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picunurse217

picunurse217

PICU
New New Nurse
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picunurse217 has 2 years experience and specializes in PICU.

picunurse217's Latest Activity

  1. So I work in the PICU and I have about a years worth of experience under my belt as a new grad. I guess several years ago the PICU I work in had the cardiac surgeon leave and the PICU lost its cardiac cases. but recently we got a cardiac surgeon back and now we're taking on cardiac cases again. We've only had a few so far and they've been assigned to our more senior nurses who have experience with the cardiac cases from the past for at least the first 48 hours post-op, but management has basically said that any of us should expect to be the main nurse for the post op cardiac patient depending on staffing. we're a pretty young unit with a lot of new grad/inexperienced nurses and most of us haven't been oriented to a cardiac patient ever. learning new drips, side effects, and just nursing care overall of a cardiac patient seems kind of intimidating. managing cardiac patients is a different type of nursing that my PICU training didn't teach me. management told us they were going to do simulations and education sessions for those of us who have never dealt with post op cardiac cases but instead they said they didn't have time to and sent us out a giant packet of papers with a couple articles and some powerpoints made by our surgeon about how to care for these patients. and then we're supposed to take a quiz on it. and that's it? to me it just doesn't seem like adequate training especially for new grads to be able to take on a patient as complex as these kids can be. maybe I'll feel different if I end up with one as a patient of my own, but as of right now it seems like it could be a safety risk for the patient and for my license and the license of the other new nurses.
  2. picunurse217

    New Grad PICU Nurse Help

    I started in the PICU last Summer as a new grad. I went through a 6 month orientation on the unit and have been on my own for the last couple months as a nurse. There are days where I feel like I have it all together and I make all the right moves, report critical assessments to the docs and modify the plan of care appropriately with the help of the rest of the PICU team but there are also days where I feel... stupid. Like just dumb mistakes or things I should have known to pick up on. For example the other night we had an overflow patient from the acute floor who was being discharged home and I forgot to check for the discharge order from the docs. The resident gave me the okay to do the discharge instructions and said she could leave anytime after X time but I just forgot to check it and sent them home. Even though it was okay to discharge them, I should have known to get the order placed. Or I had a DKA one night and the sugar was coming down very slowly. I mean very slowly. Like 4 hours after admission it had only gone down by 100 points on an insulin gtt. And I checked the IV site and it flushed fine and it looked okay and I had someone else check it and they flushed it and it looked okay and then when I was passing the patient off to the next nurse who was more experienced than me (I only had the pt for 4 hours because I was in for an overtime shift) the nurse thought maybe the IV was bad and the skin looked more taut at this point and it was cold at the site.. I should have kept a better eye on the IV site and checked it more frequently. And as soon as I questioned the integrity of my site, I should have used another site for the infusion. I was just wondering if anyone else has felt this type of frustration and made mistakes like these or if it's just me, and if anyone has any advice or words of wisdom for someone who is dealing with this frustration. I started with 2 other new grads but we almost never work the same shifts as me and I don't always feel comfortable sharing this with people because I don't want people to see me as incompetent or like I'm not the right fit for the ICU.