PICU preceptorship...what to expect

Esme12, ASN, BSN, RN · Jan 8, 2014

thread moved for best response

Annaiya, NP · Jan 12, 2014

The PICU is not a unit where you can just step in and start doing things, so communicate a lot with your preceptor. Show an interest and willingness to learn and that will help. Hopefully you will have some sick assignments so you can get a feel for the environment. This time of year there tends to be a lot of respiratory stuff, so maybe review blood gas interpretation, and vent modes and settings.

Also be sure you know what you can and cannot do as a student. That will help you be able to ask to do stuff. I usually tried to let my students draw off an art line, suction an ETT, and then I wanted them to start trying to remember and write down vital signs every hour. The pace and time management in the ICU is very different from the floor, so I think it's good to try to get used to it.

Try to focus on priorities and time management. Make sure you know everything that needs to be done and start thinking about how you would organize it all efficiently. Also figuring med administration and access issues is a big part of the job. It's rare that you have a sick ICU patient with plenty of places to give all of your meds and your continuous sedation.

Medications that are used frequently in the ICU that would be good to look up are rocuronium/vecuronium, fentanyl, versed, Ativan, precedex, ketamine, propofol, glycopyrolate, atropine.

The PICU is a fabulous place to work. I hope you enjoy your experience!

meanmaryjean, DNP, RN · Jan 12, 2014

The other BIG factor in the PICU is the presence (or absence) of parents. They are just as big a part of the workload as the patient themselves. They are the 'clinical experts' in what the patient's baseline neuro status is- and if they tell you something is wrong BELIEVE THEM!

One thing you must understand and respect is that not everyone 'parents' their children as you would. That- to me -is the most difficult part of my job on a day to day basis.

Pediatric Critical Care Columnist · Jan 12, 2014

There are numerous other threads that cover this topic really well. Have you read through them?

Nurse_Bella · Jan 12, 2014

Thank you so much for all your responses! I will review everything suggested, especially the ABGs, meds, dosage calculations, and respiratory/ventilator material (I feel that's an area I definitely need to go over as well and I haven't had much exposure to ventilators in my previous rotations as the patients on a general floor did not have too many complications). I wasn't expecting to get put in a critical care unit for preceptorship and I was initially a little scared. But now that it's sinking in, I am starting to feel more curious and excited as many have been telling me it will be terrific learning experience :) I will not let this exciting opportunity go to waste and will try my hardest to learn everything I can :)

janfrn, I started researching the other threads right after I posted this question and there are so many I definitely found them helpful and they all reassured me that I will be ok :)

Pediatric Critical Care Columnist · Jan 13, 2014

That's great! I knew you'd find lots of tips and suggestions on making this preceptorship work for you. I hope you'll come back and share your impressions!