Scared of pediatrics rotation in the fall

anonymousstudent · May 27, 2012

Here, peds is a pretty hands off rotation. Most kids get IV meds, and most Children's Hospitals won't allow students to give IV meds. I was basically a glorified PCA that term who did assessments.

Much of the peds stuff is very similar to adults. If you've had med/surg, it will map over well.

As far as dosages for kids, always look at the amount (mg) per weight (kg) per day. Look at the total dose the kid can have for an entire day. Then look at what was prescribed per day, and figure out if you're in the safe dose range.

Jolie, BSN · May 27, 2012

I've never been a clinical instructor, but I have precepted numerous students of all levels in the NICU. Nothing cheeses me off faster than a student who doesn't know normal vital sign ranges and/or developemental expectations of their pediatric patients.

I realize that as a student, you have little to no experience in this area, so I don't expect you to be an expert. But, please, please look them up, make a cheat sheet and refer to it before you (not you personally, the collective student you) scare the living daylights out of a new parent by telling her that her baby is tachypneic and can't possible be safely fed by mouth when the kid's RR is 50 following a crying spell.

Also expect that parents will be involved to varying degrees in their children's care, based upon their knowledge and comfort level. Speak with them upfront to determine what they would like to do and what care you need to be responsible for.

Peds is a challenge, but all areas of nursing are a challenge. Prepare yourself and you'll do fine :)

Double-Helix, BSN, RN · May 27, 2012

Hi! I see you're pretty new here. Welcome! I hope you find All Nurses is a great place to seek advice and support during your nursing career.

We've all been there- facing our ped's rotation. Sick kiddos. Wondering how we will handle it... Your fears are totally normal.

I'll also mention that a little bit of fear going into pediatrics is a good thing! I'm a peds nurse now, and I honestly get a little nervous when the students tell me they aren't nervous at all.

My peds instructor was intense too. We had to research our patients before clinical. We had to know everything (Literally- everything: safe dosage, indications, side effects, food interactions, administration, things to teach, etc.) about every medication our patient was taking. My first patient had cystic fibrosis and was on about 25 different medications. My research took me hours and hours that night! The instructor would quiz you about your patients before the clinical started. If you weren't prepared, she would often send you home right then and there. It was scary! But you know what? It taught me a ton about my patients and gave me a healthy respect for the field.

Study the same way that you've studied for your other classes. I'm sure that, by this point in your schooling, you've developed some good study habits and techniques that work for you. No need to change that for peds.

As far as medications, the biggest difference that you'll see is that there are not standard doses for pediatric patients. If your adult patient needs Tylenol, they'll get 650mgs. It's the standard dose. If you're peds patient needs Tylenol, the dose will be based on their weight: usually 15 mg/kg per dose. The two most important things for you to know are: 1. How to convert pounds to kilograms and 2. How to figure out a mg/kg problem.

Here's a quick example:

1. The order states to give Tylenol 15 mg/kg/dose PO q4 hours PRN. Your patient weights 30 pounds. What dose of Tylenol will you give?

Step 1- convert pounds to kilograms. 1 kilogram = 2.2 pounds. So to covert pounds to kilograms, divide by 2.2

30 pounds / 2.2 pounds per kilogram = 13.6 kilograms.

Step 2- figure out your dose. If your dose is 15 mg/kg, simply multiply the dose by the patient's weight in kilograms.

15 mg/kg x 13.6 kg = 204 mg.

Just google Pediatric Medication Calculations to get lots more examples to practice with.

As far as clinical advice- there are scores of thread about this already, and I've commented on several of them. The search function is your friend. But here's a few links that you can read through:

https://allnurses.com/pediatric-nursing/how-make-most-616563.html

https://allnurses.com/general-nursing-student/pediatric-clinical-rotations-136247.html

https://allnurses.com/general-nursing-student/pediatric-clinical-656479.html

https://allnurses.com/pediatric-nursing/tips-building-good-696054.html

This is my absolute favorite quote about pediatrics from one of my favorite shows:

~passionateSN~ · Jul 16, 2012

I'm only going into second level in the fall and won't be doing fourth level until next fall but it is my greatest fear as well.. I had a 4 yr old daughter and it just breaks my heart thinking of having to poke and hurt the little ones.. I think if I rotate into picu or nicu I will come home crying everyday! But I know it has to be done and when that time comes I'll have to find a way to handle it..

~passionateSN~ · Jul 16, 2012

Have a 4 year old daughter******

jjrodriguez, BSN, RN · Jul 16, 2012

Our Pedi rotation was pretty laid back. We could only give meds one day (I was able to administer an IVP via pump) and majority of the skills were just basic assessments, developmental care and some minor tasks here and there. My off unit experiences were fantastic! I was in the ER and OR and my preceptors on those units were very receptive to me as a student, as were the doctors and other personnell. I got to prep the sterile site for the surgeon in the OR, how cool is that?? (for a novice student like me).

QuarterLife88, MSN, RN, NP · Jul 16, 2012

I'm not excited for peds either. Not a big fan of kids to begin with, and during this rotation I will have to learn a whole new route of communication just for assessment. eh.

I've got to suck it up so I can graduate and do what I really want to do. It's a means to an end.

classicdame, MSN, EdD · Jul 16, 2012

My biggest challenge was learning how to separate heart/lung/bowel sounds when the diaphragm of the stethoscope was only slightly smaller than the chest. ONe of the nruses helped me and that was great.