Have you ever wondered what being a PICU Nurse means? What skills you would need? Or what a typical day in the life would look like? Make sure you’re all caught up with Specialty Nursing: What Makes a Good PICU Nurse? And now let’s dive in to an interview with Hannah, a real life PICU nurse!
Name and Education
Hi! My name is Hannah and I am a bachelor prepared nurse. I graduated from California Baptist University with my BSN (Bachelor of Science in Nursing).
Where Do You Work?
I worked as a Pediatric Intensive Care Unit (PICU) Nurse for 2 and a half years. I then transitioned to an Outpatient Pediatric Neurology Clinic.
What Made You Want to be a PICU Nurse?
In nursing school I loved my pediatric rotation. I loved that the goal of the day was to try and bring a smile to a child’s face who is experiencing such pain, fear, anxiousness, or exhaustion. I enjoyed working with the interdisciplinary teams and child life specialists. Overall I am a positive person, and I felt like I could be my fun, outgoing self on the pediatric unit. However, I also loved my critical care rotation because it challenged me in ways I desired to be challenged. It forced me to be attentive to detail and use my nursing knowledge. Each patient’s condition was a giant puzzle, and it was rewarding when the pieces would start to come together. I loved seeing the result of hard work.
What are the Most Common Skills Needed to be a PICU Nurse?
To be a PICU Nurse you need to have good critical thinking skills, communication skills, and organization skills. You also need to be able to assess patients well and notice change in condition quickly. You need to work well under stressful situations and be able to think clearly during an emergency. I used every skill I learned in nursing school in the PICU from starting IVs to placing NG tubes, straight catheterization to efficiently cleaning a patient. Also… A LOT OF SUCTIONING! You use it all!
What Personal Qualities does a PICU Nurse Need to Have?
As stated above, you need to work well under pressure. You are often working with a large team, so you need to be a team player. You have to be able to rely on others to help you with your patients. It is not a job you can do on your own, and you have to ask for help constantly. You have to be confident to speak with doctors, and advocate for your patients and parents when you feel their needs are not being met. You also need to be empathetic. These families are going through a lot and having a nurse that truly cares makes a world of a difference for them.
A lot of the time parents feel helpless when their child is in critical condition, so it is your job as the nurse to assess opportunities to bring parents back into the care of their child. This helps build rapport with your families and helps them to feel that they are being cared for too. Whether it is a simple diaper change or teaching them how to care for their child with new medical devices like trachs, G-Tubes, or PICC lines, bringing parents into the care of their child early on also helps the child to feel more connected and dependent on their parents again.
What Does a Typical Day as a PICU Nurse Look Like?
In California, the patient ratio is 2 patients to 1 nurse. Unless a patient is critically ill, then they are a 1:1, meaning one nurse to one patient. As a PICU nurse, you have to do vitals and assessments every 2 hours, unless ordered differently. They can sometimes be ordered every hour or every 4 hours. You can have intubated patients where you are titrating sedation, patients on high flow nasal cannula, or standard oxygen. You can also have post-op patients, DKA (Diabetic Ketoacidosis) patients, renal failure, cardiac arrest, trauma, or even non-accidental trauma patients. We often see Hem/Onc patients that need close monitoring for medication administration or who are needing further medical support. You see many different types of patients which keeps you on your toes.
You are also in constant communication with the patients’ families and helping them understand what might be going on with their child. This can be a scary time in a child’s life and also in the parents’ lives. You have to be willing to come alongside them and support them with whatever they need. Sometimes that means mourning with them. Or sometimes that means celebrating with them as their child graduates from the ICU to the general peds floor or sometimes even home.
What is Your Most Favorite Part About Being a PICU Nurse?
I loved the connection you built with your patients and their families. There were so many times I had patients for weeks in a row, and I became a part of their family. Those relationships I will carry in my heart forever.
What Should Students Looking to go into PICU Nursing Know about the Field?
You need to know your ages and stages, cardiac rhythms, PALS, and vital signs for different ages. You need to know your medications well and how to administer them. For children, medication doses are based on their weight, so it is important to retrieve a daily weight for them, and to be mindful of your calculations when drawing and administering their medication. You should also be knowledgeable about different childhood diseases and their signs and symptoms. As sad as it may sound, being prepared for “the worst-case scenario” in this job is the best way to be prepared.
Anything Else You Wish to Share?
PICU is not for the faint in heart. Though it’s rewarding, there are days that you feel like you didn’t do enough or feel absolutely defeated. There are days you have to place a patient into a body bag that you built memories with or that you felt didn’t get enough time on this earth with their family. Unfortunately, for me it didn’t get easier with time and that is why I no longer work in the PICU. It’s not an easy job, and I have the utmost respect for those who have done it for years or push through those moments to continue impacting even more patient’s lives in a positive way.
However, with that being said, not every day is an emotionally taxing day. Some days you are taking care of a “frequent flier” patient who you’ve taken care of for years. These are patients who most often have chronic conditions and depend on many medical devices such as trachs, ventilators, and G or J tubes to live. These patients are often brought in due to a respiratory illness or a GI (gastrointestinal) bug that has become uncontrollable at home. Patients dependent on ventilators are not allowed on the General Pediatric floors (at least not at our hospital), and they would then come to us in the PICU. Most of the time, these are total care patients. And even though they can be more stable, you will find yourself still extremely busy taking care of them, as they have many needs that have to be met. Some nurses tend to see total care patients as less important than other critical care patients, but please NEVER be the nurse that allows harm to their patient due to negligence. If you need help when caring for any of your patients, please just ask!
Thank you Hannah for your loving service to kiddos and their families in critical need!
Be sure to check out the entire Specialty Nursing Series, and follow along with this new Specialty Nurse Interview Series!
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- Meet Briana, a Med Surg Nurse!
- Meet Nicole, an ICU Nurse!
- Meet Theresa, a Maternal Child Nurse!
- Meet Nicole, a Peds Nurse!
- Meet Jordan, an ED Nurse!
- From Nursing School Straight to the ICU: Meet Rylee, a New Grad Nurse!
- From Nursing School Straight to the PICU: Meet Nahla, a New Grad Nurse!
- Meet Allison, an Oncology Nurse!
- Meet Sara, a Mental Health Nurse!