What are the duties of a P.I. C.U nurse?

Answer 1

Not sure how detailed you want this answer to be... but here goes... (this applies to the PICU I work in, though I'm not sure if it applies to all universally...) 1. Monitor vital signs. Patients in the PICU are on continuous cardiac and respiratory monitors. At the minimum, this means that we are watching the EKG tracings, respiratory rate, O2 sats, blood pressure, and if the patient has them CVP and Art line waveforms. We also monitor urine output, chest tube output (if applicable), and gastric tube output... 2. Maintenance of ventilatory support. Almost all of our patients are on ventilators, so we are constantly watching the vent, blood gasses, and vitals and adjusting the vent to achieve the best possible ventilation of the patient. 3. Giving meds/titrating meds. Most of our patients are on multiple drips: sedation, paralytics (about 1/4 are on paralytics at any given time), cardiac drugs, diuretics, etc. The cardiac drips and sedation have to be titrated quite often to maintain good cardiac function as well as adequate sedation. (But we don't want patients too sedated, as we would like them to still be able to try and breathe on their own--it is a very fine line...) 4. Maintaining IV/arterial access. Most, if not all, of our patients have central venous lines (IVs that go into big veins) or arterial lines (IVs that go into an artery, which we use to monitor blood pressure). We have to make sure we maintain those lines so that they are patent, can be used to give meds or draw blood for labs, and also make sure that the dressings are clean and aren't a place that the patient can get an infection. 5. Therapeutic interventions... based on how the patient is doing, we often have to: give meds to treat a specific issue (i.e. patient has low blood sugar, we have to give certain IVF to increase it); perform procedures at the bedside, such as assisting the docs with putting in a chest tube to alleviate a pneumothorax; monitor and maintain blood pressure and proper fluid balance; assist with surgery at the bedside (i.e. if patient is post cardiac surgery with an open chest and uncontrolled bleeding from the site, we may assist the cardiac surgeon with opening the wound to determine where the bleeding is coming from). Simply put, we monitor the patient's vital signs continuously and then act or react to maintain them where we want them to be. The difference between a PICU and a regular pedi floor is the stability of the patients. PICU patients are usually unstable and require constant monitoring and interventions.