Peds is NOT easy! - page 4

by Ashley, PICU RN

I just had to post this in response to the dozens of posts I see from nursing students or new graduates that want to work in peds because "kids are so cute," and "I want to take care of babies," and "I don't want to change adult... Read More


  1. 1
    Quote from Gold_SJ
    XD Have they changed the flavour?
    Nope. I have some for my dog, so I tried a couple. Wanted to keep eating them!
    Gold_SJ likes this.
  2. 2
    Quote from Ashley, PICU RN
    I just had to post this in response to the dozens of posts I see from nursing students or new graduates that want to work in peds because "kids are so cute," and "I want to take care of babies," and "I don't want to change adult diapers."As anyone who has worked in pediatrics could tell you, peds nursing is not easier than adult nursing, and at times it is more difficult.In peds, you might be assigned 5 patients, just like on a med surg floor. But your patients can't all speak for themselves. They can't press their call button to tell you when they are in pain, can't breath well, or their IV site is burning. You have to constantly be alert for these, and many other problems because our patients can't report them. In peds, you have to care for the patient and the family. Some family members are great. Others are incredibly anxious, questioning everything you say and do and constantly asking you to check on little Jimmy because they are positive something is wrong. Other families are demanding. They think that because their child is in the hospital, so are they. They want meals, blankets, pillows, and expect you to supply them with Tylenol for their headaches and money for transportation home. In peds, everything is tiny. Those veins you have to stick on an adult? 1/4 the size on a young child. Those urethra's it's so hard to find when cathing little old ladies? Microscopic on a newborn baby girl. Peds nurses don't just have to know standard adult doses (650 mg of Tylenol), but we have to know mg/kg dosages as well. And we have to be able to calculate them quickly in order to catch a mistake in an order and prevent an unsafe dose. Giving medications? 95% of your adult population will be more than happy to swallow their pain pill, or all 20 of their medications in one gulp. In peds, you're trying to convince a stubborn three year old to open their mouth so you can get the syringe of medication in them. They cry and kick and fight and more times then not they end up with half the medication on them and half on you. Don't even try to convince a toddler that amoxicillin tastes like bubble gum. They know the difference. Finally, accidents in peds can be just as big and messy as adults. Spend three hours with a two year old with explosive diarrhea. Change the diaper 6 times, change the bed linen four times, change your scrubs once, and give the child three baths. Trust me, you'll be begging for an adult who can tell you when they need to use the commode, even if they do need help wiping.
    Absolutely agree and couldn't have said it better. I LOVE peds but wouldn't get into that field for all the points you've mentioned. Peds is hard!!
    Gold_SJ and ruthalittle like this.
  3. 3
    Quote from Gold_SJ
    XD Have they changed the flavour?

    I find a lot of little ones are babied when it comes to meds though nowdays maybe it's just my area but when I was young. Mum would hold out the med and say 'Take it' all stern and I'd meep and obey. No disagreeing on my end, she didn't sit and explain it all then freak out when I hated the taste. Tough love is dying I think.

    Most of the kids you crush things for end up needing to be half pinned in the end anyway as they spit it out (2-4yr olds). Think the worst case I had was a fifteen year old boy wanting his medications crushed and put in jam (they were really small!). We had a long discussion on what his life would be if he couldn't swallow a tablet (I was nice! Not too evil). He learnt to take tablets that shift ^.^;; after a few goes but he got it eventually.
    I was just having this same conversation with some of my colleagues last night. I can't stand when taking one medication is a 30 minute process when it's a child on chronic medications. I love it when I have a 2 year old who just opens his mouth and takes his meds. I love it even more if I say to the mother, "he's so good about it" and her response is, "he doesn't have a choice, he needs to take medicine and he's going to do it without complaining." That's how I remember my mother being with me and my brothers growing up. None of us took chronic medications but we all got strep throat several times a year. Liquid penicillin is nasty but it didn't matter- she'd tell us to go take our medicine and we'd do it. There was no fighting, we did it because we had to.
    Gold_SJ, wooh, and janfrn like this.
  4. 1
    Wow. Your comment made me go back to a BAD time, 20 years ago when I almost lost my son (now age 28 & doing really well.) Also to when one of my closest friends lost her 3 year old grandson.
    Peds is a responsibility I could NEVER take on. When my son was in Children's Memorial hospital 20 years ago I was alone, no family at all, all of my close friends had moved out of state. I tell you that I would not have retained an ounce of my sanity if not for the nurses caring for my son, and my friend tells me she feels the same about the nurses who cared for her grandson in his final days. We both knew that they were not there to care for US, but the comfort that they provided to us by caring for our little ones with such skill and compassion can never be adequately put into words.
    To all pediatric nurses thank you!
    Last edit by ruthalittle on Apr 6, '12 : Reason: typing errors
    Gold_SJ likes this.
  5. 1
    Quote from osdbmom
    Interesting thread.
    Im not on your side of the fence yet, but let me say from the other side of the fence, that having a sick kid is really scary. Having a sick kid who isnt going to get better (ever) is horrifying.
    Knowing that a nurse can kill your kid with "one little decimal point" but having to trust them anyway, is hard.
    Having to ask for help from nurses you don't know when you want, as mom, to be able to fix it and make it all better, but knowing you can't....its tough to swallow.
    Being alone in a hospital (esp if its far from home) room with a small, sick child who does nothing but cry, and having no other adult to talk to but the nurse who comes in to check sometimes (bc you'd feel guilty if you rang her just bc you were so incredibly lonely, and you miss your spouse, and you havent seen your other children for days on end, and you don't want to ask for charity/food voucher but you havent got any money on you bc when you came in to ER the other night, you didnt expect to have to stay so long, and you havent gotten to go home).......its HARD. Really, really, really hard.

    So for those peds nurses who take care of that kid (and the kids family), thank you. Thank you for knowing that YOU know what meds the kid is allergic to, but listening to a nervous mom repeat, "Did you know he's allergic to PCN? And sulfas?"......thanks for not getting irritated.
    Thanks for noticing when mom/dad hasn't gone home, changed their clothes or eaten in two (or more) days.....and thanks for asking if they need something to eat, or showing them where the apple juice is.
    Thanks for knowing that parent is scared to leave the room, bc they know if they do, something bad might happen....thanks for patting the shoulder, and promising to watch the baby until mom comes back.
    Thanks.
    Thanks for being respectful and listening when that mom/dad needs to talk, or cry, at 2 a.m. when they are looking at their child all hooked up to wires, and monitors they don't understand.
    Thanks for listening to the experience that brought them to this point.

    I'm sure it can be irritating. I know it is hard. I know sometimes you probably have to bite your tongue, and that you are tired, and that sometimes, you might even joke about it with other nurses after work.


    But the fact that you do it, and you are kind, and you listen when that parent is worried, and double check everything anyway, even though you know you are already right....you do it anyway, bc you care. I know there is vomit, and diarrhea, and screaming toddlers, and spit out meds; I know you are tired, beyond tired, sometimes; I know you have your own families to think about and you wish you were home with them.

    You may not know it; you may not hear it often, but you mean the world to the parents of those kids you are caring for. You make a difference to that mom or dad; you are the difference between a night spent alone and scared, and a night knowing your child is being cared for by someone who is kind and empathetic. Thank you.


    AWWWW! Thank you!!! That brought tears to my eyes! Have done peds my entire 14 year nursing career!!!
    Gold_SJ likes this.
  6. 5
    when my son was 3, he could swallow a whole handful of pills at once...but he had to do it dry, couldn't coordinate swallow pills AND a liquid at once. But, he knew he had to take them.

    Now, he's nine, not only does he take his own meds, but he can also show a nurse where a good vein is, and when his IV's are done, he removes his own tegaderm, applies the detachol, takes a gauze and pulls his own lines out. lol

    I have never understood parents who can't "make" little kids take their meds. My kids knew that either they took them willingly, or we had to force them, which isn't fun for anyone, but has to be done.

    They will get a rude awakening when those little kids are 15 (thats where I am now), and trying to force them to take meds they dont want, its a LOT harder to do than tackling a 3 yr old! lol
    pnut8377, wooh, KelRN215, and 2 others like this.
  7. 2
    A-freaking-men! It's been almost 24 hours since my last shift and I still haven't recovered. Kids are cute (usually lol) but there's nothing cute about any of them when they're trying to go septic. Or stop breathing. Or screaming no about taking meds because the parents feel guilty about imposing boundaries on their sick child. The new diagnosis families always look at me like I'm a lunatic when I say "she has to take these meds. If you want me to play the bad guy so you can be the hero, that's fine....but it has to happen."

    My friend called me today and she loves saying "oh I bet you have so much fun with those kids!" It's all I can do to not roll my eyes and/or say something snarky. Today she got "hmmm, yeah great fun....did I mention my hamstrings feel like they're gonna cramp any second now?"

    Ashley, I really enjoy your posts, btw Always spot on!
    Gold_SJ and pnut8377 like this.
  8. 0
    Quote from osdbmom
    Interesting thread.
    Im not on your side of the fence yet, but let me say from the other side of the fence, that having a sick kid is really scary. Having a sick kid who isnt going to get better (ever) is horrifying.
    Knowing that a nurse can kill your kid with "one little decimal point" but having to trust them anyway, is hard.
    Having to ask for help from nurses you don't know when you want, as mom, to be able to fix it and make it all better, but knowing you can't....its tough to swallow.
    Being alone in a hospital (esp if its far from home) room with a small, sick child who does nothing but cry, and having no other adult to talk to but the nurse who comes in to check sometimes (bc you'd feel guilty if you rang her just bc you were so incredibly lonely, and you miss your spouse, and you havent seen your other children for days on end, and you don't want to ask for charity/food voucher but you havent got any money on you bc when you came in to ER the other night, you didnt expect to have to stay so long, and you havent gotten to go home).......its HARD. Really, really, really hard.

    So for those peds nurses who take care of that kid (and the kids family), thank you. Thank you for knowing that YOU know what meds the kid is allergic to, but listening to a nervous mom repeat, "Did you know he's allergic to PCN? And sulfas?"......thanks for not getting irritated.
    Thanks for noticing when mom/dad hasn't gone home, changed their clothes or eaten in two (or more) days.....and thanks for asking if they need something to eat, or showing them where the apple juice is.
    Thanks for knowing that parent is scared to leave the room, bc they know if they do, something bad might happen....thanks for patting the shoulder, and promising to watch the baby until mom comes back.
    Thanks.
    Thanks for being respectful and listening when that mom/dad needs to talk, or cry, at 2 a.m. when they are looking at their child all hooked up to wires, and monitors they don't understand.
    Thanks for listening to the experience that brought them to this point.

    I'm sure it can be irritating. I know it is hard. I know sometimes you probably have to bite your tongue, and that you are tired, and that sometimes, you might even joke about it with other nurses after work.


    But the fact that you do it, and you are kind, and you listen when that parent is worried, and double check everything anyway, even though you know you are already right....you do it anyway, bc you care. I know there is vomit, and diarrhea, and screaming toddlers, and spit out meds; I know you are tired, beyond tired, sometimes; I know you have your own families to think about and you wish you were home with them.

    You may not know it; you may not hear it often, but you mean the world to the parents of those kids you are caring for. You make a difference to that mom or dad; you are the difference between a night spent alone and scared, and a night knowing your child is being cared for by someone who is kind and empathetic. Thank you.

    You just explained my life in your post. I have a 14 year old with type 1 diabetes. She's had it since she was 4. Now I am a nursing student but want to get into Peds not because of the reasons the op stated but because of some of the horrible experiences I had as a parent in the hospital with a sick child. When my daughter was first diagnosed at 4, we spent a week in a hospital 2 hours away from home where I had to pay $5 a day for parking, no money, I ate crackers with pb & j because they were free, so I understand that fully. I did the best I could considering I had just had a c-section a week before and had to leave my newborn baby for a week. It was the worst week of my life and yes there were very good nurses who were wonderful but that one aweful nurse always sticks with you. The one who told my 4 year old she had to get over herself and deal with it because she didn't want to eat what she was told and cried everytime they came in to stick with another needle or another finger stick. Needless to say I reported her and never saw her the rest of the week. On another instance I was in the ER all night when she was about 10 years old with a stomach virus. They hooked her up with an IV and I didn't see anyone for the rest of the night. It was me who cleaned her up everytime she got sick and practically carried her to the commode and held a bucket to her face because it was coming out both ends and she was barely able to walk. When I tried to get help, they only help I got was when they emptied the commode. I could go on and on. I've encountered A LOT of wonderful nurses over the years as well and I should say I also want to be a Peds nurse because of them too. The ones who came in a least every hour offering food, pillows, blankets, etc.. even though I never asked. I even had a nurse offer me money to buy dinner one night because she knew I had nothing to eat. I wouldn't take her money and a half hour later she showed up with a sandwich and a juice. You are the reason parents with sick children make it through our hospital stays. I want to be one of those nurses, the ones who care. Thank you for caring and you are appreciated. Like osdbmom stated You do make a difference.
  9. 0
    Quote from Ashley, PICU RN
    I just had to post this in response to the dozens of posts I see from nursing students or new graduates that want to work in peds because "kids are so cute," and "I want to take care of babies," and "I don't want to change adult diapers."

    As anyone who has worked in pediatrics could tell you, peds nursing is not easier than adult nursing, and at times it is more difficult.

    In peds, you might be assigned 5 patients, just like on a med surg floor. But your patients can't all speak for themselves. They can't press their call button to tell you when they are in pain, can't breath well, or their IV site is burning. You have to constantly be alert for these, and many other problems because our patients can't report them.

    In peds, you have to care for the patient and the family. Some family members are great. Others are incredibly anxious, questioning everything you say and do and constantly asking you to check on little Jimmy because they are positive something is wrong. Other families are demanding. They think that because their child is in the hospital, so are they. They want meals, blankets, pillows, and expect you to supply them with Tylenol for their headaches and money for transportation home.

    In peds, everything is tiny. Those veins you have to stick on an adult? 1/4 the size on a young child. Those urethra's it's so hard to find when cathing little old ladies? Microscopic on a newborn baby girl.

    Peds nurses don't just have to know standard adult doses (650 mg of Tylenol), but we have to know mg/kg dosages as well. And we have to be able to calculate them quickly in order to catch a mistake in an order and prevent an unsafe dose.

    Giving medications? 95% of your adult population will be more than happy to swallow their pain pill, or all 20 of their medications in one gulp. In peds, you're trying to convince a stubborn three year old to open their mouth so you can get the syringe of medication in them. They cry and kick and fight and more times then not they end up with half the medication on them and half on you. Don't even try to convince a toddler that amoxicillin tastes like bubble gum. They know the difference.

    Finally, accidents in peds can be just as big and messy as adults. Spend three hours with a two year old with explosive diarrhea. Change the diaper 6 times, change the bed linen four times, change your scrubs once, and give the child three baths. Trust me, you'll be begging for an adult who can tell you when they need to use the commode, even if they do need help wiping.
    Also, the sad stuff is really sad. Death, terminal illness, bad home situations, violence, trauma....when you have a bad outcome not only did you lose a patient, but a kid fricking just died.

    I'll admit that when I was in school I thought of peds as a "soft" and "fluffy" option for nurses that just wanted to play mommy instead of doing "tough stuff." Boy was I wrong.
    Last edit by hiddencatRN on Apr 10, '12
  10. 0
    Quote from hiddencatRN
    Also, the sad stuff is really sad. Death, terminal illness, bad home situations, violence, trauma....when you have a bad outcome not only did you lose a patient, but a kid fricking just died.

    I'll admit that when I was in school I thought of peds as a "soft" and "fluffy" option for nurses that just wanted to play mommy instead of doing "tough stuff." Boy was I wrong.
    I spoke to an RN yesterday who said she did her clinicals while in school at a PEDS burn ward, 34 years ago. She said that to this day she still remembers the screams of a little girl when they went in to debride her, that's exactly why she isn't in Peds. She said after 34 years the memory still haunts her to this day.


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