The floors are known to be mundane for many therapists. Some hate it, some love it.
The case against it: We don't use our skills. The residents don't care about our opinions. I don't have to think as much.
The case for it: It's less stressful. There is more "down-time" than ICU. I don't have to think as much.
Our hospital makes us work the floors 50% and PICU 50% which ends up being a pretty good system in my opinion.
We provide useless and countless albuterol treatments for patients that don't need them. I've been told that there are many non-indicated albuterol treatments due to the fact that albuterol is cheap and safe while the phsyicians want to protect their butts.
The work load is usually split by how many treatments a floor recieves. If I were working floor 5 that has 12 treatments and floor 6 has 20, I'll probably take 4 of his treatments so we both have 16. By treatments, I just really mean albuterol. Sure we give other types of inhalation medication and provide other servies such patient education but those don't really matter in the system.
The Q2 (every 2 hours) albuterol treatments are pretty annoying simply because most of the time they are not indicated. Most kids end up on Q4 treatments which are usually done at 2000, 0, and 0400 "rounds."
We have a hour leyway too provide a treatment so for 2000, we have anywhere from 1930 to 2030 to get our job done. Each nebulizer treatment should take roughly 10 mintues if done correctly. That includes talking to the patient, vitals, finishing the neb, more vitals, and charting. The first rounds usually take longer just because we have to establish rapport with the parents, usually do addional BID (twice a day) treatments, and find the drugs.
We don't stack treatments here. Stacking refers to starting a nebulizer on patient 1, 2 and 3 and then coming back to 1 to take the nebulizer off. It saves time but that time should be used for patient educaiton. Also, some of these kids will rip that little mask off the moment you turn around.
There are two big things that I like about the floors more than PICU.
The kids are not as sick: This allows me to build a relationship, have fun, and joke around with the kids. And when there is "down-time," we could play video games.
Down time lasts longer: Down time is the time before the next rounds or any other responsibilities. If I finish my first round of treatment by 2030 and the next set of Q4 albuterols are due by 0000, I theoretically don't have anything to do for nearly three hours.
It does seem like a lot of the night shifters love the Facebook. Others will pick up a book or magazine. I try to expand my knowledge by talking to co-workers. I'll also snack a lot.
You'd think that there be more down time in the PICU since the nurses do the nebulizer treatments, but that's not true. Since the kids are definitely sick, we have to keep a careful watch. Our time is spent on discussing patient ventilator goals with the physicians and helping nurses with various tasks. More thinking is involved, but I sometimes don't mind turning off my brain.
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5 comments:
When I have a kid I usually stay in the room, but being a smaller hospital I do stack adult treatments. I especially stack treatments if they aren't needed or if the patient has the medicine at home anyway.
And I never take 10 minutes to give a treatment. The few exceptions being a new patient, a patient whose heart I don't trust, and the few patients who really need the drug.
It has to be this way where I work because we're a small hospital and there are usually onle one or two of us available.
Being at a large hospital does have its perks sometimes. I never feel truly alone. I could always call out to the other 8-9 therapists for help when I feel overwhelmed.
Downtime is horrible! We have way to much of it where I work! Either that or we are WAY overstaffed.
I could see how having too much downtime could be horrible if you don't get along with your nurses or other therapists.
Some say downtime makes them feel unproductive. We have a decent balance of downtime and work work at our place.
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