adult patients admitted to a pediatric hospital - page 4

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... Read More

  1. by   sergel02
    Quote from ~PedsRN~
    I LOVE LOVE LOVE my teenage patients. Seriously, they are some of my favorites. I like that they can carry on real conversations. I think the biggest difference is simply the psychosocial differences. A teenager is one of those things that looks like an adult, acts like an adult, but just isn't one yet. We tend to have a little more time and patience over in the peds world, and I do think that makes a difference in their care and recovery. Not only that, but with family centered care - we know how to deal with those parents in a way that the adult world can't get their heads around.

    BUT, that being said - there are some teens that NEED to be in the adult world. Like the child molester. Please. Or the married kid with kids! Or the gang banger. I'm sorry if I have to post a police officer outside of your door you need to be OVER WITH THE ADULTS. It's very frustrating. But your average teenager definitely can benefit from the peds world.
    The gang banger and molester i agree with, but why not the mother?
  2. by   ~PedsRN~
    Quote from sergel02
    The gang banger and molester i agree with, but why not the mother?
    If you are married,, and have your three kids in the hospital room with you - are you really going to benefit from pediatric care? LOL!!! Like the previous poster said, that kiddo didn't deliver her baby in the pediatric hospital. I dunno, it just feels very odd to take care of someone who has a family unit themselves. Some things force you to grow up and motherhood is definitely one of them.
  3. by   NurseStorm
    Since I work in a smaller hospital we actually regularly have adults and not just congenital defects/developmental delays etc (which we do have a few severe CP or other similar cases that the pediatrician still follows them and they are in their mid 20s).

    We get a lot of post-op gyne patients (hysterectomies, bladder repairs, etc) as our most common adult patients. Then we also get sometimes random things. You never know what you're going to get I think my record age was an 86 year old with COPD. I really enjoyed her actually, she was hilarious. Her language though, while funny to me would've been inappropriate if any kids heard I'm trying to think of some examples- pregnant woman influenza +, 80 year old woman with parkinsons and high blood pressure post op, forget the surgery but something very simple and routine.. Adult with pancreatitis, adult with small bowel obstruction.. um,

    Once we had so many adult medical patients we joked that we were now the medical floor Those few days included a post op lap choley who had some type of serious rare infection previously, I think in her spine? Anyway, she and her entire family became enraged when the doctor tried to discharge her 24+ hrs post op (most people don't even stay..) She also was stating she needed vicodin for the pain (which we don't even have in canada technically), the family was yelling and cursing at me that I was trying to send her home "like this" ... Another few post ops plus a few women with about 10 diagnoses each including type 2 diabetes, hypertension, migraines, fibromyalgia, sjogrens, hernias, anxiety, UTI... etc. I'm not joking, at least 10 each. The meds (connected together in clear plastic packets) were longer than I am tall when I held them up, and that was just morning meds. One of them got meds almost q2 hours, all different regimes. It was an insane time on the unit for sure.

    I don't mind the gyne patients because since we get them a lot I feel very comfortable with their care, and it's very straightforward for the most part anyway. What we don't like is when the supervisor tries to put inappropriate patients up- adult psych? adult chest pain possibly cardiac? adult with inappropriate behaviour , etc. Or things we don't often get it is sometimes uncomfortable because you aren't familiar with it. I always just try to read into it quickly and sometimes we will consult with nurses on adult units for advice of management. I think it does help with my skills though because I get exposed to so many different things it makes us a bit of a jack of all trades in some sense.
  4. by   KelRN215
    It's been a while since anyone posted on this thread but I'm still encountering the same issues I wrote about 4 years ago.

    One of my patients now is a 21 year old with a history of a rare cancer. He is treated at the pediatric hospital. He is cognitively intact and was a college student prior to his diagnosis. He went through treatment and transplant and now has been back in the hospital for a while. For weeks, it was documented in his notes that the possibility of relapse was "discussed with mother but not discussed with him [patient] per mother's request." Why does anyone think it's the mother's decision whether or not to disclose to the ADULT patient that he is being worked up for a possible cancer relapse?

    Fortunately in this case the Social Worker stepped in and told the medical team that the patient had a right to know this information but why would any healthcare professional even entertain the idea that it's ok to withhold this information from an adult? Rarely do we allow parents to withhold such information even from children. We have Child Life to help explain things to them but a child old enough to understand is prepped for their diagnoses, procedures, etc.

    I've also had several patients recently (18 yr olds, 20 yr olds) who were their own legal guardians and the medical team insisted on "family meetings" or parental involvement prior to discharge. A 20 yr old who was going to go home on IV antibiotics (again, her own legal guardian) and they insisted that the mother had to be trained to administer it. The mother was completely disengaged in the teaching but the patient participated and demonstrated that she would be capable of managing it at home, with nursing support, though the team decided she wasn't an appropriate home care candidate because of her mom. If we don't require the Mom of a 40 year old patient to learn such a thing before discharging him, why do we think it's ok to make this requirement for a 20 year old? She is just as much a legal adult as the 40 year old.