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  1. stacylethani

    Night shift mentality: keep them alive until day team comes on

    Thanks for all your responses! So the situation was a kiddo in severe heart failure who couldn’t hold their temperatures. They kept dropping to 35C and at one point went as low as 33C. Most of the shift they were 34-35. I had utilized all warming measures I had available - increasing temp in the room, warming blankets, heat packs, etc. At one point the docs just stopped responding to my pages about the kids temps being low. I understand that they have a lot of patients and they don’t want to make changes but in my opinion, temps this low need to be addressed/fixed, especially in a heart failure patient. What do you think?
  2. I’ve been a nurse for two years on a cardiac step down peds unit. As I’ve grown as a nurse, it’s hit me how much pushback I get from doctors, team members, and charge nurses to make changes in the middle of the night when my pt isn’t looking good. Unless my patient is actively crumping, I get a lot of “we’ll pass it along to day team.” Or “it’s not an immediate issue right now, we can wait a few hours to address that.” It’s so frustrating as a newer nurse though because a lot of the time it feels like my concerns are not being validated. Then day shift comes on and states they feel uncomfortable with the patient and the team does 20 interventions. Sometimes it makes me feel incompetent even though I know what I’m doing at this point and feel comfortable on my floor, because of how much pushback I get. Yes, you can call an rrt if it’s bad, but i deal with a lot of chronically sick kids who always look bad. When “looks like crap” is your baseline, it’s hard to get you moved to icu. Ive just been so frustrated lately with the lack of action on night shift/the lack of concern. I don’t know what to do anymore. Almost every shift I come home frustrated that we didn’t do something else for the patient.
  3. I’ve been a nurse for almost two years now on a cardiac surgical floor. I’m interviewing for the pediatric cardio thoracic icu and the peds icu/cardiac icu (the units are combined) next week at two different hospitals due to needing to relocate. I have no icu experience, however, I have worked a lot with lvads and cardiac drips (milrinone specifically). I know both icus specially deal with ECMO, CRRT, and VADs. Does anyone have any advice for interviewing for the icu/what to expect? One of the interviews is just an interview with the manager. The other interview is a manager interview, a peer interview, a floor shadow, and a medication (math I assume?) test. Should I prepare for nursing types of questions surrounding drips, vents, etc? (Anyone have any good material for this since I know next to nothing about that icu specific stuff?) I’ve gathered good stories for all the typical nursing questions (mistake you made, why critical care, time you advocated for your patient, most complex patient you’ve had, pushback from team, how to handle patient complaint, where in 5 years, what do you bring to the team, abrupt change in patient care, how do others describe you, etc). I’m just unsure about icu specific questions being asked, especially since I have zero icu experience!