Pediatric rotation

[CountrifiedRN]

For the summer semester we are doing med-surg, psych, and pediatrics. This past week I did my first peds rotation, and have another one coming up next week. Next semester we will be doing more of a peds focus. I really thought I would love peds, but my first day was so hard! Not skill wise, but just, well, from a psychological standpoint.

There was a little baby whose mother had used crack while pregnant, and the baby was currently in foster care. The foster parents hardly ever came in due to obligations with other children, and it was just so sad. No one has heard from the birth mom, and it is assumed that she is still on the street. I was surprised at the number of children there that day that social services was involved with (5), due to questionable family situations or other issues. I knew we might come across neglect/abuse issues, but i thought they would be an occasional thing, not seeing several at a time.

Then a pt that I had was at the age where she had stranger anxiety, and would cry when I came near her. I had to do a physical assessment, and she got so upset when I was trying to assess her, I had to stop and return when she had fallen asleep. I felt so bad about making that baby cry, I just kept thinking what am I going to do if I have to give a shot to a child? I don't know if I can do it! My instructor said just think about how you deal with your own kids, and get in the mindset that even though they are upset, some things have to be done in order to make or keep them well.

But it's just a different ball game when you are the one comforting vs being the one who has to do the procedure.

Anyone have any suggestions on how to make pediatric rotations easier? (For me and the kids!) I knew we might come across neglect/abuse issues, but I thought they would be an occasional thing. Was this just a bad day, or is it a usual day? And how do you deal with having to do procedures on children? Next week we will be doing all the meds for our patients, so I might have to give a shot (I'm hoping and praying that I won't!).

[uk_nurse]

RN2bNC

I am a final year paediatric student here in the UK. Well, i know how you feel and i did too. The first thing to do when you begin to assess a child is explain to them what you are going to do. If it is not going to hurt tell them it won't, but if it is tell them it will hurt a bit but not for long. Tell them it is to help them get better. Alot of working with children is down to communication and not to treat them as 'little adults'.

If it is a baby explain to the parents what you are going to do and why.Babies sense things from their parents, so if parents are relaxed chances are baby will be too unless in alot of pain. Talk to the baby too that helps. It is difficult at times and can be upsetting but just think whatever you are doing you are helping the child. Just think you will see the child from being unwell or whatever to getting up and walking home. Children recover quickly but can also deteriorate quick. So good luck in you placements. I hope this helps you.

uk_nurse :) :) :)

[peaceful2100, BSN, RN]

RN2BNC, Sadly enough in Peds you will run across a lot of children where social services are invovled for all kinds of reasons like the one's you mentioned. It is more of a problem in certain areas all though it is everywhere. It is tough seeing a drug addict baby.

I use to work in a daycare center for 3 years. The whole time I was there it was almost as many children in foster homes/children who were adopted that were previously in adoptive homes than children who were with their birth parents. It is truly sad. I have seen several babies gone through drug withdraws, it is defintely not a pretty sight at all. It is very heartbreaking to see a helpless innocent victim go through something like that.

As far as procedures some kids don't care what goes on with them and are pretty laid back and others cry before you even begin. It is tough, you have to try to be as creative as possible. Find out if the hospital allows bubbles. If so bring some bubbles in with you. I have found when I worked in a pediatric hospital last summer that bubbles work wonders. Many kids love them. Talk to them and play with them first. Let them see the equipment first and if it is something that does not need to stay sterile or is not dangerous let them touch it. Role play with them. Get a doll and tell the doll what you will do and do it to the doll. I have found that has worked with some children.

It just takes a lot of patience working with kids. When some kids are going through seperation anxiety for many of them they need to see that they can trust you. So talk to them first and act funny. Like with the role playing using teddy bears or dolls or even hand puppets.

Peds is a hard area and can be a very emotional area for many people even one's who have been in it for years and love it. You have to pray about things and certain situations and realize that the kids have it tough and that they are trying to get the best care possible when they have not received it before.

[jschut, BSN, RN]

I think Peds is going to be hard for me too. Not only the addicted babies, but the Mom's who come in are so young! I recently had a rotation where I spent the day in an OB office. A young girl came in, just turned 16 and found out she was pregnant again. Baby number 2. Where are these girls parents? Babies having babies...I just don't get it and I'm not sure I want to.

Some ladies are mature enough to handle a child, but what's going to happen to most of these babies and their young mothers? It grinds my insides to think about it. Fear, I guess.

May God love them all~

Julie

[shay]

RN2bNC, I had a 'child protective services' (that's what I called it, 'cause it seemed like I was ALWAYS seeing them with my patients) rotation in peds, too!! I had a 3 y.o. who was hospitalized for INGESTING cocaine at his mom's house. That was just the top oh-my-God story from my rotation. Saw a lot of stuff like that. Shaken baby syndrome, suspected abuse, etc..

It's hard to see stuff like you describe, but honestly, you've just got to leave it at the hospital or it's going to eat you up. I know that sounds so cold. I don't mean shut off your feelings. But there is only so much you can do, and if you let it get to you it can be frustrating. Care for these kids the best you can. Love them, do what's appropriate nursing wise (social serv. consult), but at the end of the day just let it go and realize you did the very best you could for these kids. I find my faith is very helpful in situations like this. Not to sound like a bible-thumper (I'm not), but sometimes the only thing you can do for a person is pray.

Anyway, it's normal to feel what you're feeling. Seeing the ugly things people do to eachother close up is hard, especially when the victim is an innocent child. Quite frankly I'm glad you're upset and have personal feelings about it. You'll make a compassionate, caring nurse one day. Hang in there. :kiss

[CountrifiedRN]

Thanks to everyone for your helpful responses and insights. I finished up my pediatric rotation last week, at least for this semester. We'll have one more rotation in the fall. Last week was not quite as bad as the first.

I tried to use all of your advice last week, and it did help. Plus, the child I had was older and more relaxed. I am glad that I had this experience, but so happy that it is over for now! Plus, I didn't have to give any shots - woohoo! I never thought I'd say this, but I want to go back to med/surg!

Anyway, the rest of my summer is in psych, so I have a feeling that it will be a challenging rotation. Thanks everyone!

[allthingsbright]

I dont have much advice for you, except to say that as a mom I know where you are coming from ( I tend to see my own children when I look into teh faces of kids who are suffering.)

It is a good thing that you are saddened by what you see-this is what will make you a good nurse. But, you also need to make sure you are supported and can talk about what you see and feel!

Something that helped me when I was a CNA was taking a moment with each patient and saying a little prayer for them inside my heart. If you dont pray, maybe you could just have a little moment of silence for each person you encounter and wish them happiness, health, etc. As a religeous person this helped me put things into perspective.

I have learned (and am still learning) that I cant fix everything, I cant explain why bad things happen, and I am helpless in many aspects. But, I can say a prayer, do my best in my job, give excellent care, protect my patient as much as possible, and offer a hug, a touch, etc.

Good luck to you! (Good luck to all of us who are students!! )

Amy