Nursing Issue in Pediatrics?

  1. Hello amazing forum! I've been reading and learning from all of you on and in the Pediatric Specialty for a few years now. I am a (unemployed) new grad RN thats working on my RN-BSN while waiting for a great job in the area that I love, pediatrics.
    Well, my capstone project is coming up and I need to find a current issue faced by nurses in pediatrics. Can you all please give me some suggestions? It needs to be a nursing issue, not a medical issue. I don't have any real floor nursing experience to draw from, and looking back to my preceptorship, I was very focused and getting it all to take notice of issues that could be researched and addressed. Any suggestions would be greatly appreciated! Thanks!
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    About MassagetoRN

    Joined: Jul '07; Posts: 334; Likes: 145


  3. by   llg
    Here's one that may or may not work for your assignment as it is more "nursing" focused than "patient" focused.

    A lot of undergraduate nursing programs provide little education regarding inpatient pediatrics as it is not emphasized on the NCLEX and not required by many State Boards of Nursing. Therefore, the burden of teaching that subject matter falls upon the hospital who hires a new grad from such a school. Most hospitals are strappend for money and don't want to pay big bucks to provide that education -- leading them to not want to hire new grads from such schools.

    What do you see as the best solution to this problem? Whose responsibility is it to provide that education? If students choose to go to a school that offers minimal inpatient peds experience, should they then expect an employer to give them that education for free? Is the answer for hospitals to offer such programs, but charge a fee to the new grads for taking them ... or to pay them less than they would pay a new grad who went to a school providing a better peds foundation?

    This is a problem faced by many hospitals in many different specialties -- not just peds. But it is a big problem for children's hospitals because so many new grads have had so little education in peds in schools who emphasize only what is required for NCLEX.

    How much peds education should be required? Should schools revise curriculums to allow students to focus on 1 or 2 areas of special interest beyond the basics needed for NLCEX?
  4. by   classicdame
    In response to llg - we may have to do like other countries and require students to declare an area in which they want to pactice, then focus their education on that area.

    In response to original post: consider pain management. It is difficult to asses with patients who are non-verbal, fearful, parents answer for them, etc.
  5. by   NotReady4PrimeTime
    Both of those issues are very significant. I must say though that my very first thought was pain management. Our hospital is taking part in a pilot project to improve the assessment and treatment of pediatric pain, including prevention of pain where possible. The use of topical anaesthetic agents for painful procedures is often neglected due to the length of time required for the stuff to work, although there are newer agents that are effective in a much shorter interval. The difficulty arises when the chosen site, properly perpared, ends up not working out and a secondary site has to be sought. Now the kid is cranky from being held still and poked, the person starting the IV is frazzled and just wants it done, and maybe the IV meds are way behind... a bit of a concern. But there you go, that's something you could think about - how would you improve pain management for children?
  6. by   MassagetoRN
    Thanks for the great input, keep it coming! I am thinking that the pain management would be too medical and not so much a nursing issue (although super important!). I recently found an article about ped's new grad orientation programs.....
  7. by   Purple_Scrubs
    I guess the immunization debate would be a medical issue too? Hmmm...well if you have any interest in school nursing, you could talk about recent budget cuts to education causing some districts to cut nursing positions. As the students are coming to school sicker and sicker (diabetes, asthma, life threatening allergies, seizure disorders...) the nurses are being stretched thinner and thinner.

    Anything else I can think of is more of a medical issue
  8. by   annabeap
    How about medication safety in pediatrics?

    In my unit, we have all meds double verified once ordered- we annotate in our documentation what page number in the Harriet Lane we found the dosing on, and the names of the nurses that found it appropriate. This is done upon the initial med order, and every time the med dosages change.

    Upon administering the medication, we're fine going through the 5 rights by ourselves- given it's not a high alert med that needs another RN anyways.

    I'd be curious what info is out there, and what other institutions go through and double verify ALL new med orders. Even IVF.

    Anyways, good luck with your capstone!