A Med-surg/onc/tele floor to add Pediatrics!

[jsepark119]

I actually wasn't sure where to put this post, and I'm not sure how many people would be able to comment, since this is a bit of an odd situations, but hey, I'm a noob-nurse, and I can use all the help I can get. :).

I've been working on an Oncology/Medical-Surgical/Telemetry floor for over a year now. Our hospital system isn't doing so well financially, sad to say. In the last few months, the administrator decided to merge Pediatrics onto our floor, since we average 1 pediatric patient/day, and there just isn't enough pediatric volume to justify an entire floor for pediatrics. So now we have kids on the floor.

Other than a personal fear of small children unrelated to treating pediatric patients (har-har), it's been an odd transition and it's only been a few weeks. Our floor is just not very kid friendly, but we don't have the room or resources to make it environmentally more welcoming for the kids. We're having one of the old storage rooms be turned into a play room, but it's relatively small.

I wanted to ask of all you veteran peds nurses, how would you go about using this kind of situation to make sure we can provide the best nursing care possible for these new patients? if you've had a merge like this before, I'd appreciate the advice. We get almost every kind of patient on our floor, but we do focus on oncology, and most hospice patients in the hospital are also sent here. Would you organize the floor a certain way? We've already grouped together the "peds" rooms, although these might also be used for another kind of patient as well.

A few of the ideas we've had are making craft boxes or toy boxes for each kid who comes in, maybe donated by staff or even by people outside the hospital (crayons, markers, coloring books, stickers, etc.). We already have the small playroom idea going. Should we do something for the parents?

Looking forward to the comments. :)

[Kidrn911]

This actually pretty common in smaller hospitals. One hospital I worked at had a playroom, never used though for that. It did store toys so we could bring some in their room. We also had a treatment room for spinal taps and other invasive procedures. But we usually never used it for that. Just mord storage. Guess it depends on what you will use.

[umcRN, BSN, RN]

Treatment rooms are nice if you are able to use them because it keeps the kids room "safe". Where I did my pedi clinical they had a procedure room and would use it for everything from IM injections to spinal taps. I know the floors at my hospital utilize them as well. I work in an ICU so all procedures are done in the rooms but I think for an acute care floor environment that's a nice thing to have

[NenjaRN]

Definitely a treasure chest of some sort with coloring books & crayons, stickers, bubbles (which are great for pneumonia/surgical kids that don't understand the concept of IS), etc that they can choose an item from when they come in and/or when they have a poke or something. Distraction is key!

I third the treatment room if you can find space for it. Unfortunately, it is never used as much as it should be at my current hospital, but when I worked in peds at a community hospital all IV starts, lab draws, caths, LPs, etc were done in there. The lighting was better and they need to feel safe in their rooms. It will make your life easier when they don't scream every time you walk in the room. :)

ASK mom and dad if they want to be present for procedures. Sometimes it's easier with them in the room soothing the child, other times it's awful with them watching over your shoulder and you're sweating bullets...but ask. Many don't know they have a choice.

Also...if mom and dad say something isn't right with their child, it's not. Figure it out fast!

[umcRN, BSN, RN]

yes bubbles! use them all the time with my cardiac kiddos. Every time I go to target and see bubbles on sale I grab a bunch