EmilyUSFRN

i've used my brain sheet for about a year. not foolproof but definitely works for me-- on the right side of the page are spaces for each hour of the shift, what needs to be done when... and on the right i have 5 big boxes (normal patient load) with room for name, age, room, dx, doc/team, IV site/fluids and misc info and to the left of that on each kid i write the WEIGHT as everything in peds is based on weight. i carry that around in my pocket with me so i can whip it out when a parent asks when the next med is due or the POC for the night, and also... our IV pumps ask for pt weight as a safety mechanism so that is valuable to have on hand instead of leaving my pt w a beeping pump i just turned on... anyway, good luck in peds!!

well, we just got rid of 1:1 due to hospital wide budget cuts, so cameras were installed in pt rooms and a sitter now sits at the desk and watches the monitor of all these pts simultaneously. so now more space at the nurses station has been taken up, there isn't any real 1:1 there anymore, and the "sitter" is supposed to use the calllight system to tell the pt to stop or get back in bed. really, REALLY dumb

i think we're long lost sisters. seriously, i panic too! someone just has to say "i'm nauseous" and immediately my heart starts racing and I panic. My ex boyfriend would say he was nauseated all the time.... and it got to where I would grill him, asking if he felt like he was going to vomit OR he had indigestion, etc. usually it was the latter. I've pinpointed that its the noise of retching that get me. I've cleaned it up many times without problem. I work in peds, so most of the puking episodes i deal with are the kiddos after eating, or taking a gross medicine, that doesn't bother me. It's the older kid, or someone post-op.... i get a little nervous automatically... its weird. hang in there, i am!

our p&p for post-op patients is vs q 30 mins x 2, q 1 h x 2, q 2 h x 2 then q 4 standard floor vs. also, for anything requiring q 1 h or more frequent (like resp. nebs), we can only do it for 2 h, anything beyond that the child needs to go to the ICU for more frequent monitoring.

if you have the time to read it, i highly recommend "Nursing Against the Odds" by Suzanne Gordon. I read it and I think it gives a pretty good picture into the life of nursing, not so much the sugarcoated things we're fed. As far as your questions go: Can anyone out there shed some light on what would make a good nurse? A good nurse,I think, needs to be knowledgeable about his/her patient conditions, pathophysiology, medications, as well as the technical skills you learn. A good nurse can organize and prioritize well, should be pretty flexible, and keep their patient's best interest in mind. They should not be afraid to advocate for their patient, as well as be able to treat the patient w dignity. What are the best things about being a nurse? Job security, working three days a week with a decent pay, days when you leave and know that you did what you could to genuinely help someone. What are the worst things? This is where the book comes in.... for me, having higher-ups not always backing the nurse, staffing issues sometimes--although rarely where i work thank goodness, nasty attitudes of the patients, and i mentioned decent pay, butttttt it could definitely be better! Good luck to you

i work in pedi, but we float to PICU, NICU, newborn nursery and the postpartum floor and have an assignment of just babies. Part of orientation to our floor is to float and have a preceptor on each of those floors since things are really different. Maybe your manager or education coordinator could arrange that, if not for you, then the next group of new grads... However, we float somewhere I'd say once a month. Luckily, our census has been nice and high so its not as often these last few months. PICU floats to us often, but rarely do we get NICU nurses, unless they're pool and then its just part of the job description.

I'll try to answer your questions, as I'm pretty new myself, 9 months in... I've explained to parents many times that the pulse ox is just a machine and many things can cause it to go off, it helps me to evaluate the child, but it is not diagnostic. Usually it self corrects, and I've asked parents to let me know if it goes off persistently for longer than say 10 seconds. Otherwise they will stand over the crib freaking out and wondering why I'm not doing something every single time it beeps. As far as normal desating, that is pretty much age related too. As far as I'm concerned, it is acceptable to say to a parent that when it beeps sporadically, thats usually ok and part of the child's breathing pattern, and if you were at home, he/she would still be breathing like that, just without accompanying beeps. We keep bulb suction in the crib for our RSV kiddos and if they have secretions, we suction them prior to feeding. I've deep suctioned only a few times, as the bulb suction will usually work, and i'll keep the nasal cannula on them even though O2 is turned off, but can be turned on without wrestling. If I'm unsure, I definitely utilize our RTs. They're amazing! You'll learn a lot more about respiratory problems and management when you take PALS.

i learned "chart on exception". we have flowsheets, obviously. i will usually write "assessment completed per flow sheet" with notes pertaining to whatever tubes the pt has, orientation, and then whatever the plan of care is, charting specific to that, regarding interventions and whatnot. it usually ends up being 6 or 7 sentences.

i think you should expect to revamp your time management skills if you have many struggles w time management, ditto for organization. you will be studying and reading ALL the time. it gets boring, frustrating, and awful feeling (myself, reading makes me fall right to sleep in a pavlovian style, so I would go to the library, the park, a coffee shop, ANYTHING to not fall asleep). what you learn your first semester is the basic fundamentals of nursing practice, the things you will do most often. everything else builds on this information, so pay attention!! Your school should have the prices in a catalog or online (cost per credit x credits taken, just like normal school). be prepared to spend money on things like uniforms, supplies, and sometimes testing supplies. You'll make new friends and they'll know what you're going through, so be prepared that noone else will and chances are your own family won't understand what is going on in your life. IT GETS BETTER! Just stay on top of reading/studying and take care of yourself.

our nicu-- hospital issued scrubs, full 3 min surgical scrub prior to pt care and upon returning from lunch break or somewhere else not the nicu. each baby has their own stethoscope and thermometer. you don the overcoat for each different baby for feeds. no drinks allowed at all, even covered water bottles, no watches, rings, etc. hooking a baby up to anything-- IVs, central lines, connecting HAL requires full sterile procedure-- hat, gown gloves, certain curtain shield thing... i work in pediatrics, so when floating to the nicu, it's like a whole 'nother world, but there were some infection issues a few years back i suppose. definitely a different environment.

2 things different with working than being a nursing student, -going from not knowing anything, to having to know everything seemingly overnight -responsibility and my license on the line. 3 things that helped you to succeed in the role as as professional nurse -organization! i spend a good amount of time prior to my shift starting getting organized, not just my paperwork, but my pockets, claiming my "spot" at the desk, and doing chart checks at the beginning to make sure something important, like a bowel prep, wasn't neglected to be passed on -asking for help when i need it, and not letting myself continue to drown if i'm overwhelmed -a good support system outside of work, of nurses and non-nurses to help me keep my sanity, remind me that i'm a good person, and that i can't always do it all. and how can you handle the care of more than one pt., it seems to me impossible right now. -you just learn to prioritize. you will know what you have to do, what you need to do prior to the end of shift, and what is able to be passed on. i'm not one to pass things on if i can help it, but its a 24 hr job, and sometimes you can't do it all. if you have someone requiring some extra attention, a glass of water and extra blankets can wait until the next time you're over there.... it really just comes with time though.

liquid colace. i've tasted it. terrible stuff. i'd say 7 times out of 10 its guaranteed the kid will puke.

worst: a plastic non dishwasher safe coffee mug advertising the opening of a new area of the hospital best: $100 publix gift card for the holidays and a nice polo shirt for pedi nurses week

as of 09/01/07 we were not allowed to wear crocs with holes at my facility. starting in june or july they put flyers up saying this. but, we can still wear the clogs that have a solid top, no word on heelstraps. personally, i thought it was kinda disgusting to be wearing shoes with holes in the top... what if something gross got on them and inside and on my socks? the thought of that just grosses me out. so i have solid clogs and do just fine.

i've had families completely chew me out when they wake up next to their kid and there is some trash in the wastebasket (not overflowing) and a few towels in the linen bag hanging in the bathroom and demand to know why i didn't take it out during the night. i have had a few kids that demand a cup of sprite and when i said "i'll be glad to get if for you after you say please" they say "nevermind. i don't want it anymore." I have not really been disrespected by doctors. The ones I have been fortunate enough to work with are pretty cool and listen to what I have to say. I have to agree with the above poster; thinking of all of the experiences I've had I think most of the abuse comes from the families... after explaining unit rules they still want to bend them and feel that their neighbor shouldn't have visitors but there is no reason they can't have 7 in their small little room.