Advice for a new peds nurse?

sunnie16 · Aug 28, 2014

Firstly congratulations on getting a job in Paeds u will love it! I have been a Paeds nurse in Australia for 5 years and I'm currently doing a post grad degree in paediatric nursing... Here are a few basic tips for u as u start out...

Listen to your patients parents! Basic but important. Parents generally know what normal is for their children and they know if some thing isn't quite right with them. I once cared for a 6 month old baby girl who was otherwise seemingly very healthy but had just started having difficulty feeding. Her mother was concerned because it wasn't normal for her baby but our paediatricians were not very concerned at all... After some blood test she was diagnosed with a very rare genetic disorder that was terminal. She deteriorated very quickly and passed away just before her first birthday. So if a parent has concerns listen! It might be nothing but it also could be something serious!

Include the whole family in your care! Families come in all shapes and sizes these days and they are generally the most important thing in a child's life. In order to treat a paediatric patient you have to treat the whole family... It's a bit obvious I know but clear communication with the family will go a long way. That might even mean helping an anxious sibling understand what is happening to their unwell brother or sister. I was once preparing a little boy for surgery on his fractured leg... The little brother was watching every thing that was happening. He was looking really worried so I asked him if he knew what the doctors where going to do... The poor little boy blurted out with this scared look on his face "are they going to cut his leg off?!" After a little chat he was a lot happier ??

One of my all time favourites... Keep it fun!!! Kids in hospital are still kids so have fun. Tell a joke... Pull out some magic tricks... Act like a clown (when it's appropriate ?)... Smile all the time and keep them happy they'll get better faster ?

Check double check and triple check drugs! Even small drug errors in kids can be fatal. I'm not sure of policies where you will be working but over here all drugs for Paeds patients have to be checked and signed by two nurses... And just because an order is written by a doctor doesn't make it right! I've come across some big errors by doctors that are not used to paediatric drug dosing and have ordered adult doses for Paeds patients. Nurses are the last line of defence against drug errors so be really really careful...

Last tip... Look after YOU. Paediatric nursing is really awesome... BUT it's also really really really hard sometimes... When kids are diagnosed with cancer... When they die... When they have been abused or neglected... When a new born is withdrawing because of their mothers drug use... When their stories are so horrific you are lost for words... When you just want to put them in your bag and take them home and look after them... Remember you can't fix everything. And sometimes the hardest thing to do is to step back and let go. And keeping professional distance with kids is super hard because they are just children and you instinctively want to care for and protect them... It might take a while but you will find that point of balance between caring and professional distance precarious as it may be... I can say that there has been a few of my patients that have broken my heart. One little baby was born with a congenital cardiac disorder and we cared for her on our ward for the last week of her life... She was from a beautiful big family from the Cook Islands. I was caring for her the night she passed away... All her family like all 100 of them!! Where packed into the little hospital room singing a 4 part harmony islander song that could be heard around the whole ward when she passed away... It was the most beautiful and the most heart wrenching moment ever. Her paediatrician and a few of us nurses went to her funeral... It took me months to get over that beautiful little baby girl...

I hope that's been helpful... All the best for your career in Paeds! Have fun be careful and look after you!!!

meanmaryjean, DNP, RN · Aug 28, 2014

Sunnie has said everything I would have said except this: Do not trust little ones. What I mean is this: If you put a baby in a non-cage crib who has never pulled themselves to standing in their life- they will learn to pull to standing (and attempt to climb out of the bed) as soon as you turn your back on them. The cuter they are- the less I trust them!! :whistling:

Pediatric Critical Care Columnist · Aug 28, 2014

My variation on that is "Never turn your back on a child. You know that IV in their hand? Well, it's in their mouth now."

sassandscrubs · Aug 28, 2014

Thank you so much everyone for your responses! It gave some great advice!! Can't wait to start next week, I know it will be very very difficult at times but it sounds SO rewarding!

meanmaryjean, DNP, RN · Aug 28, 2014

Peds is great! You know how you have to cajole and drag an adult out of bed after surgery? Bribe them to sit in the chair? How some adults ENJOY being sick?

Not in peds. In peds, you about have to duct tape them to STAY in bed when they need to. Kids HATE being sick.

Nepenthe Sea · Oct 31, 2014

I agree with all the previous posters. I will say, however, that some of my teenagers remind me of the adults I used to take care of, in regard to not wanting to ambulate, not wanting to go use the bathroom, or eat, drink, whatever. I have especially see this in my post-spinal fusion patients. Sometimes we really have to get after them. A lot of the parents are good about encouraging (or making) them do things, but sometimes they are useless, so we have to be the "bad guys". I still love it, though. You can definitely tell when the kids are feeling better - they are climbing the walls!

NurseKateC · Nov 5, 2014

Thank you so much everyone for your responses! It gave some great advice!! Can't wait to start next week, I know it will be very very difficult at times but it sounds SO rewarding!

I was wondering how it was going in PEDs now that you have been there for a little while?

Fl_peds_rn · Dec 19, 2014

Let them be children. Too often we expect them to behave like miniature adults. Always give them the opportunity to demonstrate spontaneity and provide them with appropriate choices. Build solid assessment skills, seek out a mentor,listen to the parents (they know their child better than we ever will) and for God's sake double, triple and quadruple check your med dosages. Other than that, have fun...working in peds is a privilege.

mooniemine · Feb 15, 2015

Im kind of wondering how pediatric nursing is working for you? I graduate in May and am considering peds :)