Oncology PICU?

[mpier]

I'm an RN in a PICU/CVICU currently and recently got a travel job offer from the PICU at MD Anderson. It sounds intriguing, especially considering the reputation that MD Anderson has. I'm a little concerned that its not going to be a true PICU, more of a step-down, considering that they only have 9 beds and only treat hem/onc patients. Any one have any experience with this type of unit? Thoughts?

[ebritt]

I currently work in an ICU in a children's oncology hospital. We have 8 beds. We are definitely a real PICU. I have also worked PICU in a traditional children's hospital and there are major differences but I wouldn't pass up a great opportunity out of fear that it's "just" oncology and won't be real PICU life.

The major difference between typical PICU and Oncology PICU is that by and large the oncology PICU is full of multi-system-organ failure. there is very little trauma and hardly any isolated system issues- typically multiple organs are negatively impacted by the chemo and radiation and they all go south together. In my unit we do everything but ECMO (just because we are too small and a neighboring hospital takes our ECMO patients if we need a bed). Many of our patients are on hemofiltration or we run CVVH circuts. We have heart failure, lung fibrosis, kidney failure, liver failure, DIC, neuro changes, encephalopathy, any number of post-ops, and all of that squeezes into a tiny 8 bed unit.

All of the above mentioned problems come IN ADDITION to the cancer. I have yet to care for a patient with only one set of doctors, everyone has consulted teams seeing them and it really is a great unit to work on. I would ask MD Anderson what type of patient to expect, because it sounds like they may have a unit like ours, and it is definitely NOT step-down.