10 Things I’ve Learned in the PICU

I’ve officially passed the six-month mark as a pediatric intensive care unit (PICU) nurse. It is no longer completely terrifying, though they say it takes one to two years to become comfortable — and then many, many more to be an expert. For example, there’s one hardcore nurse who has worked the night shift in the same PICU for 28 years. She qualifies as an expert.

Anyways, six months in the PICU, and all I’ve got to show for it is a stinkin’ water bottle:

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Just kidding … I also got a CHONY PICU fleece sweater and cool crayon print scrubs and aren’t they all the cutest? Anna bursts out laughing every time she sees me in my crayons and claims she can’t take me seriously in them, but we know she’s just jealous.

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OK, OK, so I may have picked up a few other things besides CHONY pride gear.

Here are 10 things I’ve learned in the PICU:

1. You have to be just a little bit obsessive compulsive.  

PICU nurses love to joke about having OCD. As with a true obsessive compulsive disorder, it’s a way to deal with anxiety and prevent your shift from down spiraling. As long as the baby blanket is positioned just so (the pink and blue stripes can obviously only run parallel to the bed) then the baby’s vital signs will stay stable, his airway patent and mood happy.

2. You become a tiny bit superstitious.

Though I’ve never been particularily superstitious, the PICU will bring it out in anyone. Before each shift, we sign out an iPhone to scan and document medications. Some silly person numbered one of them 13 and everyone throws it straight back in the bin, opting for a safer number. And once before a shift I spotted a huge black moth on the bathroom ceiling. Needless to say it was not a great shift.

3. You have to be a bit of a neat freak. 

While everyone will keep the sheets spotless, the diapers stacked in neat piles and the creams and powders lined up like perfect little soldiers at the foot of a crib, some nurses will take it even further. One nurse brings a label maker (!) to work to label her bins “diapers” and “trach supplies.” But when a kid is so sick that he has a million pumps and machines in the room and tubes and wires covering his body, a tidy, meticulously labeled room makes it all seem a bit more manageable.

4. You don’t want to get sick in July. 

As many people know, July is when all the newly graduated doctors enter the hospital and start to really learn how to be a doctor. Obviously it’s not their fault, but they don’t really know all that much, just as I knew nothing coming out of nursing school. Usually it works out because the experienced nurses and respiratory therapists will tell them what to do. But it can still be scary when you have a kid who’s not doing well, and you can tell that the newly-minted doctor would rather go hide in the call room.

5. You’ll build a hearty immune system.

I’ve been exposed to so many germs and every possible bodily fluid that I don’t see how I can ever get sick again. These kids have inoculated me against just about everything.

6. It’s the best when parents show you pictures of their kids outside of the hospital.

Many times parents will put up a photo collage of their kids on the hospital wall when they were “normal” and healthy. It’s really fun to see what your patient looks like in the real world. It’s also a pretty sure thing that if your patient is a teenage male, within five minutes the father will make sure to show you a photo of him looking strong and healthy playing baseball or basketball.

7. It can be fun when the parents aren’t there.

I really shouldn’t say this, because every child’s parents really should be at the hospital with them at all times. It’s best for everyone if the parents and medical team work together to keep a kid safe, but sometimes parents can really not be there.

And in that case, the staff gives lots of extra love to the baby. If the parents were there, I’d be too self-conscious. But when it’s just you and a chubby baby you can coo all night to him about how he’s the best baby in the world and the cutest baby on 11 Central and how it must be so hard to be a sick little fellow. And sometimes when they get fussy, I’ll sing the little song that Jude made up, “Baby it’s ok, baby it’s ok, come along, sing our song, baby it’s ok.”

8. You start to talk in a baby voice to everyone.

After three nights in a row in the PICU, it takes time before you’re not shooing a fly away in a gentle sing-songy voice.

9. Kids outside the hospital amaze you.

When I see kids walking around and playing outside, I’m so proud of them for being able to walk on their own, breathe on their own, eat on their own and survive without someone bringing them medicine every few hours. And then I remember I have a skewed perspective on things. But I’m still impressed with all these tiny humans inside or outside the hospital.

10. You can sleep anywhere.

I can count on one hand the number of times I have stayed fully awake for the entire hour-long subway ride home. Within 20 minutes, I’m asleep with my head in my lap and not caring how I may appear to other subway riders. Amazingly, I’ve only slept past my stop once. P.S.: If you see someone in scrubs in the morning, please give them your seat.

But no matter how fun the shift is, it’s always a beautiful sight when you see that first glow of the sun rising. Meaning: it’s almost time for bed!
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This entry was published on September 13, 2015 at 4:56 pm. It’s filed under Uncategorized and tagged , , . Bookmark the permalink. Follow any comments here with the RSS feed for this post.

2 thoughts on “10 Things I’ve Learned in the PICU

  1. Any child in your care is very lucky indeed.

  2. This may be one of my favorite posts. If I had a child in PICU I would want you as the nurse!

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