nic_noc1

Hi I work in a PICU in the UK, and our scrubs are provided for us. Pale blue for staff nurses, navy blue to charge nurses/ sisters, purple for health care assistants, grey for physio, green for theatre people. They are in a different room, depending on which dept you work in, and there is a member of staff who makes sure that the scrubs are paired up correctly (eg same size top and trousers on a hanger together) and are hung on the rails in size order. So we go at the start of the shift, pick up our scrubs, change on the unit, and at the end of the shift they all get thrown in a linen skip and off to the laundry. It is nice not having 5 uniforms to wash every week anymore, as I did in my old job! And it is also nice to know that the RSV, MRSA or what ever other nasty bugs you've been around all day are left safely behind at work, not brought home with you! Just out of interest, those of you who wear your own clothes, do you travel to work in them, or do you change at work?

Hi I'm pretty new to PICU here in the UK. I have never heard of this "rule of 3" that you are talking about. We have an injectable therapies guideline, which tells us how to make up and infuse any IV drug, eg paracetamol over 20 mins, certain antibiotics over 1 hour, others over 3-5 minutes etc, what to dilute different drugs with, their compatibilities etc. For things like sedation, it will tell you what concentration to make up, for example, 5mg/kg into 50mls. The prescribing Doctor can use this as a resource when prescribing a drug, and he tells us what amount of the drug he wants in the syrine, what he would like it making up to, and what dilutant he would like you to use. He also specifies a rate (or a range) at which he would like the infusion to run eg 2-5 mls/hour. It is then up to the nurse to double check all of those figures (using the injectable therapies guidelines) before making up and administering the infusion. We use infusion pumps which are set up with a "drugs and dosing" function. This allows you to label the infusion with the name of the drug being infused through that pump, and it has pre-set programs for the commony used drugs. It will ask you the drug you are using, the childs weight, and whether you are working to standard protocol. Once you have done this the pump will calculate the strength of the infusion, ask you to confirm that this is as you have made the infusion up, and then once running the display tells you name of the drug you are infusing, the rate at which it is running (eg 2.5ml/hr) and the dose being infused (eg 5mcg/kg/hr). It is not fool proof, and all infusions are checked by the nurse taking over the patients care at the start of the shift and yes, mistakes do happen. But it seems a good system, and is clear and fairly simple to use (its just my explanation which is long winded!).

I have never thought of the information on IV labels being used in such a way that they infinge on confidentiality.... We do not remove them, or deface them, we just sling them in the clinical waste bin. We do have another bin specifically for confidential waste, but we are NOT allowed to put labels etc in these, as they clog up the shredder!

I have recently moved to a different children's ward having recently qualified as a children's nurse in the UK. In my new unit they no longer do an NPA to test for RSV, the kids are just "suspected bronchiolitis". Apparently the RSV test is no longer evidence based practice, although I have not yet had chance to find out the ins and outs of this practice. When cubicles are full, as is often the case during our brochi season, it is sometimes necessary to nurse all the brochs together on the open ward, and use the cublicles for the non-brochi kids. However, if the RSV test is not done we do not know for sure who has, and who has not got it. No-one seems to have an answer for me when I ask what we would do should the need arise for the babies to be nursed on the open ward. With regards to isolation, all our babies are nursed in isolation cubicles, however neither the staff nor family are required to wear aprons, gloves or masks, just to ensure we wash our hands thouroughly between patient contact.