LoriA

Hi to All- Are there any PICU's out there who have specific pain mgmt criteria (ie order sets) based on pain scales (FLACC, MAAS, Numeric)? We use these scales but are trying to come up with a way to be more consistent in our approach to improve patient care and outcome. There are so many variables associated with pain mgmt and they become even more difficult to assess in the pediatric population. If you have something that would help give us a starting point, I really would like to see it. Let me know and I will give you the fax info. Thanks Lori A:balloons:

To All PICU's- How has your patient census been this fall and winter? Please give me your bed capacity and average census. Let me know if you are up/ down/ about the same. Our census the last 6 months has been lower than in past years.Possible due to synagis, flu vaccine, and prevention training & education. Let me know what is going on other places. Thanks Lori A PICU Nurse Educator:balloons:

Our staff has turned over 50% in the last 2 years. We have 6 nurses who have more than 5 years of PICU experience. The other 14 have less than 2. We are considering starting a mentoring program in our unit. Does anyone out there have one in place? If so, how does it work? and how long is it? With budget constraints, we cannot offer additional money to our mentors, but do you have ideas for recognition? I would appreciate feedback. Also, if you have been mentored how do view the experience? Thanks Lori A. PICU Nurse Educator:)

we have 3-4 rn's per shift. vacations and specific requests are approved if possible. everybody is really good and will cover extra shifts or switch with someone who needs off. i guess the key to any self-scheduling is flexibility! self-scheduling is a privilege and once you get accustomed to it- you will not want to give it up. so everybody chips in. we are so small and our census is so unpredictable that we use prn staff and oc staff if necessary to cover busy times and vacation. i think returning to weekend teams will also help. holidays are scheduled according to preference and past work record. if you work christmas day or christmas eve night, you have all other holidays off unless you won't to work. everyone else works @ least 2 holidays (thanksgiving day & eve; new year's eve & day; christmas night). there again everyone knows the rules and this works out too. we have done this so long that the nurses would revolt if it were taken away:rotfl: . it can work! loria

Hi- I have been a pediatric nurse for 18+ years. I started my career right out of college on the general peds floor. Best thing I ever did. I did 2 years on the floor and then transferred to the PICU where I have worked ever since. Working on the floor first was the right thing to do. I got a strong foundation and new what "normal' was. Let's face it PICU patients are anything but normal. It is hard to assess critically-ill kids, if you don't know what normal kids look like. During my career in PICU, I have seen new graduates burn out and leave within a year. Those that stay have either worked general peds floor, or have worked as an intern or nurse tech in PICU while they were in school. If you have no pedi experience, my advice is to work with general floor for at least a year and then make the jump to the more critical care. You will love it more and be a better nurse for it. Believe me, there are always jobs in PICU. Just don't bite off more than you can handle as you start out. LoriA:)

We are an 8 bed PICU. We self schedule by putting nurses into 3 groups(attempting to get FTE's approx =). Our sign-up schedule comes out on Monday. Group 1-signs up Mon/Tues; Group 2 signs up Wed/Thurs; Group 3 signs up Fri/Sat. We rotate groups every month. The rules include; charge RN each shift; no one can sign up in the 3rd spot until all 2nd spots are full. We are looking to make weekend teams- so every 3rd weekend you are automatically scheduled. It seems our problems are covering weekends. Full time employees are required to work 3 weekend shifts on days & 4 on nights (nights include Fri/Sat/Sun). Part time have to work 2 shifts/schedule. It works for us. I don't know how it would work for a bigger unit. We also include our nurse techs in our groups. If you need more info, i will be glad to fax you our guidelines. Thanks LoriA:rotfl: