Peds is NOT easy!

Specialties Pediatric

Published

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.

Specializes in Pediatric Hem/Onc.

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?" :banghead:

Ashley, I really enjoy your posts, btw :) Always spot on!

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.

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.

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.

Specializes in Peds Med/Surg; Peds Skilled Nursing.

Well said!!! I have been a peds nurse for 6 years. You hit everything. Also nursing students that don't want to deal with adults and want to go into peds....even in a pedi hospital you will end up having an adult as a patient at some point...i had patients in their 30s, 40s, ,mid 50's! And some parents can be very overbearing and yell and curse at you. I've had a father spit in my face and a mom try to fight me. Its crazy sometimes but i love caring for children and their families i keep coming back for more LOL.

Well said!!! I have been a peds nurse for 6 years. You hit everything. Also nursing students that don't want to deal with adults and want to go into peds....even in a pedi hospital you will end up having an adult as a patient at some point...i had patients in their 30s, 40s, ,mid 50's! And some parents can be very overbearing and yell and curse at you. I've had a father spit in my face and a mom try to fight me. Its crazy sometimes but i love caring for children and their families i keep coming back for more LOL.

Well said!

After almost 3 years in nicu/peds I had my first parent yell at me the other day, have never had that experience before but I think I handled it well at least. Then her 12 year old proceeded to throw his incentive spirometer at me! She didn't even say anything to him! Goodness, it was a go home and drink wine kind of night

Specializes in Peds Med/Surg; Peds Skilled Nursing.
Well said!

After almost 3 years in nicu/peds I had my first parent yell at me the other day, have never had that experience before but I think I handled it well at least. Then her 12 year old proceeded to throw his incentive spirometer at me! She didn't even say anything to him! Goodness, it was a go home and drink wine kind of night

hahaha...i have had many wine nights after a long shift. I cant believe he threw that at you. Kids will always crack me up.

Specializes in NICU; Acute psych; pediatric psych.

phillycpnp-pc,

How in the world did you deal with the father who spit at you and the mother who wanted to fight you?!

ps- I know this is an old post and I'm sorry for bumping it but that's too good of a possible story there!

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.

Extremely powerful and well said! You go Mom!

Specializes in Emergency and Neonate.

I hate Peds but here I am now..LOL. If only people knew how hard to insert cannula to 1 month to 9 months? I mean inserting to newborns is much easier because their veins are visible.

When I was in Nursing school, Peds was never on my radar. There was one classmate who was very nervous and needed at least one classmate there with her to make her feel confident in working with her patient. She always said she wanted to work in Peds. I always wondered why, and I just assumed she thought she could communicate better with a toddler then an adult. I often wonder what route she took...

I work in Peds, but in a clinic, so I don't have all the horror stories must of you had. But I can relate to a lot of it. Peds is a place where you need to be very confident and communication skills have to be on point when dealing with the family and being able to give meds orally or injectables, not to mention doing a Cath and the parents are too comfortable with it. Like I said before, I never even once thought about working in peds when I was in school, but I'm glad I did because I truly love it. Though I do want to advance my career, and the thought of possibly having to leave peds bothers me. I was a new grad in peds, but again, I'm in a clinic vs. working in a hospital. Much respect to those Peds nurses in the hospital!!!

That was a wonderful post. Thank you.

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