*PICURN*

I work in a transplant PICU in Los Angeles. Our hospital has like 10 ICU's (one for liver transplants, heart/lung transplants, kidney transplants, etc) where there is a separate medical ICU and separate surgical ICU. The PICU however is a mix of all transplants/surgical procedures, however I would say most of the patients are either waiting for a transplant, or have recently gotten one. PM me if you have any ?'s.

benadryl.....benadryl....benadryl.....

i just finished my first week of nights and let me tell you the first one is the WORST! after that i came home @ 8am, took a benadryl and off to sleep until 5pm when it was time to get up and do it all over again. The second and third night was a piece of CAKE as long as I got enough sleep!

Some parents/families are very difficult. You just have to not let them run you into the ground. It's hard to draw the line, but sometimes you just have to let them know that right now you need to do "x, y, and z" for their child and you will get to "1, 2, and 3" (which are less important, and what they want you to do right this second) when you are through. They are going through a really stressful time in their life and basically handing over their child for you to take care of, so you can imagine the stress...so just remember that when dealing with the parents. I agree with suzanne, sometimes the "kids" are adult size! It is a very rewarding area to work in though

new grad, $25.36/hr....however cost of living is higher than you may think.

i always try and use the needleless system if possible, but the needleless caps SUCK at drawing a med out of a vial....so then i just use the needle to draw it up, then recap it (one hand scoop), and then remove the needle, and attach a needleless

when i first graduated, these were the two areas i was debating between as well. ER: I did one shift in the ER and although I loved the variety and loved the somewhat "organized chaos", I felt like we were just like a holding area until they moved the patient to a floor or sent them home. I also didn't want to deal with the drug seekers, etc. PEDS: Love kids, but at the same time I was scared to specialize, especially right out of school. I felt if I specialized, maybe I would lose all my "adult" knowledge since kids are so different. Whereas if you were in the ER you would treat kids and adults. In the end I chose PICU b/c I was interested in critical care, and pediatrics. Overall it just seemed to be a better fit for me *and I LOVE IT!!!* Just remember you can always switch again! If you try peds and hate it, then you can always go to the ER later, or vice versa.

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Maintenance IVF go through the buretrol. Any high risk or incompatible meds are put on a syringe pump (as well as all gtts). If the maintenance IVF is running at over 25cc/hr and the med you want to give is compatible, we drop it into the buretrol and adjust the rate to get the med in over a certain amt of time. The good thing about dropping meds into the buretrol vs. a syringe pump is the volume issue. If you have a kid who you don't want to fluid overload, and your med has to be mixed w/50 cc of fluid, instead of adding another 50cc and giving it over the syringe pump, you can mix it in the buretrol and avoid giving them unneccessary fluid.

You have to at least have a med running @ 2cc/hr to keep the line open, so if we have anything running @ less than 2 cc, you need something to "push it in". We have piggybacked the PCA to maintenance IVF on the Baxter pump, but like the poster before me, you have to make sure you ALWAYS have a one way valve on the PCA line.

I was told to use Sprite/7-up b/c it is colorless.....but it all works the same!

one with a long enough orientation to make you feel comfortable being "on your own" i personally like the teaching hospital atmosphere, the nurses seem to more willing to teach new grads *and of course the hospital that meets YOUR needs ($/hr, benefits, etc)

wow i can't believe he was ordering for IM injections.....ESPECIALLY if your child had IV access!!!!!!

I would say some nurses more than others feel more comfortable allowing parents to be present during procedures (which seems more practical if you have a 3-4 year old screaming when mom/dad leaves). For the most part though, I think our nurses are comfortable enough to allow the parents to participate in a lot of the care. We don't document anywhere about agreements/assessments but I think if a procedure/emergency were to happen, parental presence would most definately be documented on the flowsheet.

We also have a family-centered PICU where the parents are free (and encouraged) to do as much care as they feel comfortable doing. Right now they are talking about whether or not to allow parents to be present if their child codes in the PICU. As of now, the policy prevents the family from being present. However, my unit director has told us stories about the benefits of having the parents present during a code (as long as there is a staff member available for support). They can see that everything possible is being done for their child, can say their last goodbyes, tell them it is okay to let go, etc. Of course now I think I'm off topic!