*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.

.

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!

I PM'd you some info about UCLA's new grad program :)

From my experience as a nursing student..... 9 times out of 10 the nasty nurses who have issues with students work @ crappy facilities with awful ratios. They are severely overworked and don't have time to teach and I am sure they are stressed w/their patient load as it is......still no excuse to "eat their young". You will notice when you do your clinicals at facilities that are better staffed and have better ratios, you will find NICER nurses. Ones that will welcome students and have time to teach.

when i had to have an emergency appendectomy 2 years ago, the surgeon (not anesthesiologist) started talking to me about my job (I was a waitress @ the time at a pretty popular place)...he would tell me what his favorite burger was, etc..and before I knew it, I was asleep. Thought talking about a hamburger was a weird way to have me go to sleep, but I didn't know what hit me!

I always treat all my patients like they are "VIP" patients We have an entire VIP floor (for all that can afford it). $1000/day gets you a private room on this floor, and for another $50/day you can eat whatever you want. Lobster, crab, filet, you get the drift. Brought up to you by guys in tuxes on china. (not exaggerating at all).....what are we a hotel!?!? A lot of new grads wanted to work on that floor (b/c of the celebrities) but IMO i'm not about to be anyone's servant. A lot of these people will also pay extra $$$ to hire a private duty nurse

I agree. I can't think of another job where you can make that kind of $$ straight out of school with your Associate's Degree, with that kind of job stability.

I thought the EXACT same way when I first started nursing school, and up until I started as an RN.... Here in CA I'm making between $25-29/hour depending on the weekend/night differential. I thought WOW I AM GOING TO BE RICH!!!! Especially when compared to what I was making as an aide.....all throughout school I was thinking WHY are all these nurses complaining?!?!?!?!?! Well.....after my first day orienting in the PICU as a new grad, my thinking definately changed. I thought "wow...i am earning EVERY last dollar". Then my thinking changed even MORE when I got my first paycheck...."WHO THE HECK IS OASDI!?!?!?!.....whats this "agency fee" OH and btw we have to pay $52/month for PARKING!!!!" well you get the picture. It didn't really hit me and I didn't really realize what all the huffing and puffing was about until after my first two weeks of working as an RN.

I didn't have ANY select all that apply :bowingpur Our teachers started doing that the last semester of nursing school, and I never got them right. I always ended up choosing an extra one, or not choosing one.

hmmmm....well from what you included in your original post, I would have thought the EXACT same thing that elkpark thought. It sounded to me like you had no background in child psych by the way you worded your post. It came off to ME like you were in it to sit around and play with the kids all day (which is what 95% of your original post is about) WHICH IS NOT totally impossible for someone to think. I know a lot of people who went into peds thinking you could sit around and play all day.....I think elkpark did a decent job of being respectful towards your post (unlike your response) while trying to offer advice. I didn't sense any paranoia or skepticism in elk's post.....but hey your the psych nurse. I hope you act more professional and more mature with your new job

At our hospital, all the CNA's wear maroon scrub tops (with either black or tan pants) The only nurses that are required to be color-coded are the ER nurses, who have to wear all royal blue The hospital bought 2 pairs for each person, the rest you have to pay for

At the hospital I work at, you can work as an "IPRN" or Interim Permit Registered Nurse" until you take your boards (after you apply for the permit) If you pass, you become a Clinical Nurse I (CNI), and if you fail, you have to send your permit back to the state and the hospital may offer you a position as a CNA until you pass your boards. The second an IPRN fails her boards, her permit is invalid and she can no longer function as a GN. The IPRN's basically function as a regular nurse, but with an RN supervising them (since most of the time when you are an IPRN you are just starting out and on orientation anyway).