A pediatric intensive care unit (also paediatric), usually abbreviated to PICU, is an area within a hospital specializing in the care of critically ill infants, children, teenagers, and young adults aged 0-21. A PICU is typically directed by one or more pediatric intensivists or PICU consultants and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff, although this varies widely depending on geographic location. The ratio of professionals to patients is generally higher than in other areas of the hospital, reflecting the acuity of PICU patients and the risk of life-threatening complications. Complex technology and equipment is often in use, particularly mechanical ventilators and patient monitoring systems. Consequently, PICUs have a larger operating budget than many other departments within the hospital.

Between 1930 and 1950 the poliomyelitis epidemic had created a greater need for adult respiratory intensive care, including the iron lung. There were times when children would contract polio and would have to be treated in these ICUs as well. This contributed to the need for a unit where critically ill children could be treated. Respiratory issues were also increasing in children because neonatal intensive care units were increasing the survival rates of infants. This was due to advances in mechanical ventilation. However, this resulted in children developing chronic lung diseases, but there was not a specific unit to treat these diseases.

As a PICU nurse, extended knowledge and certifications may be required. Recognition and interpretation are two of the many required skills for a PICU nurse. This allows nurses to be able to detect any changes in the patient's condition and to respond accordingly. Other skills may include route of administration, resuscitation, respiratory and cardiac interventions, preparation and maintenance of patient monitors, and psycho-social skills to ensure comfort of patient and family.

Working in the PICU result may in emotional stress and/or occupational burnout of the staff. For patients that do get discharged from the unit, often they are not free of chronic conditions or disabilities. There are other factors that lead to stressful work conditions for the staff of the PICU. The staff often work for long periods of time in order to stabilize the most critically ill pediatric patients. They must collaborate with other members the healthcare team in order to develop the best plan of care. Once a plan of care is developed, then the staff must communicate the plan with the patient's family in order to see if it matches their beliefs. If the plan of care does not match the family's beliefs, then it must be modified the plan causing more stress on the staff. All of this causes the staff a great deal of stress and each member of the unit must develop their own coping mechanisms in order to prevent burnout.

Regards
Rutherford
Managing Editor
Journal of Pharmacy Practice and Education