PICURNROCKS

Visible tattoos are against our dress code. I have one on the inside of my wrist and have never had anyone say anything. I know some nurses that have sleeves (full arm tats) and do have to wear long sleeves. I know that if needed I can easily cover it with a 4x4 and tegaderm for my shift. If it is something you truly want, I say go for it. I love mine!

The hospital in which I work does both nasal and oral intubations. We usually prefer nasal because our kiddos seem to have some serious oral secretions and we are continuously retaping the tubes. However some physicians do not like nasal because of the risks. Either way, when we tape we use mastisol and cloth tape. Depending on the size of the patient you use 1 or 2 inch tape and cut two pieces, long enough to go cheek to cheek. We then, split the pieces lengthwise leaving about an inch (give or take) at the end. If OET we place the tape as close to the corner of the mouth and one strip goes over the top lip, while the other strip goes around the tube. Then we use the second piece of tape the same except instead of over the lip we do across the chin. I hope that makes sense. We tried neobars on our little kiddos however some of our docs and nurses did not like them so we continue with tape.

The Hybrid procedure, named hybrid becomes it combines interventional cath lab with surgical procedures, is an alternative to the Norwood. The reason for the hybrid is because it is less invasive, takes approximately 5hr less and can generally be done without cardiopulmonary bypass. It can also reduce the number of pump runs, which generally has a better outcome. This procedure then allows the infant to grow older, stronger and develop a better immune system before proceding to the next stage (Glenn Shunt) for major reconstruction. They implant a stent in the ductus arteriosus, which connects the pulmonary artery to the aorta. Then band the branch PA to restrict some pulmonary blood flow. I think the problem we have been having is, for whatever reason, when they are doing the banding it is too big. My last patient that had this procedure passed away. I was told the band was too big. I am not sure if it is because she was so small and there wasn't a way to get the band tight enough to restrict enough of the pulm blood flow. I guess typing this has made me think of some things I'd like to speak to our CV docs about. So Jan I hope your little baby is doing better!! And I hope the above info was informative enough. Bless you all!

i am actually really happy to say that my special girl has finally gone home. after spending almost two years with us in the picu she was finally to the point where she could be at home with family. she has 18hr nursing care at home, but i am just excited that she is doing well and hasn't looked back. she is able to play with her brothers and sisters and is smiling and laughing every day. it means so much to me knowing that miracles happen!!

I hope she does really well. Thank you for sharing your insight and experience with me.

I graduated a couple years ago, but can't imagine them changing very much. I had clinicals at HF wyandotte, Oakwood Heritage, DMC CHM, HF Bi-County, HF main and DMC Harper. It is nice to go to a variety of hospitals because it gives you a sneak preview into where you may or may not want to work. Plus sometimes your choices are limited due to what class you are taking. Also, if they still do the lottery for your classes, sometimes your choice of where you want to go may be limited. Good luck!

1Totry31~ The majority of the nurses I work with have children and when a child is very ill and/or passes, it is very hard for them. It is hard for everyone. I think you put yourself in the position of the parents and think "that could be my baby". I find what I do very rewarding. Many people ask how we do what we do, and I have to say it's what I was born to do. Yes you will cry, you will be shaken up and it won't be easy. But I believe what shroeder said, they are in heaven healthy happy and playing. If you really want to do peds you can always choose an area that you wouldn't have to face that situation as often. Like, avoid ER, NICU and PICU. I hope that helps a little. Good luck in school!

Hello! I am very curious if many hospitals are having success with Hybrid procedures for HLHS?!? We do many Norwoods and Hybrids and I know that these babies are so fragile but it just seems as though there is not as much success in the Hybrids. Some of the hybrids have gone home and unfortunately the majority return to the ER doa (not to sound coldhearted). Basically I would just like to know if other hospitals seem to be having more success and what your post-op care consists of. Thanks for any insight!:redpinkhe

We are going through the process, inservices etc, in starting to use Painease, EMLA and LMX4 for needlesticks. Painease is the cold spray and it actually hurts a little when sprayed on the skin, in my opinion. I work in the PICU so we probably won't be using these products often, because they are not for emergent needlesticks. There are many instances in which you cannot use these products as well. I do believe it is a good idea because it may make the childs experience less painful and scarey.

I work in a PICU, as well, and unfortunately it is part of the job. It is very difficult, in my opinion, no matter what the situation. Sometimes it is what is best for the child, but it still is difficult when you have to wash them up and prepare them for the morgue. I think everyone has their own way of dealing with the situation. I am grateful I work with people that are like family because when something like that happens we are there to give a crying shoulder or to just be there for you while you take some time and regroup. You never get used to it, if you do there is something wrong. Every child and their family touch your heart. But like others have said you go home and tell your friends, family and children you love them. Good Luck in your new possition as an RN!

It depends on the medication. I haven't given an IM in a long time but from what I remember the antibiotics we had came with inserts that told you what you could mix the meds with. Some of them it was a NS, water or lidocaine etc., so you could use whichever you choose however you do need to make sure it is compatible. I'm not sure f the is what you were looking for. Good luck.

we do multiple heart transplants where i am. i had a ten year old boy post transplant. i came in got report, once he woke up we extubated him and the first words that came out of his mouth were "did i get my heart?". it was so incredible to tell him yes as the tears rolled down my cheeks. i also have a special girl i have been caring for for the last year. she has been through hell but she is still fighting. everytime she smiles and signs i love you to me it melts my heart. people always ask me how do i do what i do, and i always say how could i not?!? every patient i care for touches my heart in one way or another, as well as most of their families. i feel lucky that i can touch their lives as well. bless you all and all that you do. :heartbeat