Is pediatrics disappearing?

  1. I've worked as a pediatric nurse for a few years now and before that I worked with adults. Working as a pediatric travel nurse I've noticed many community hospitals and adult hospitals throughout the country are closing down their pediatric units. I understand pediatrics doesn't bring in much money but how will this affect their care? It seems as though many families are having to take their child to either the pediatricians office or a children's hospital. Has anyone else noticed this? Is pediatrics becoming a smaller and smaller field?
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  2. 6 Comments

  3. by   Wuzzie
    No, it is a huge field. It is also a highly specialized area and pediatric patients deserve pediatric experts. As with all health care the trend is to treat things on an outpatient basis. Kids who are sick enough to be hospitalized now are usually quite ill and the margin for error is very small. Better to have a sick kid in a tertiary pediatric center than in a small hospital ill-equipped to care for them necessitating transport. Frankly, I don't see it as a bad thing that they are closing. Kids aren't miniature adults. Small hospitals rarely have a pediatric census high enough to warrant specially trained nurses so often nurses with minimal opportunity to care for pediatric patients end up providing the best care that they can in a sub-optimal situation. I've had first-hand experience with this and it was troubling.
  4. by   RNperdiem
    I have had my child in community hospital that can make a few beds available for sick children, and I have been to large medical centers with pediatric emergency rooms, PICU and pediatric floors.
    I much prefer the big medical centers. If my child were to go bad medically on a pediatric floor, I would want a peds ICU available in the same hospital. Places that specialize also have better facilities for parents. The volunteer-run parent lounge where I could fix a cup of tea, take a shower or take a break was a sanity-saver.
    Some places don't admit kids at all. When there is an emergency, the child is stabilized and sent over to the nearest hospital that admits peds patients.
  5. by   meanmaryjean
    Agreed with both of you. I think it's not disappearing, but rather these smaller hospitals are just waking up to the incredible risk involved, and turfing kids to specialized care. Also, so many surgeries are now outpatient, and kids with diabetes are managed so much better with pumps. There's just less of a need for inpatient beds in every little hospital.
  6. by   KelRN215
    Quote from Wuzzie
    No, it is a huge field. It is also a highly specialized area and pediatric patients deserve pediatric experts. As with all health care the trend is to treat things on an outpatient basis. Kids who are sick enough to be hospitalized now are usually quite ill and the margin for error is very small. Better to have a sick kid in a tertiary pediatric center than in a small hospital ill-equipped to care for them necessitating transport. Frankly, I don't see it as a bad thing that they are closing. Kids aren't miniature adults. Small hospitals rarely have a pediatric census high enough to warrant specially trained nurses so often nurses with minimal opportunity to care for pediatric patients end up providing the best care that they can in a sub-optimal situation. I've had first-hand experience with this and it was troubling.
    This.

    My best friend gave birth at 23 weeks and 6 days. Her child has a number of ongoing medical problems as a result of this. Last year, at one point, she was seen in the Pediatrician's office and found to be hypoxic. They sent her to the ER. She went to the community hospital in the town we grew up in since it was closest figuring they'd stabilize her daughter and send her to the Children's Hospital. This community hospital had NO business trying to treat her very complicated daughter. They did try, they admitted her and mismanaged her for 10 days before she had to be emergently transferred to the Children's Hospital. They didn't even have a monitor for her to be continuously on and when I went to visit her, the crib she was in looked like it was from the 80s. Said hospital has since closed its pediatric unit (which, in reality, was a corner of the adult surgical floor).
  7. by   BogieRN
    You see more Children's hospitals now. I live in an area where the hospitals have less beds for minor things, major issues are sent to one of the two major peds hospitals. It's not easy getting hired at them either!
  8. by   PeakRN
    This is not specific to pediatrics, it is happening all across healthcare. Everybody wants to go to see a specialist or go to a special hospital. Nobody wants to be managed by family practice.

    Adults want to see pulm or allergy for their mild asthma, they want to see cards for that palpatation that happened one a month ago, they want to see an oncologist for the swollen lymph node they noticed when they had a cold.

    Same goes for parents, they now believe that their child's care must be managed by a world renowned children's hospital, even though their 17 year old has a headache or their 9 year old has a sore throat.

    Because of the hospitals are now specializing in all kinds of things, and community oriented hospitals are falling by the wayside.

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