PeakRN

Just for perspective I have found essential hypertension in otherwise healthy 2 and 3 year olds several times in the ED. While the ED is not the kid's primary care, that may be the only medical provider they see for months or years. These kids could ...

When we hire in my center we typically favor critical care over floor pediatric experience. Unfortunately adult med/surg is unlikely to give you either experience, but you also have to start with the job you can get. If you are willing to relocate th...

The ICU book. The Ventilator book.

Query: Professionalism.

One of our PICU intensivists loves giving haircuts to the long term kids.

Reducing dislocations. Instantaneous gratification.

While I agee with some of this I would like to clarify a bit. I was a messy medic. The floor and bench of my bus were a disaster by the end of my call. That was because we thoroughly cleaned the back after every call. Also since we only us a few call...

You seem to have a bit of a chip on your shoulder. Why did EDs start hiring paramedics? Simply put they are cheaper labor than registered nurses. Paramedic and nursing education is not the same, I’ve done both. Paramedics are taught the technic...

In my opinion your ED has not provided adequate training. All of our new grads must have ACLS, PALS, TNCC, ENPC, NIHSS as well as complete their online ED modules and all of their staged orientation (which would include things like gastric tube place...

We never furloughed anyone, but we did cancel every traveler and PRNs have been removed from the schedule. We did rotate a lot of nurses with adult experience back to the adult world. PICU nurses back to adult ICU, peds onc to adult onc, peds floor t...

I’ve taken care of more famous people and their families than I can count. Professional athletes, national media reporters, politicians, several heirs to european monarchies, CEOs who’s names are nationally known, and so on. We are a bit well known a...

No offense but if you have nothing to do as a nurse on a peds unit for several hour you aren't really a peds nurse. There is always a kid that needs help with homework, another disease to be studied, an infant that would benefit from holding, and so ...

For something like a glucose check I don't understand why you would really need to use the limb alert arm. In the unit we stick patients every hour when on IV insulin, often (repeatedly) on the finger of their choosing.

I'm fortunate to have the perspective of having worked with adults and peds in EDs and the units. Life is unpredictable, it isn't fair, and not everyone gets dealt a good hand. I've had plenty of kids with poor outcomes from heart disease, the flu, a...

I think that it's just part of the business for hospitals that have unions. There is probably variation based on union contracts and state laws, but if your union has the right to strike then is it egregious that the hospital has the right to hire te...

Do you have TNCC and ATCN?

I did the hour commute (a decent bit more than an hour actually) for almost two years. It wasn't fun but it can be done. Some HCA hospitals have a very poor reputation, some have a good reputation. Magnet status does not guarantee a good manager or a...

It depends on the matrix but if we are down one nurse (as long as it is a float/resource) position and not a patient assignment we get your normal pay (1.5 for overtime, regular pay if under 40 hours, etc). If we are down two nurses they offer $10 an...

The society of trauma nurses has a study guide.

Because the expectation of parents and family are just that. They aren't going above or beyond, but rather to not be present is to do less. When you become a parent the bar is set at the top. This isn't to say that the family doesn't have a hard go a...

I don't say this as an anti religious statement, but those aren't just miracles. Those kids are the result of the hard work, perseverance, and love from their nurses, docs, therapists, pharmacists, and every other member of their care team.

The hard thing about premies is that their NICU course may have little to do with their eventual outcomes. I have taken care of 23 weekers that code 5+ times and make it out without any serious deficits. I've taken care of 'healthy' 32 weekers who en...

Know your limits, know your emergency drugs and procedures, learn when to say no. Take advantage of every learning opportunity. Don't be afraid to ask questions. Don't be afraid to talk to the Docs. Don't get abused, but don't immediately withdraw f...

Another thing to consider is the massive difference in independence in between the NICU and PICUs, even if the latter cares for preemies. We will take premies as long as they present with serious congenital heart disease, but our management is very d...

If an ED has ESI 2 patients waiting in the waiting room for any amount of time, but especially over 10 minutes, the leadership needs to restructure how the department flows.