refusing to take report

SICU Queen · Aug 10, 2007

Your charge nurse is an idiot if she thinks that a pediatric patient is "just a small adult."

You need to make it very clear to your nurse manager that you will refuse any assignment that includes a peds patient. Then, if you get to work and you've got a peds patient in your assignment, you let them know immediately that you do not do pediatrics, that your NM is aware that you do not do pediatrics, and that they'll have to redo the assignments so that you don't have the peds patient(s). Stand your ground and don't sway in the least. Don't let them talk you into it "just for a few hours" because "we're so short" etc etc.

How big is your hospital that they're mixing adults and peds?

Bluehair · Aug 10, 2007

I currently work in a small hospital where we mix peds in with adults also. Our peds population is small and usually "not that sick". I am the same, I DO NOT care for peds. It has been too many years since I took that in school, I do not have any children of my own. My 'prepared speach' includes the words "I can not demonstrate competency in caring for pediatric patients." I have been known to use this phrase only once and it worked like a magical incantation. They floated me to Med Surg and one of the other Med Surg nurses went to care for the pediatric patients down the hall. I don't enjoy floating (ICU is my usual expertise) but recognize patients need care and nurses need help getting the job done. I won't leave my co-workers without help, but do put my foot down about not doing care I am not competent to do. I would not ask a peds nurse to come take care of a ventilated patient. The reverse is no different.

Good luck!!!

crb613, BSN, RN · Aug 10, 2007

Our hospital has ~ 100 beds. The thing is some of the older nurses will say....you might as well learn to take care of kids because you will have to sooner or later. Sorry, but no I will not! It makes it kind of hard to stand your ground when it seems everyone is pushing you to take peds. The other night they put a new nurse there with absolutely no experience! She had been refusing then due to all the pressure caved in & took them. Something bad is going to happen I can just feel it!Thanks for your reply.

Bluehair · Aug 10, 2007

Something bad is going to happen I can just feel it!

My feelings exactly! I read a signature on a thread somewhere that went something like 'you can develop competency through trial and error, but is that the best way to go about it?' Not an exact quote but you get the idea.

fergus51 · Aug 10, 2007

Are they completely unwilling to train you to peds? If all the nurses are expected to float there, then I see no reason to refuse training in that area. If they won't train you, then you can only keep doing what you've been doing.

Tweety, BSN, RN · Aug 10, 2007

Are they completely unwilling to train you to peds? If all the nurses are expected to float there, then I see no reason to refuse training in that area. If they won't train you, then you can only keep doing what you've been doing.

I was going to say the same thing. Rather than be so fearful daily. Why not rise to the challenge and ask for some orientation and training?

Is it very clear to the one making the assignment that you are not to float there? Make 100% sure it's understood you're not to be assigned to peds, no ifs and butts, so there won't be an ugly scene one day. Then if you are assigned there, tell them "I refuse to go, send someone else and please call the manager."

fergus51 · Aug 10, 2007

It's also going to cause a lot of resentment with coworkers if only one nurse is special enough to be able to refuse peds assignments. I've seen that happen on units and it isn't pretty.

crb613, BSN, RN · Aug 10, 2007

I do not want to be trained in peds. I have no desire to work in that area. I made this clear when I was hired, and yes it is well known. So I just keep repeating this very thing.....but my heart rate goes up until I see the shift assignment.

fergus51 · Aug 10, 2007

I do not want to be trained in peds. I have no desire to work in that area. I made this clear when I was hired, and yes it is well known. So I just keep repeating this very thing.....but my heart rate goes up until I see the shift assignment.

Unforunately then this will probably keep happening and you'll have to keep doing what you're doing and decide if this job is worth the stress.

I do know the feeling btw. I'm a traveller so we float first and that usually means to peds. I've always been able to negotiate appropriate assignments, but I always go there with trepidation.

mamalle · Aug 11, 2007

do you not have to have PALS working with pediatric patients in the hospital? I too agree that something bad is going to happen. I work with some individuals that think taking care of kids are no big deal- until today we had a apneic 10 y/o come out of the OR into pacu today. Now they know why we have everything set up in our "pediworld" for any type of emergency, why we take extra special care of these little people and know what to give with dosaging in a pediatric emergency.. I wouldnt want my child being taken care of by a nurse that was floated, etc from the med surg floor that didnt have any pediatric experience but thats just me..

crb613, BSN, RN · Aug 11, 2007

It's also going to cause a lot of resentment with coworkers if only one nurse is special enough to be able to refuse peds assignments. I've seen that happen on units and it isn't pretty.

I know & I sure don't mean to be a pain in the butt! I have had zero training/orientation....I don't want it, but there has never been an offer either. The only thing I have gotten so far is....they are just small adults. A six day old baby is not a small adult.....:angryfire I do not want to harm anyone, and I would really like to keep my license. I also would not want a nurse without proper training taking care of my baby! Thanks