal floor than it does a PCU. At least it's a day shift (for me personally, nights are a killer). I'll be honest - I'm disappointed. But I might not have much of a choice.

Mary C, MSN, RN, APRN, CNM · Jul 16, 2009

Well I finished my interview, and asked many of the questions recommended here. Unfortunately it sounds more like a normal med/surg floor than it does a Pulmonary PCU. In fact the nurse manager even said, "It really should be a called multi-system PCU". And with a 5:1 ratio, no ventilated patients at all, and "lots of our patients are bariatric patients as well" it sounds closer to a normal floor than it does a PCU. At least it's a day shift (for me personally, nights are a killer). I'll be honest - I'm disappointed. But I might not have much of a choice.

Just saw this-- oh no. That doesn't sound like what you're looking for. What did you decide? I loved my vented patients!