wendyw2

Hi all It seems that nursing is in dire straights world wide. It has been a standard in Australia that all ventilated children are nursed on a 1 to 1 basis. Occasionally if they have low accuities and are side by side we will double up. Today at a meeting we were told that it is usual that American PICU nurses double up and we could do it too. We said that you guys can do it because you have Respiratory Therapists. We don't, the nurses do everything. Our administrators are trying to tell us that we can double up on 2 ventilated patients because you guys do it. Is this true? Do respiratory therapists exist and what do they do? Thanks in anticipation

Hi from Australia, A mentor is really someone that the learner choses. A preceptor is someone that you chose for them. Our nurses all have 2 preceptors. We work on the buddy system and the learning nurse agrees to work shifts with their preceptor. Preceptors are chosen with a supportive relationship in mind. If you know that they are not going to get on, it won't work.They are allocated in close proximity to one another. I assume there is a supernummerary period prior to taking patients solo and this is where the relationship unfolds. We also have a New Staff support group every week where they take their gossips and grumbles and we try to act on any issues. All new staff are offered a 3 professional development days over a 6 month period. The expert nurses, nurse educators and doctors do lectures on things such as haemodynamic monitoring etc. Also all nurses get 4 hours study time a month. The other thing we do is poach from other areas by offering a 6 month rotation. Hopefully if we give the poached nurses enough support, they will stay. I hope this helps. Cheers

Hi, I located the abstract of the article but can't get the full text yet. There was another book about the Notting Hill Model that came out after that. There has also been subsequent evaluation using the Fawcett Method which seems to be undecided about whether it is a nursing model or a theory. evidently some research needs to be done. It seems very much to be a UK thing. Our situation gets down to where do we document assessment of normal prehospital characteristics and how do we demonstrate consistency with our family centred care? Although we argue that we all practice FCC, we are being asked to provide evidence of that, which questions a standard practice fundamental to a philosophy of nursing practice against a structured model. Cheers

No thats not off the point. Our parents stay for critical incidences and one of the nurses is doing her PhD on parental presence during the times you mention. On occasions the parents have even been involved in CPR and sometimes they will tell us when to stop. The parents should always have a support nurse to explain and provide acknowledgement. Concerning parental involvement in care, would you say all nurses are consistent with what they offer the parents? Do you document anywhere about any agreements and assessments you make in PICU? Cheers and thanks for your info,

Family Centred care is sort of related but our understanding is that we negotiate the children's management. We've got this document that the parents are supposed to sign when they have 'agreed' to the care for the day. The parents also, if they wish, participate in care. Most of us maintain that we provide ongoing and flexible negotiated care anyway so why do we need another document. How do you implement your family centred care and how is it measured/evaluated? Thanks for your response.

Hi, In our PICU and childrens hospital, we don't do anything other than isolate. Otherwise the usual universal secretion precautions prevail. Cheers

Hi all, Does anyone have experience, information or comment on the use of Negotiated Care in PICU. Would love to hear from anyone who can help. Our unit in Australia is trying to intoduce it, not too successfully at the moment. Most of the info we can find is for chronic care and discharge planning and therefore we are having some trouble seeing its applicability. Cheers and thanks in anticipation.