blueflower77

I work in a 24 bed Cardiac PICU and we have the primary care nursing model. I believe it works well for us. Generally what happens is in report, the charge nurse reads off all the patients, then says if they are paired or not, then goes through the pt list and pre-assigns primaries (nurses who have signed up for a pt) and then asks the orientees (if any) which patient they want. After that, the rest of the nurses pick as the charge RN reads off the pt list. Usually, if an orientee wants a pt that has a primary pre-assigned, the orientee goes with that primary nurse. No one usually complains unless the same long-term pt has many primaries that are on that same day/night. For the most part, people communicate well between each other and our families like it. ps: usually, it is customary for the nurse to ask the family first if they are ok with her being the pt's primary, then tell the charge nurse. Once one has signed up, only a supervisor can take the primary's name off to avoid situations like someone taking a particular pt ONLY when they are super sick and taking their name off when the pt is better and jump to another sick pt. It's easy to sign up but takes work to get yourself off the list.

I found Mary Fran Haznski's book "Pediatric Critical Care Nursing" a life saver. In our hospital one of our surgery PAs wrote a book on the most common heart defects in children. Maybe your hospital has gotten a hold of it. It's great. I only have 1 year of PCICU experience, but can tell you right off the top of my head that knowing your EKGs well definitely helps (there is no "best way" to learn, just keep going over them and once you see it on a real patient - you'll never forget!). Knowing how to use the equipment in your hands is almost just as important because during fast interventions it's annoying (to you more than anyone) to putz around looking for "that tube" or remembering how to hook up a pacer. Definitely know that it's impossible to know everything. Sometimes older nurses will make you feel like crap for not knowing something but don't let that get to you. You will know with time. It took me at least 7 months to become more comfortable and not worry every time I came into work. You will also get to know your peers - some are great help in bad situations and some gossip about you if you mess up or ask a "stupid" question. You will learn the good people and who not to ask questions. You don't have to "like" them, but definitely respect the 'dinosaurs' (older nurses) - they can be cocky, but are full of great tips and advice not written in any book! (but take it all with a grain of salt anyways) :) Your orientation people are wonderful resources. Sitting memorizing EKGs and defects at home isn't going to help you. Just bring the book/manuals with you and learn as you go at work while on orientation. Trust me, even the oldest people still look up stuff! It's not embarrassing, it means you know your resources and that's half the battle. enjoy PICU. I hope you will like it.

So I am wondering what visa will I be on while I'm waiting for all this? I can't be on F-1 because I will be done with school and I only have 9 months of OPT left. Will they process everything in time?

Hi Suzanne4 - I have a question for you. I am a current nursing BSN student who is also an international student on F-1. I am just starting the program, which will take about 2-3 years to complete, but I wanted to find out when and how I would start looking for an employer who could sponsor me for a green card (or H-1B). I have already used 3 months of my OPT by working during the summer, so I only 9 months left. I guess I would be ready to move anywhere in the US, but would prefer to stay in the city where I live now. Thanks so much for your help. I can't wait to hear from you (or anyone who could address my question).