adults to peds career change question - need advice!

ChristineN, BSN, RN · Nov 29, 2008

Hi guys! I have a question for those of you working with a mix of age ranges. I have a job opportunity that I have sort of pushed to the back burner, and I wonder if some of you could share your experiences with me to help me decide whether I should pursue this or not.
I currently work with adults only - the youngest pt I have ever taken care of was 16 years old (except for nursing school clinicals). I chose to work with adults because I like that I can explain what I am doing to them. Kiddos don't understand why they have to get a shot/IV/dsg change, etc, and all they know is that you are hurting them. I know that many of you have the gift it takes to be able to work with sick children, but I just can't do it.

Wow, Ironically this is exactly one of the reasons I choose to work peds. I love being able to explain things to my pts and teach them about their care. The majority of my pts are teenagers, but even when I get a younger one, I'm sure to explain what I'm doing to mom and dad (and to the kid in terms they'll understand, depending on their age). I've taught many families how to manage a child just diagnosed with diabetes, taught a couple kids how to administer Lovenox shots, how to do dressing changes, the list goes on. I fully expect my pt (and their family if present) to participate in care if at all possible, and I do all I can to educate them on it.

miko014 · Nov 29, 2008

Wow, Ironically this is exactly one of the reasons I choose to work peds. I love being able to explain things to my pts and teach them about their care. The majority of my pts are teenagers, but even when I get a younger one, I'm sure to explain what I'm doing to mom and dad (and to the kid in terms they'll understand, depending on their age). I've taught many families how to manage a child just diagnosed with diabetes, taught a couple kids how to administer Lovenox shots, how to do dressing changes, the list goes on. I fully expect my pt (and their family if present) to participate in care if at all possible, and I do all I can to educate them on it.

You seem like you're upset with me, and I'm not sure why. All I said was that I don't like working with kids because I can't explain things the same way I do with an adult. Even though some 4 year olds might be smarter than some of the grownups I work with, that's not the norm. I don't like poking little kids for IVs and the like. Clearly you are happy with your decision. Good for you. And I'm not talking about teenagers - I said that I take care of people 16 and up already. I'm talking about little kids who aren't able to understand why I am doing what I am doing. Maybe I am misunderstanding you, but you seem to be insinuating that I don't know how to educate pts. I don't think there was anything in my original post to suggest that I don't educate my patients or that I don't want to educate kids or their parents. Please forgive me if I have misinterpreted your statements.

All I want is information from people who have made a similar change on what the biggest challenges are, the pros/cons, and whether they are happy with their decisions. For people who were uncomfortable taking care of kids but made the change anyway, how did it work out for you? For those of you who are uncomfortable around the kiddos in the healthcare setting (I know I'm not the only one), what do you think of all this?

ChristineN, BSN, RN · Nov 29, 2008

You seem like you're upset with me, and I'm not sure why. All I said was that I don't like working with kids because I can't explain things the same way I do with an adult. Even though some 4 year olds might be smarter than some of the grownups I work with, that's not the norm. I don't like poking little kids for IVs and the like. Clearly you are happy with your decision. Good for you. And I'm not talking about teenagers - I said that I take care of people 16 and up already. I'm talking about little kids who aren't able to understand why I am doing what I am doing. Maybe I am misunderstanding you, but you seem to be insinuating that I don't know how to educate pts. I don't think there was anything in my original post to suggest that I don't educate my patients or that I don't want to educate kids or their parents. Please forgive me if I have misinterpreted your statements.

Yes, you have misinterperted my post. I was not upset, not insinuating you don't know how to educate your pts. You sound like a great nurse. I was simply trying to show you some of the common education issues I've seen come up in peds, sorry if you misinterperted it.

miko014 · Nov 29, 2008

Yes, you have misinterperted my post. I was not upset, not insinuating you don't know how to educate your pts. You sound like a great nurse. I was simply trying to show you some of the common education issues I've seen come up in peds, sorry if you misinterperted it.

My bad, it just seemed like you thought I didn't want to to education or something, which is basically the opposite of my view of nursing. I love education, which is why I would love to work with outpatients, who get to be much more hands on with their care than inpatients. But I have no experience with kids period, so I would have no idea of what they would need as outpts (besides the stuff you do with the parents). I love kids, but I don't like the idea of them not liking me because I give them shots and they don't understand why. Does that make sense?

scribblerpnp · Nov 29, 2008

What type of clinic will you be working in? I work in out pt clinic as a PNP (but still do my own nursing duties). We don't do IV's or blood draws. The most invasive procedures we do are st caths, IM injections (vaccines), glucoscans, and maybe an I&D of a small abcess. I have done all of these on multiple age groups, and can say that 90% of the time the kid isn't upset by the time they leave the office (giving out treats helps a lot, as well as being very speedy).

And some things we provide education on:

Development (physical and mental) of your child/infant

Basis child/infant care

S/S resp dist

S/S dehydration

Care of teh child with a cold and common peds illnesses

Dietary needs

Prevention of illness

Yes, there are going to be kids that have severe stranger anxiety and who cry the entire time they are in the office, but it is the minority. And I have seem some 16 year olds be more whiny and PIA with vaccines than a 4 year old- once we had to have four people hold down a 16 year old to give her her Gardasil vaccine (!!!).

The MOST frustrating part of the job are parents who are either high strung or who aren't providing their best care to their child (you do deal with CPS). As well as bratty kids who aren't behaving appropriately and who act out while the parent just sits and watches.

Most peds nurses (who are honest) will admit that SOMETIMES and to SOME PT's, deep, deep down in your Bad Place, you enjoy giving a shot now and then to an onery kid.

As far as critical- I have seen it maybe 4 times in 6 years. In Out Pt, usually you don't code people. Those critical situations were kids in resp distress who were sating about 60-70 on RA and were put on O2 while we waited for the ambulance to come to take them to PICU.

There are quite a few threads under Peds concerning out pt clinics, try looking around there for some more info. You aren't the first to ask this question.

dekagirlsRN · Nov 29, 2008

My bad, it just seemed like you thought I didn't want to to education or something, which is basically the opposite of my view of nursing. I love education, which is why I would love to work with outpatients, who get to be much more hands on with their care than inpatients. But I have no experience with kids period, so I would have no idea of what they would need as outpts (besides the stuff you do with the parents). I love kids, but I don't like the idea of them not liking me because I give them shots and they don't understand why. Does that make sense?

I don't know how you managed to misinterpret ChristineN's reply. I thought it was very nice, very helpful. My guess is maybe because it's so late and we're all so tired! Good luck in whatever you decide.