Semele

Glad I am not the only one giving themself a shower unspiking a bag. The peds floor I used to work on also contained a general hospice wing. Most pts were elderly and came from a nursing home and had no family. When they passed, we called the doc and got the order and then we call the funeral home etc. One night I called the doc on my pt and told him she had passed and he was quite relieved as she had been suffering yada yada. Of course you realise I called the wrong doc on the wrong pt so I called him back and apologised. He laughed and said for me to keep her comfortable. Wouldn't you know it I ended up calling him later the same night and he actually asked me if I was sure this time. We recently had a pt from Nicarauga come to our facility for a lifesaving esophageal surgery. He and his mother were here for 7 weeks and they learned a little english and taught us a lot of spanish. We had made some cards from an internet translation spot. We were all telling him he was a silly lil boy...we thought. Turns out we were calling him stupid. No wonder he didn't trust us!

I would never put in a 20g specificly for lab draws, knowing how short term it will be and the possibility of collapsing tiny, obviously needed veins.I will do art sticks or even finger/toe sticks to get the lab rather than using a piv. Plus if one nurse draws from the piv and the next sticks the kid..the parents get very confused about why we would choose to stick when the other nurse didn't. What policies do you all have regarding drawing from lines? Our facility even requires a doctors order to draw from PICC lines. We do it frequently but only if said order is on the chart.

Sweetie I didn't mean anything negative by my comment honest. You will find your niche and will help so many other nurses along the way because you will remember how it feels to be treated unfair. I still think agency or even travel nursing might be the way to go...just to get some experience. Travel jobs may be easier to get since you live where jobs are limited. We need help in the PICU...care to come learn with us? I am sorry if my comment upset you. I tend to be very brief when typing and it comes across as abrupt at times. I wish you all the best my friend. We all have to stick together.

We typically use a combo of fentanyl, versed and vecuronium drips.

I will only draw from the initial stick, like others have said. There is usually a good reason for the iv and it needs to be maintained over lab draws. Besides a heel stick or finger stick can get most of what is needed.

Our PICU is all RN staffed, but we do occasionally get NA or LPN help from the peds floor to come help with less critical pts when we are busy. They can feed babies etc.

Not too long ago we treated an infant with DIC. It was horrific and I hope to never see it again. This poor little thing was bleeding from all the little holes we made and we were still having a terrible time trying to get lab because it would clot in the tube or sometimes in the syringe. There was no time to get a central line. He came in through the ER with a three day history of fever and vomiting. 5 wks old. We were able to get an iv and gave lots of FFP and everything else the doc could think of, but he still bled out fairly quickly. Toward the end he was bleeding from every orifice. CPR was ugly for the two minutes that it lasted. That experience pretty much shook every one up for a long time. The doc ordered DIC profiles on like three more patients over the next few weeks. Haunting.

If you have hated what you are doing from day one, job one, maybe it shows through in your work? Perhaps the preceptors arent monsters, but genuinely evaluating you as they see it? I think perhaps agency work where you can try many different places would be worth a shot. You just may find your niche'.

Don't flush ivs in babies and kids with a syringe larger than three mls. I see ER nurses all the time use the prefilled 10 cc syringes. Also heparin for capped lines if you ever want to use it again.

See one,do one, teach one. Welcome to the world of nursing.

I have only seen one case of VAP in our unit and it was a situation where we couldn't rise te head of the bed because of un undone fundo and the child was orally intubated or three weeks or longer. We also only have orally intubated kiddos. In fact I have never encountered nasal intubation. But we don't do cardiac at all.

First of al, congrats on passing boards and entering the world of nursing. It will be a fun and exciting ride full of emotions. You have chosen wisely and you are very lucky to get a great position. You will be years ahea of your fellow grads who start out in med/surg. I work in a unit that has a really good mix of experienced old timers as we call them and young fresh babies and the middle children of which I fall into. We work well together as the experienced nurses know all the ropes and tricks of the trade and they are more than willing to teach the newer blood that is offering them some relief from the overtime. The one piece of advice I can offer is to ask questions constantly. Even if you are fairly certain you know what you are doing, asking advice of other nurses will build trust which is vital in the working environment.

In our PICU we are only required to have PALS and our manager is very good about scheduling time off for the course and we take it in house and get paid to do so. We are not required to have ACLS and so I have never had it...I think this is a grave mistake, as we get adult sized kids and young adults..and even the odd regular old adult who had no other bed so we had to take them. Just this weekend we had one of our beloved patients who had grown up on the floor in our unit because we all work right thre together and the docs are comfy with us. She was 21 and end stage and it was an emotional time of not knowing whether the family would want the chemical code after all. We were getting prepared as the heart rate fell and even discussed drawing up the Epi. LOL! Thank goodness an adult icu nurse had floated down...she laughed at us and reminded us we can just use the whole vial. So there was no drawing up things ahead of time necessary. We didn't end up doing any meds in that situation bu it was a real eye opener about the necessity of ACLS in our unit and I plan to bring it up with our educator.

I think you will find it very comfortable learning alongside nurses who will be thrilled to have the help. Plus you will be exchanging info with the other nurses as they will come to you for questions regarding NICU grads. At least that is the way it is in our unit. We have NICU nurses float to us occassionally and we always try to assign them the smaller babies for their comfort and we usually end up discussing the differences in our patients etc before the shift is over. Mutual exchange of knowledge under friendly terms is great for all.

I have to laugh at the irony most of us display when we discuss legal and moral issues. We will do anything to preserve life, our own or someone elses, yet we will also condemn someone to death when they committ a horrible crime. We put them on trial and give them a fair chance to prove their innocence then we decde their fate. We allow people the right to decide most anything about their lives, why not when they are over? We test people all the time to see if they are mentally competant to stand trial. The same tests coupld apply to whether or not they are competant to decide if they want their life to end. We allow and even rally support for the rights of women to go into the doctor and decide their babies life should be over before it really gets started good. What is the difference between one almost life and one miserable, ready to end life. Because it might get better you say? Depression is curable unlike a physical terminal illness? We are a selfish society indeed when we would rather see someone forced to continue the misery they are seeking to escape rather than taking things into the hands of ther trusted family physician who can aid them in any decision they make, be it treatment options for the depression to make them feel "happy" or an exit on their own terms. I suppose it is obvious which way I voted. Semele