adult patients admitted to a pediatric hospital - page 3

by rnsusan

7,527 Views | 30 Comments

How do pediatric nurses feel when they have to take care of an adult patient? We do not get that many, but we do get a few when there is no one to transition them to. Many of my co workers get upset and think they need to go up... Read More


  1. 0
    Quote from janfrn
    Wow... Just wow. Very unprofessional. Did you call her on it?
    Yes I did actually. I was very upset. Especially since I had yet to even tell my family that I had gotten the biopsy results, and I'm 25, not a child. She was a little taken aback on the phone when I talked to her but she did apologize,she just didn't want me to not get the memo.
  2. 0
    We get patients up to age 24 in our hospital.... most of these are CP, CF, Cardiac kids, etc.
  3. 0
    The oldest patient I've nursed in a paediatric setting has been a 20 year-old CF patient on their last admission for tune-up prior to transition to adults (next door).

    Interestingly, I've seen a lot of children nursed in complex adult settings. The leading cardiac ICU in the state very often treats congenital cardiac adults and almost equally as often, takes teenagers (I think some of the younger ones have just broken 14 years of age) on ECMO, transferred from either of the paediatric ICUs in the state, who've suddenly jumped to the top of the transplant list. They typically become extremely unwell, extremely quickly in the paediatric hospitals, end up on ECMO and at the top of the transplant list and are (obviously) to unwell to be transported to the only state in the country that actually does paediatric transplants in a paediatric hospitals. They stay in the adult ICU until the organ becomes available, are transplanted in the adult hospital, cared for post-operatively until stable enough to be transferred back to the PICU and transitioned out onto the wards in the paediatric hospital.
  4. 2
    Ahh, my favorite soap box...

    Quote from PedsNP2013
    I know some of these adults have pediatric diagnoses but this is the reason i chose to do pediatrics because i cannot stand adult patients that act like this.
    I drive an HOUR to work peds. If I wanted to take care of adults, I'd have an 8 minute commute.
    The patients we get, there are services for them in the adult world. They just do not want to transition. We're nicer than the adult hospitals. Because we have a bunch of bleeding heart sweet young girls that never worked adult care and have a complete inability to put their foot down and tell the patient that they need to start acting like a grown-up and take responsibility for their own health.
    It's one thing when there truly is no other alternative, and the congenital cardiac stuff? Fine. The young adults with oncology, until the adult oncologists get up to date on what will work better for them? Fine. But sickle cell? Cystic fibrosis? There are adult programs now. Various handicaps since young? The adult hospitals have people that can take care of them.

    The most irritating thing is that the only time our hospital actually WILL refuse a patient is if it's a young woman that's given birth. So we'll refuse to take a 12 year old that's had a baby, but a 23 year old guy that has multiple kids by multiple women? We'll take him. Even if he's spending the entire hospitalization hitting on every staff member with boobs under the age of 30.

    We have to do mg per kg math. We've got to be up on the developmental processes. We shouldn't have to deal with adult patient drama on top of it.
  5. 2
    I had a 51 year old today...FIFTY ONE! Good lord

    I'll give the pt credit for being alive though, I had to actually ask the Dr. to explain to me how the pt was getting blood flow to the lungs because I could absolutely not picture it in my head (unrepaired asd/vsd/tricuspid atresia/hypoplastic right heart...and all the long term complications that come with that too)
    DeLanaHarvickWannabe and wooh like this.
  6. 0
    My hospital doesn't admit adults unless they came in through the ER so unstable that transfer is out of the option or there are no adult services for them. With many of the complex cardiac patients, they're only just now starting to live in to adulthood, so adult facilities don't know the ins and outs of caring for them yet. That I can understand. But if there's care at an adult facility, and they are stable, we transfer them.
  7. 0
    Wow! At our paediatric hospital we have a transition program to get them to an adult facility. The only time we see adults is when they are pregnant with a child who is going to be a patient in our hospital OR if the child is potentially going to pass away prior to ever getting use of transitioning. In ED we take kids up to 15 years and 9 months (unless known to us) and transition them when they finish school (around 17).
    The doctors taking care of a child who is not transitioning in the guidelines actually have to do a form and send it off to a department explaining why they are not transitioning and basically get it "approved". It comes down to funding I guess.
    The oldest pt in my paeds hospital I have taken care of was 19 and was still there because he was SOOOOO complex, and wasn't expected to make it till 20. We all knew him so well anyway we didn't want him to go!!
  8. 0
    I am actually a patient at a pedeatric hospital. I have a complex medical history and have been a patient there since I was 3. I have a genetic disorder (called Neurofibromatosis) that there are only 2 groups of docs who treat it in the state. there are 3 types of my disorder (actually all completly different but called the same disorder) and my doc's group focuses on my type. The other group focus' on one of the other types.


    I also see lots of other docs, but because that doc is there it is better to have everyone there so that they can all talk easily because my disorder can cause problems with any system at any time.
  9. 0
    I work at a stand-alone peds hospital that is not attached to any adult hospital. We get the cardiac/congenital defects patients mentioned already on this thread. We also will get some patients that had their life-changing event (head trauma, etc) as a child and the family is more comfortable with our set of MD's because they know the patient so well. We have had patients in their early 20's that fit into that category. I'm sure they must phase them to adult medicine at some point. . .

    We have had a couple of very much older patients who had rare congenital syndromes and the only MD's available in our geographical location who are familiar with those are peds MD's. Usually those patients are very much cognitively impaired and their mental/emotional needs are easily handled by us. The ones I've cared for are also smaller in stature, more "kid-like" in many ways.
  10. 0
    I have been doing a placement in adult respiratory and we get all the paeds for lung transplants. All the nurses have been doing extra training, but it's tricky to adjust. We get all the CF patients when they are over 18 though.


Top