RNNPICU, she could handle one patient, but not a critical one as of now. I had to tell her to turn off sedation for the sedation vacation. I had to tell her to titrate down on pressors since we had more than adequate blood pressures, but she only did it because I told her to and didn’t take initiative to continue to titrate. Also, I told her that any fluids running less than 15 mls an hour needs a tko (our policy) on one day, then the next day...same patient, same med, running at 2.89 mls for a couple hours and she didn’t even realize it, but said she wanted to ask for an opinion since we were diuresing. Valid statement, but she should’ve spoken up sooner because we could’ve tried turning off the pressor or ask the providers if they wanted to try albumin. Turned off the pressor, pressures dropped to 70-80’s and she was reluctant to turn the pressor back on. She’s also afraid of speaking to the providers, which the nicest ones in the world were working that day, and their recommendation? Turn the pressor back on.
I feel like I do well at helping my orientees recognize what they struggle with and try to come up with solutions, but it’s like every day we start all over again and she’s forgotten important things or she focuses on one aspect of the patient rather than the whole entire picture.