chancie

woah woah, these were just some practice examples. no quiz or anything. just wanted some verification. i guess i'll make that more clear next time.... the first one i got 2.55mL 17kgx15mg = 255mg 255mg/240mg = 1.0625 1.0625x2.4mL = 2.55mL next i got about 6.27 mL 92lbs/2.2 = 41.81kg 41.81kgx0.3mg = 12.54mg 12.54mg/5mg = 2.5 2.5x2.5mL = 6.27mL

Just trying to practice medication calculations with a friend - Here's my question You need to give a 17kg child 15mg/kg of Tylenol liquid form. The Tylenol you have on hand is 240mg/2.4mL. How much Tylenol do you give? You have a 92 lb child who needs 0.3mg/kg of Midazolam. You have 5mg/2.5mL Midazolam on hand. How much Midaz do you give? THANKS!

Ha, that duck T-shirt idea is really cute. And the "PICU nurses Roc" - LOVE IT

Let's see I've been at my PICU job for about 11 months now (and it was my first nursing job! New grad! AH!) and I'll tell you I still have many days where all I can see is everything I have done wrong. I leave work feeling like a moron a LOT. BUT I don't tell you that to discourage you, just to remind you that everyone still feels like that from time to time. And it does get better. When I'm not worrying my socks off about my last shift or patient I took care of, and actually look back at where I started and where I am now, I do see improvement. It gets better! I still get pretty nervous going into work, but it's no longer the sick to my stomach, up all night kind of nervous. Just continue to ask questions. Oh my goodness I still ask soooooooo many questions it's crazy. And don't worry too much about what to say to parents. If you don't know something, tell them you'll go find out! They usually don't get upset if that is your response. And hey, you can always go ask the PICU docs to explain the situation too. I've found that to be very helpful to me and the parents if I still am confused about something we are doing. And parents like to see that doctors and nurses are working together as well :) Good luck to you. Don't worry, you'll be great! Hang in there!

I was going to say psych or rehab as well. Lots of education going on there I hear.

Ugh, man we put up with a lot as nurses. But it's all about taking little steps to improve your physical and mental health. Personally I HATE working three 12 hour shifts in a row. I feel like a zombie by day 3, and then need to take the entire next day off to recover. I found that if I work 2 days, off for a couple, work a couple, etc etc I am able to be a bit more productive on my days off. That way, even if I ate terribly and didn't exercise on the days that I worked, I'd still be able to do pretty well on the four days I have off each week. And start slow with the exercising! You have to build up to these things, otherwise you could injure yourself. Also, maybe it's the job you're in? Maybe it's time to look elsewhere for a different environment? I wish you good luck, and try to stay positive. Don't forget to stop and smell the roses (I know, easier said then done...I'm a constant worrier and often forget to enjoy the little things in life, but I'm getting better!)

I don't know, I guess I like to believe that you only live once, and if you're really unsatisfied in your current position, change it! However, I'm sure there are some employers or hospitals that might frown upon "job hopping" but it sounds as though you're wanting to try something different than hospital nursing anyway, so maybe they won't care. Also, I've heard before that the average person switches their profession 5 times in their adult life. Their profession, not just their current job! You're not talking about leaving nursing, just trying to find the right fit within nursing. Lastly, it never hurts to just look. Maybe you'll see a posting that is right up your alley!

Thank you for the replies! I've actually started looking into school nursing, and pediatric outpatient specialty clinics (hem onc, etc.) and home care! My question is, how much experience would I need? I've been in the ICU for a year (only been a nurse for a year!)

Hi there, currently I am a pediatric ICU nurse, but I'm not sure this is the best fit for me. I'm looking for some ideas for different types of nursing! I'm just not sure where I want to end up. Here's what I do know.... I really like working with kids and families I tend to enjoy my work more when my kids aren't super super sick (sedated, on a vent, life saving measures, etc) and can actually interact with them. I enjoy being able to talk with the families and make a connection with them. I'm not entirely set on working in a hospital setting....sometimes I think I'd rather be outside of all the hospital craziness...maybe a pediatric clinic? I just don't want to end up only checking kids into their appointments and getting them set up to see their physician. I like working both with little kids and adolescents. I do not think I'm one of those nurses who thrives on the crisis-type moments....at least not at this point in my career.... Just trying to brainstorm! I appreciate all ideas! Thanks :)

Thanks for the responses everyone. I am a pretty new RN, started in the ICU, and still getting the hang of things. I am also a HUGE worrier . This was not a matter of becoming lax in practice, just learning the ropes still. However, I will also remember to clamp my lines. :) And yes, it was a syringe being loaded into the pump, and since I did not press down on the syringe I'm hoping none of the medication went into the line when it was changed. However, I can see how some pressure could have been applied when the syringe was changed. So yeah, I just got nervous about it. As I said, patient was stable when I left. I appreciate the reassurance. I like to think that all my worrying helps me stay more aware and on top of things. I don't ever want to get too comfortable in my practice, esp in an ICU. So thank you everyone. :)

hmmm, ok. i mean, i did have to open the actual pca pump to replace the syringe. basically, i opened the pump with the key, unscrewed the old syringe from the tubing, screwed in the new syringe into the iv tubing, and then replaced the new syringe in the pump (made sure it was in the correct position, continued my settings, closed door, locked pump, etc). but i failed to clamp my iv tubing. i made sure not to press down on the syringe, but i'm nervous some make have been infused to the patient with this process anyway. so in that sense, yes the pca pump was opening and the tubing was handled to replace the syringe.....ahhhh! i appreciate your feedback!

Our PCA pumps do allow programed bolus doses and loading doses. But I'm just worried that the action of screwing the new syringe into the line, and replacing it into the actual pump may have caused some of the medication to flow into the line and then into the patient. does that make any sense?

Hi there, ok I'm pretty worried about this so here goes.... my patient was on a dilaudid pca, and I realized after my shift the other day that when I changed out the syringe i did not clamp the iv line. thus i'm afraid i may have bolus dosed my patient when i put the new syringe in.... i changed the syringe about an hour and half before i left for the night, and basically i'm just worried something may have happened. what if i did bolus them? the patient was sleeping, but arousable when i left, vitals stable. but i'm still worried. i will always be more careful in the future. just looking for a little reassurance. thanks.