SprightlySparrow

1.) This obesity epidemic has brought a whole new set of occupational hazards... 2.) This is nothing...you should've been there for the rectal exam! 3.) "Be a veterinarian," they said..."specialize in exotic animals," they said...

Whoa!!! Keep us updated for sure!! I am so curious!

Gosh these cases sound crazy. Were thyroid levels checked? Cort stim? That's all I've got! ?

I PROMISE you Vandy will NOT pay a new grad anywhere near $24 an hour. You may get $18-21. They have good shift differentials though, and good insurance. And another poster mistakenly said they require one OT shift each six weeks, which is slightly misleading. They require an on call shift every 6 weeks, but if your unit is short then you will probably get called in.

I went to Belmont, and while it was a fabulous institution, I am now deeply in debt. From experience I can tell you that both universities are wonderful and are highly respected. What school you attended doesn't really matter as much as you might think...make good grades and gain experience whenever and wherever you can. Take it from me...don't go into great debt just for your résumé. It really isn't worth it!

That is so disheartening that your Child Life Specialist isn't doing what she should be doing. Both peds ICUs I've worked in have had amazing CLS and social workers. I was going to suggest your CLS coming up with a schedule (with the parents) and then having every care provider involved in the patient's daily care (MDs, RNs, RTs, OT/PT, etc.) STICK TO IT...but then I saw where you said yours isn't very helpful. Our CLS usually meets with the patient or family and comes up with a daily schedule. It is then printed out and made all pretty with pictures, colors, etc. and posted all over the place in the patient's room. Sometimes it is still a struggle to get patients and families to adhere to this, but usually after a few days and some awesome, tough nurses making sure the schedule is mostly maintained, the schedule sticks. Unfortunately, this requires active participation from your CLS. I have found that the parents are usually quite receptive and helpful (especially if they are involved and part of the planning process), but I'm not sure I have any solid advice on your CLS situation...I'm so sorry!

Hey everybody! This is my first travel assignment, and I've gotten a TON of helpful information from my fellow travelers thus far during orientation. I'm hoping to add this post in an attempt to get some additional helpful info for not only myself, but also for anyone reading this. :) What are your favorite travel websites? (There are a TON out there!) Do you have any helpful smartphone apps that you find helpful to use? Thanks in advance

I know the original post here is a little old, but I just stumbled across it. At my center, we actually had our first pediatric ECMO patient to be extubated not too long ego (VA ECMO). I'm not sure whether this has been done before in the US on a pediatric patient, but I know it was our first. This patient was cannulated through the neck. It was a pretty amazing (and scary!) thing to be able to witness! Really awesome for the family to be able to interact with their child as opposed to him needing to be sedated and/or paralyzed the for the whole ECMO run.

I'm not sure that it would matter much one way or another if the child was eating/drinking (unless you are thinking about it from the standpoint of interrupting the child's dinner, in that case, maybe that child could be done last in line). Otherwise, I think one could argue if the child was about to take a large poo, then THAT could affect their weight! Basically, in my humble opinion, I don't think it matters much being that it is dinner time. What matters the most is consistency (same scale, same time of day, etc.). Our stepdown unit has a piece of paper taped to the end of the crib/bed that is filled out daily with the child's weight. There are several lines printed on it where you can easily write the weights down. It's an easy reference point when the RNs/techs are obtaining the weight ("oh, that weight seems way more/less than the one yesterday..."), and the parents seem to appreciate it, too. It may serve as a helpful reminder, too, that the child is a "daily weight".

Our stepdown unit weighs every patient every night around 2000. (Actually, it's part of the nurse tech's responsibility, but the nurses assist when they are able). Though this makes the beginning of the night kind of busy, the parents are awake as well as the child, usually. The nurses are already in the room anyway bc of meds/vitals/feeds/assessments, etc. unlike at 0600 where you may have no need to go in there at all. I've not seen the whole 6am weighing thing work out well because A.) patients are usually asleep B.) parents are usually asleep C.) they are some nurses who habitually won't do it for whatever reason and D.) 0600 is a really busy time! Weights at 0600 are easily pushed aside because of any reason whatsoever...patient threw up, meds came late from pharmacy, someone needs a pain med, med student/resident/NP wants an update on your patients, someone pooped the bed...you get the picture. The 2000 thing seems to work beautifully for our stepdown unit. Maybe you could pitch the idea and see what people think? If you meet resistance you may try suggesting a trial run? See if you can get the techs to assist with them, too. Having the nurse and tech work together makes things easier for everyone, obviously. Hope that helps!

I was not under the impression you were speaking about larger children. That is why I used the phrase "I may be missing something". Clearly I was...one would never expect the nurse to lift a patient that large in the manner I was speaking about. Most of our patients are quite complex, and they are therefore small as there are repaired as early infants/neonates. These 2, 3, 4-kg kids are the ones I am referring to and thinking about when I suggested lifting them. I was not intending to offend you in any way. We do get the larger children as well, and they generally are weighed once they are extubated which typically is POD 0, 1, or 2. And a patient on CRRT?...not getting weighed. If our cardiac patient is on CRRT let's suffice it to say their weight is the last thing on our minds. That patient is usually quite ill.

I forgot to say I was appalled when I read the original post about using sling scales! I am SO sorry you guys have to do that...it seems absurd to do that on a postop. Dangerous! Our kids are weighed/measured immediately prior to surgery and are not weighed again until they are stable. We rarely have an unplanned extubation bc of weighing a patient, but we don't use the sling scales...it definitely seems like your unit will benefit greatly from you looking into this more closely and trying to find a better way. I'm sure your colleagues will be forever grateful to you!

I may be totally missing something here, but can y'all not just lift the patient, zero the bed w/everything on it, then weigh the patient after he/she has been placed back in the bed? Our Panda beds as well as some of our cribs have built in scales, and we always use this method (lift child, zero bed, weigh child...). I will say we also have a standing scale and a regular baby scale we utilize at times, too. We weigh every patient weekly (as long as they as stable) and our chronic feeder/growers get weighed daily or at least 2x/week. Our stepdown unit does daily weights every night around 8pm as a standard. Of course the weights we obtain will be less accurate with all the "gear" our patients have in the ICU (leads, chest tubes, ET tubes, manifolds, etc etc), but we do the best we can. Sometimes we need a third person to help out. Our physicians/NPs more or less understand the difficulty, however, and I feel they view the weights from a nutrition perspective as opposed to a fluid balance one. We use very strict electronic charting for that.

When it's no biggie for your patient to have an open chest and be on 12 different drips takin' up 10 lines of space on your monitor, but the thought of a patient alone in a room on absolutely no continuous monitoring absolutely FREAKS you out!!

I am looking into traveling, and I have only found one company thus far (Cross Country Travel Corps) who seems to have job availabilities for my speciality which is Pediatric Cardiac Critical Care. Every other company website has Peds or PICU listed as specialties from which to choose, but no PCICU. Does anyone out there know of any travel companies with this specialty listed? Thank you for any information! (Not looking for any particular recruiter, please.)