Monday, 3 December 2018

Second Shift in PICU!

Today was my second ever shift in PICU as a newly qualified nurse. I'm supernumery now for 8 weeks, and today I worked with a nice nurse who explained a lot to me - some went over my head, especially the maths stuff, but I was able to try suctioning ET tubes today which was great. You have to go down until you feel resistance (at the carina), then pull back slightly and then suction while coming out. The hardest part is making sure I have a clean hand and I only touch the parts I’m supposed to!

We were looking after a tiny bronchi baby today. She was very cute, and her parents were lovely too. She was on a ventilator and the nurse I was with was explaining some of it to me and I’m very slowly getting my head around it all. I think ventilation settings and blood gas values are two things I’m going to have to really keep going back to because they’re all numbers and values and acronyms that don’t make intuitive sense. Tried to do a capillary gas today and got air in the tube… found it really hard, not a fan of the gas tubes! Also struggle with IV calculations and reconstitution - don’t really know what I’m doing yet! And figuring out fluid restriction (it’s done differently in PICU - more maths) and how many feeds vs fluids. Lots to learn and figure out but at least I’m not bored. Everyone has been really nice, too, and nobody seems to expect me to know loads at this point. I'm a bit nervous already about my first shift as not supernumerary but hoping 8 weeks will be long enough that I can cope!

What’s been good though? I found gastrostomy feeding / medicine via PEG came back to me super easily on Friday, and I did NG feeds today with no trouble. Apparently, you have to use a 20ml syringe minimum to get aspirate to not cause trauma.

Today I learnt/practiced…

  • Learnt ETT suctioning! 
  • Learnt how to get an emergency drug sheet printed (each child has one by their bedspace in case there is an emergency) 
  • Practiced NG feeds 
  • Learnt safety checks - although still a bit hazy on them off the top of my head. 
  • Practiced drawing up IVs - but need more practice calculating 
  • Learnt about the drugs needed for intubation - and draw up x2 of each. Ketamine, fentanyl, rocuronium. 
  • Did not watch intubation but watched tapes being changed.
All very interesting!