Elicec

and yes, i am so terried for my license...i actually want to disappear whenever i go on duty..and every single day i pray to God for my little patients..and i almost always wanted to cry at the end of days work..

from my last post i have been coming in and out in the forum..unfortunately i don't have any good news to share.. , the situation is all the same..true enough, most if not all public hospitals in our country has this problem..very unsafe indeed..we are understaffed, in a week we work 5-6 days( only 1-2 days off), with not enough equipment to support critically ill children...this is most of the public tertiary hospitals deal with for the longest time..its like a chronic disease that doesn't have a chance for recovery at all.. Our unit is trying to make the most of what it has, whew.. what is evident is that critically ill children has slow progress ( since most family here are poor,due medications are missed because they can't buy it, very sad), so what i do is, i take out a drug from our stock and share it those who have same prescribed drug and give the prescribed dosages..like if 7 kids were to receive Pen-G, i'll get one 5 M unit dilute it, calculate the desired dose for each kid and administer it, that will last for a couple of days only since our unit get short of meds, which is so not good..medications are supposed to be continous especially antibiotics right? one worst thing i just encountered and realized as i became staff in PICU is that the Doctors are toxic.. ..very hot headed..they are like ticking bombs that will blow at you in no time.. most doctors are females and they would raise their voice at you roll their eyes and slam charts, and scolds the parents of the patient for not complying with the treatment regimen and some other things..whew..I don't know what the situation is in some hospitals here, but as i observed, We've got a feudal system in our nurse-doctor working relationship. Nurses are not recognized as equal health care partners here...very sad isn't it?... should i quit? if yes where will i go and practice? private hospitals are not hiring as of now..in another public hospital?with the same situation?...i actually wanted to quit, but where will i practice?Im so confused.. :/ as of this time, i am continuously reading materials regarding critical care in pedia..trying to figure out how to take care of my patients with so little that we have...so much for an intensive care unit...

Good day to Everyone, I just graduated last year and after our oath taking, I took a three month training in an Adult Intensive Care Unit i in a tertiary, 800 plus bed capacity public hospital in our city... After my training, I was hired by the Hospital..in my first month I was assigned in the Medical Adult Ward, it was difficult but manageable.. I was reassigned and became a permanent staff in the newly furnished Pediatric Intensive Care Unit...specifically in the septic (infectious)unit (since we have non-septic and septic PICU, which rooms are just adjacent) Most of the staff are new and have a little or almost no job experience in dealing with sick children..including me.. I know sick children by the book, but i know experience matters A LOT. In PICU Septic Unit, we have 16 bed capacity. 6 for sick neonates [ if you wonder why they are not in the NICU, i'd probably say the NICU is full and we have to cater them..] 8 beds for sick children and 2 isolation rooms.. Our ratio is 2 nurses and one nursing attendant to 16 patients with different needs and health conditions... I am mortified and terrified to death because there are times when my partner is scheduled 10am-6pm as i go 7-3 or 3-11 sked OR both newly exposed nurses are on duty...both badly inexperienced... the thing is...i am absolutely terrified for our patients... I mean this IS PICU..intensive care unit...for very very ill kids...these are not dolls...we deal with 16 of them, almost 4 of these are intubated on continuous ambobagging ambobagged by one of the parent (because the PICU septic only have one mechanical ventialtor), 3 are candidate for intubation, preterm infants who would suddenly go into apnea....terrible...if i was a cry baby, i would have cried a long time... i realized that children are more toxic than adults in ICU's. you need to keep close watch and monitoring on them, VS every Hour seems not enough because just after 15-30 minutes, one of the kid becomes cyanotic and tachycardic then bradycardic...When they go into arrest, they are difficult to revive.. I am new here, and I MUST cope fast with the fast forwarded procedures and interventions since the Doctors get mad, and i mean really mad at you when your resucitation is (as what the Doctors say) "slow"... I was scolded once because the Doctor said I am wasting too much time giving epinephrine..but from what i understand in Advanced Cardiac Life Support after the first dose of epi, the second will be 3 min. after.. i mean there is pacing...the Doctor wanted to give first dose epi then after 10-15 seconds give another dose... i want to know if the ACLS in Adults is THAT different from the PALS?? was she right?? I was not even acquainted of what ET sizes for this child is, what OGT or NGT is for this child...it was only there that i heard of Continous Positive Airway Pressure for children..since in our hospital, what is familiar to me is PEEP.. Please help me. I have been here in PICU for only just a week and I cannot stand this situation. I feel very incompetent. I am still trying to get hold of PALS manual. I am browsing, surfing, reading my books on Pediatrics..refreshing and trying to update myself with the Pediatric world... if you'll ask where our headnurse is, she is approachable but she is currently sick..another blow..where is our nurse supervisor? nowhere to be found. from what i observed, they come in our unit just to ask the census, who are intubated, who are toxic. and that is it. i mean that is it. I almost wanted to cry. the Chief Nurse? i can only shake my head in dismay...i don't know what to do.. can anyone tell me what are the apporpriate ET sizes for children in PICU? I know only of 3.5-4 for neonates and f.8 feeding tube. I don't think I can ask the Doctors, i think they have a heavy heart towards us. I fear that i'll only get insults. which happened to some of us here... please tell me what to do