Okiecruffler

I love that this thread keeps coming back to life. It shows me that I was not alone in how I felt. It is true that most of your pts live and get better and go about their little lives. But those are harder to remember. It's much easier to remember that BT shunt that threw a stitch and bled out before you could call for help. I remember each and every one of those who didn't make it. I carry a part of each of them with me. Each of them taught me something and I owe them for that. On a board in my shop I have pictures of some of them, obits, a hospital wrist band. I think of them as MY children, and in a way they are. Now I work with CP kids, I'm barely a nurse. It's a different kind of pain, and they teach me as well. Nothing but love for you....John

Reminds me of my very first patient in the PICU. Here I come to meet my preceptor, me a big bad ass nurse fresh from adult CCU. I find her sitting at the bedside of a beautiful 8 y/o boy. So I ask, "so what's the plan today?" She tells me we're waiting for the phenobarb level to drop so we can declare brain death. I learned alot about myself in the next 12 hours, some stuff I didn't want to know. Still not sure how I managed to go back in the next day.

Horribly painful, beautifully touching. I've always said, I've met people at their absolute worst, and been surprised by how wonderful they are. Too many times the immediate family is in such shock that the peripheral family comes into play which can be good or horrble. Now I work at the other end of the spectrum, rehab for mostly CP kids. About 80% of our's are happy kids, even if they aren't great candidates for rehab alot of the time. But then there's that 20% that should not be. I have one pt, 6 y/o profound MR. blind, deaf, responds to stimuli with seizures. Family is just as good as gold, his skin looks great, no contractures, but also no awareness and I have to be at the bedside with ativan for diaper changes. Wonder why I miss a good trauma every now and then?

I sometimes think that doctors are our worst enemy. Working for so long with residents I've seen all the false hope I ever want to see. Had a 14 y/o come in one night, ATV accident, C2 internal decap. I took him down to radiology with the bright new resident at my heels. Even the housekeeper could have spotted the herniation. We get upstairs and I start a round of manitol. Mom ask the resident if this med will make everything alright. He looks her straight in the face and says, "Yeah, once this kicks in we'll be in good shape." I had the charge run him back to his den while I sat down with the family and explained what was really going to happen. I used to have a picture of a room in our PICU. Somewhere in there was a bidirectional glen pt who hadn't come out well, but you couldn't see him. All you could see was the ECMO, the PRISMA and 3 full IV trees. I used to show it to people who said how nice it must be having a job where you just played with kids all day.

This is what I was hoping to see, an open discussion that boils down to "damn right, this is hard" I remember my first tour of the PICU. I asked the nurse supervisor how she coped with losing children. She answered, "you get used to it." So I asked her how long it would take. Her reply, "I'm still waiting." Other than each other, there was no support net for the physical, emotional and perhaps the worst, the spiritual exhaustion we all felt. The last one I lost was the worst. I had literally known her since birth. I was floating in the NICU and admitted her the night she was born. Born early and a twin, things don't always go as planned. CP, hydrocephalic, DM to boot. For 6 years she made continual visits to the PICU. We pulled her thru non ending seizures, a really nasty spell when her shunt malfunctioned. Each time we thought it could very well be the last. But the little bugger would pull thru and be back to her loving charming self. A nicer family I've never met. And after all that time, all those threats, she dies because someone in the field couldn't tell the difference between intubating a trachea and pumping a stomach full of air. I spent my day off sitting with her and the family while the organ procurement team called all over the US to find matches. And so I keep her close with the rest. Each and everyone taught me something. I love them for allowing me to share in their bright, too short lives. My son is born, perfectly healthy, but even after a year of being away from it, I still look at him and wonder when the cancer will show itself, or will he choke on a cracker, or be hit by a car. Whatever it is, it will be something, it always is. And so now I'm out of the game, never again to wrap a kid in plastic or to walk into the next room and pretend nothing has happened. And those of you who still play the game, I watch you with that same sense of awe that I used to enjoy being in so much. I used to tell my trainees, "If you can do this, you should do this. Not enough can." Never thought I'd be on the other side of that glass. God keep you all, for if this isn't his work, what is?

Why shouldn't we? We're not afraid. I'll never forget my first code, I think I had been a nurse for all of 32 hours. Wasn't my patient, so I just hit the chest compressions, good physical job where you don't have to think too much. And as I looked out from drowning in my own panic I noticed everyone else was just casually going on about their business. And I couldn't believe they were all so calm. That was many many many codes ago. I can believe now. Since then I've coded them all, from 2 days old to 102 years old. Won some, lost some, and some I'm just not sure either way. I've seen codes in the PICU go so calm and smoothly that the families to either side had no idea anything was happening. I've seen parents faint, doctors cry, but the nurses are there solid as a rock, unmovable. During the code anyway. But we talk. And I know what you do when the day is done and you get home. I know how we keep the demons at bay, too often with the help of other demons. And yet we go on. For what we have done we deserve nothing more than hell, for what we do we deserve nothing less than heaven. And now I'm a floor nurse for the most part and don't have to deal with the stress of the codes or that continual feeling in the back of your mind that it's coming. And I'm happier, finally the dreams are retreating, the faces are fading. But in a sick way, deep down inside where my demons dwell, I miss them....

Actually, it was mostly being a dad in general;). No, you know once you've been in the game awhile, become one of the senior nurses, gotten you certs, then you become the go-to when something bad hits. And over my last year in the PICU I lost some chronic kids that I had known from birth, a couple from just stupid mistakes in the field. (No offense to my EMT brothers, you guys are like knights of old.) And now I've gone from someone who was treated like a pillar of strength by the famiies, to being treated as an interloper, not only by th families, but by the rehab team as well. Nurses are seen as a neccessary evil, but certainly not part of the process. But I worry that what's pulling me back into the PICU is pride and an addiction to that rush, and not a love for the work itself. Time will tell, the soul searching continues.

For 10 years I worked the PICU and loved it. Then my son was born. Every coping skill I had failed me. I could no longer remove myself from the patient. Finally last december, after losing 3 pts in 2 weeks, I had to give it up. Now I work in a state facility working rehab on mostly CP kids and I love it. The kids are great. They teach me something everyday, but lately I've been missing the good old days. I work 7p to 7a here and by 9p everyone is asleep, and they stay that way. I check them every hour and they never need anything. The night drags on. And so I find myself missing that constant rush of sitting on the edge of your seat. Waiting for the next code or the next trauma admit. I always told my trainees, "If you can do this, you should so this." You folks know, not everyone can. Am I being a coward by hiding here at this cushy job? And I miss the respect I recieved as a PICU nurse. There's no respect here, more indifference than anything else. Such is life I suppose.

I'm originally from Blanchard, now living happily in Norman. Been working for the past few months at MWC regional hospital in the float pool. Had a son born last year and kinda lost my coping skills for the PICU. Starting my new job next week at JD McCarty Center working with those kids.

In Oklahoma he did some adults. Not sure what he'll be doing there.

One of our Ped heart surgeons, Dr Christopher Knott-Craig, just relocated to run the cardiac program there and I was just wondering if he had gotten settled in yet.

Sorry, I wasn't very clear last night. In the PICU we run 2 to 1, sometimes 1 to 1. Some of us more experienced nurses will take 3 to 1 if we're baby sitting floorbait. This was just an adult med surg floor, mostly homeless and mentally challanged folks.

I'm not sure why OUHSC has such a high turnover rate. I love the PICU, it's the only place in the hospital I would work. I'm not sure if they hire grad nurses in the ER or not. I know we do in the PICU and it works out pretty well. Pay isn't up to par with some of the other OKC hospitals, but supposedly they're going to do something about that (how many times have we heard that song?)

I have a full time job in the PICU. I love it. I trust everyone there from the monitor techs to the unit supervisor. We're a great team that works well together. But that's not my problem. I also have, or had, a part time job at another hospital in town. A few weeks ago I had mentioned that I could charge if they really needed me to on a very limited basis, but having never been a charge nurse, I would need to be oriented first. At that time I was given a 2 page letter that listed what the charge nurse was responsible for. That was the last time I've worked there until tonight. Tonight I walk in to find that I am the charge nurse. 17 patients, myself, one staff nurse and one float pool nurse. No Nurse tech, no unit secretary, but I might get another nurse if I take an admit. It was the last straw. I'm done with them. Anyone else had anything like that happen?

If you really want to work ER you should work University. The pay isn't as good as some places, but it's the only level one in town.

Children's Hospital Oklahoma City here. We run 18 beds but can usually only staff for 16 and that's if they are all 2:1pts. We have 2 top notch cardio surgeons so we see 6-10 hearts a week. We used to see alot of neuro kids, my personal favorite behind trauma, but we've lost our neuro surgeons so that will slow down until we replace them. We do three 12 hour shifts a week with one on call day every other week. Typical nursing is 2:1 except on the fresh hearts and otherwise critical kids. A few of us in the old guard will take 3:1, but only if we're babysitting floor bait. I can't see myself working anywhere else. BTW, we just stole 2 of your docs from Dallas, Dr Gormley and Dr Allen, but to be fair, they were our's first.

I know there is an ADN to BSN program at OU med that several of the nurses I work with are in. I'll ask Friday when I go back to work and post what I find out.

I think you may have gotten the remedial nursing thing from me. I've refered to it as the school of remedial nursing since my first semester there. I'm also old enough to refer to the whole school as socjoc. It's all tongue in cheek I assure you. My class had a very high first test pass rate. Since I went it seems to becoming a kinda OU Tech college. I was down last month to check on some just for fun classes and hardly recognized the place. I'm sure you'll be very satisified with the OKCCC School of Remedial Nursing.

We're typically 2:1 unless the pt's condition makes it otherwise. I've taken some 3:1 assignments if they are the right pts and I'm feeling especially spry. We usually have 1 RT who does Tx and vent checks, also runs most of our gasses after we draw them. But unless our census is high we often have to share that 1 RT with the NICU. That RT also has to accompany pts to CT, MRI, etc. so you can't always rely on them being close.

Not only that, but some offenses are going to more okay if you declare them up front rather than have them find out. Sneaky is not seen as a good quality by the OBON or an employer. And for what is worth, the OSBI check is very extensive, if you're trying to hide something from another state it will turn up.

Hi all, John here, originally from Blanchard, now in Del City. Graduated from the school of remedial nursing (OKCCC), worked at first in the stepdown unit at St. Anthony's, then found myself in the PICU at Children's hospital. Did a short time in Texas at a rural ED, but found myself drawn back to the PICU.

I'm currently a PICU nurse in Oklahoma, but my wife and I are considering relocating to N.H. I was just wondering how the nursing situation is up there. I would hate to leave the PICU, but ICU or ED would be a nice change of pace.

I don't know where you are, but if you're interested in a ADN program, have you considered OKCCC? Granted, it's been a few years back, but IIRC my class had around a 95% pass rate. Quite abit cheaper than OU too.

I love my post op heart kids, they keep you jumping all night, and I have a special place for the hemoc kids, but I'm a trauma dog at heart. To many years watching ER I suppose. So I see most if not all of our CMH25 kids. Nothing is as enraging as sitting at a kids bedside who has multiple skull fractures and hemorrhaged retinas listening to yet another version of the "2 month old who rolled off the couch" story. But I also think I give the best care to these kids, because I realize that I'm all they've got. The ones that really break my heart are the drownings, most of the time to very nice families who just let down their guard for a few minutes.

Our trachs come up on just a tad of sedation, sutured and tied of course, no bagging for the first 24 hours but nothing else. The only trach I've seen come out was one that a new nurse tried to bag about 6 hours out.