[Danamegg]

I am the mother of a student nurse. As part of her rotation to acquire practical experience in a general hospital, she has to work in a childrens' ward for a few weeks.

She is scared to death about this because she has NO experience of young children.

Are there any tips about handling children as patients that you could share with her? Or would you say "you have it or you don't"

Any help would be appreciated!

[uk_nurse]

I'm A paeds nurse and all i can say is you have to be on their level of understanding. Children ask many questions and you have to answer them truthfully and in a way they understand. If a proceedure is going to hurt then tell them so, but be careful how you say things. Another important factor is remember their parents. It is their child and always ask for their consent in anything you do. The adolesents are different in many ways. I advise reading up on consent.They like to be treated as adults. Don't speak down to them and at the same time remember they are still minors. They ask more in depth questions and always remember what you said. Just remember what you were like as an adolesent.

Don't forget that it doesn't matter how old they are many children are scared. Your job as a nurse is to help overcome this and play helps, in adolescents good explanations in lay terms is advisable.

Working with children is fantastic and very rewarding. Children make quick recoveries and to see them on the road to recovery is so good. Children also are very comical at times. You should enjoy this placement. I would not work in any other area.

Good luck and enjoy!

[bergren]

I am a peds nurisng instructor and I have been shocked at the number of students. compared to even just 10 years ago. who have never spoken to, touched, dressed, diapered, or otherwise been in the presence of young children or babies. I am not sure what this is saying about our society......and how is this generation going to know how to take care of their own children? I have had rotations where out of 8 students, only 2 know children and both of those students are mothers.

When does the peds rotation start? If in a few weeks, she should "borrow" some kids, offer to be a mother's helper, go visit a relative with small children and get down and dirty with them. Hands on, play games, put them to bed, change diapers, give them a bath, etc. Volunteer for a brownie troop, a day care.

If there is not time for that, she should tell her instructor immediately that she is not skilled and scared. I'd rather know that before I get interrupted in the middle of a procedure by a student who wants me to accompany them to change a diaper. The other danger is safety - not knowing to turn your back on an open crib, how to pick up an infant, leaving items near toddlers, how small to cut peices of food.

It is very difficult to learn pediatric nursing while learning basic child care - Peds nursing is a very distinct specialty with many skills and knowledge specific to this population. I do think schools of nursing need to address this growing problem. I believe they need to consider requiring students to have basic child care skills just as they require other prerequisites prior to caring for sick children.

[Danamegg]

Thank you for the excellent advice. She is starting in the children's ward next week, so not much time for the exposure suggested. This is sad but true: We have no family members or friends with children. (Her youngest cousin is 17).

Any other members who would like to share?

[Jolie]

Fortunately in peds, there is USUALLY a parent or family member present at the bedside. Observe how they handle and speak to the child. Ask for their suggestions and input. No one will ever know a child as well as his or her own parents. While the parents may not be skilled or knowledgable about medical treatment, they are certainly the experts on everything else! Utilize their expertise. It will help them to know that their input is valued in an otherwise frightening and overwhelming situation. And it will help the student to learn how best to interact with the child.

[janfrn]

Some little tips...

Distraction is a great tool for dealing with older infants and toddlers. Put something in their hand while you examine them and they'll be less likely to pitch a fit. Even preschoolers will respond to distraction.

Examine Mommy first. Temps, BPs, chest assessment... anything the child is likely to resist will be easier if they see Mommy go through it first and see for themselves that she survived. Mom probably won't agree to modelling IV starts though.

Offer preschoolers and older kids choices, but realistic ones only. "Do you want your meds now, or in five minutes?" "Do we do your BP on this arm or the other one?" "Would you like a happy face on your bandaid when I'm done with your test?" But never ask them if it's okay to do something you MUST do.

Meds are often difficult to get into kids. If a parent is experienced at giving their child meds, you might let them do it in your presence. Don't give PO meds to a crying child unless you're comfortable with aspiration. Most liquid meds will go down better if you get them into the back of the child's mouth, past the taste receptors. I like to slip the syringe far back in the buccal pocket and only instill a bit at a time. Otherwise, they let it ooze out their mouth and all over the place. For infants, you can get them sucking on a nipple with a small amount of formula in it, then drop the meds into the open end a little at a time, alternating with formula if necessary. This takes practice. Oh, and prednisone is disguised very nicely in chocolate pudding.

Parents of children with chronic issues often want to do all the things they normally do at home, including central line care, ostomy care, physio and such. If they're around when such care is due, ask them if they want to do it, and respond accordingly. But don't expect them to do it, or "save" it for them. Sometimes we all need a break.

If I think of anything else, I'll be back.

[catz]

best advice has already been said. most importantly remember that young though a child may be they are still people. ask them the questions and ask momma to help out with the answers. even a tot can tell u wat they had to eat for breakfast and momma can back up wat they say or correct them if wrong.

remember to introduce urself to the child. im x and im one of the people that is going to look after u today usually suffices. i usually ask the child (as long as they can talk) is this ur mommy, daddy watever in order to establish who is with the child. sometimes granparents or friends will stay for a while to give parents a rest or time at home with other kids.

remember to ask the child if he/she has ny questions as well as asking mom.

ur daughter should be given the oppurtunity to shadow a member of staff before actually doing nything herself. she will be fine i am sure.

[Alley Cat]

Danamegg, I noticed your post was a while back. How's your daughter doing with her rotation?

[Josie K]

'Kids don't come with instructions'. Threads highlight our changed society - reduced family size and therefore no sibling experiences to go off. Just go's to show the need for 'Parenting Education' to equip future Mom's/Dads. Even teaching adolescents some 'baby sitting' skills might bridge some basic gaps............The prospects are endless.

[vemiliob]

Danamegg, I’m sure it isn’t too late yet to give your daughter another advice. Mine is a peculiar case. I am already divorced but married since 1979 until 2003 with more than one wife, I’m 47. I don’t have children of my own, I never wished to. Also I believed I didn’t like children until I started studying nursing.

In ten years, I passed trough vaccination campaigns, PICU and neonatology practice, ER and Ambulances, always combining adults with peds. I never touched peds deep enough until June 2003. My colleagues pushed me to the swimming pool. “Just do it” they said and let me alone in the delivery room on my third presence. I received already 22 newborns; only one went to the neonatology unite for few hours. I never did a diaper before or a toddler bathing or dressing, by the way, I’ve never been so happy. I just did it naturally, as if I knew it all my life.
In my job, besides working with peds, (mostly toddlers) I have to control neonates for a minimum of three days and perform parenting teaching in the meanwhile. I guess your daughter must be already in the swimming pool. I know I have a hard stile, sometimes on the “Macho way”, even tough I believe there is a mother inside everyone, capacity for empathy or some protective instinct hidden in everybody’s genes. Don’t scare! Just let it go out and nature will take care by it self. Intellectual explanations will not help it. Only the heart can understand. Think about the meaning of the word “Nursing” and welcome to our files.