Advice on Pediatric Nursing Please!!

vamedic4, EMT-P · Jun 12, 2006

hi nurseforever30...I am not a nurse but I don't regret leaving field care for in hospital care of peds for a second. I've worked in peds for almost 12 years.

I Say go for it!! Peds is a challenge...but it's very rewarding.

As far as IVs...I've posted some info on that very topic...and there are excellent resources here...just remember - the more you do...the better you get.

Good luck with your decision!!

vamedic4

Children's Medical Center Dallas

Humbled_Nurse · Jun 13, 2006

I would personally think twice about it. I personally wouldn't want to be the only nurse on the peds floor. What happens when you need help holding a kid down for an IV or you can't get the IV in or you just need a second opinion on something. If they plan to give you a very thorough orientation then maybe I would consider it, but if it is a very small pedi unit then not sure how thorough of an orientation you will get. If you really want pedi then I would look into working is some bigger units that have a wider variety of patients and lots of other staff to be available as a resource to you.

Good luck to you!

Keep us updated!

pierce27rn · Jun 14, 2006

I also would really think twice about it, even though your place sends the really bad kids out, who's going to take care of them until transport comes. Little ones can change in a very short period of time especially during Rsv season and sometimes you need someone else to get a second opinion from. Unfortunately unless your nursing sups are peds nurses they are not going to be able to help you really and tele nurses will run the other way. Also when kids get admitted who will be starting the IVs, doing blood work, and spinal taps( which should be done on most babies especially very young presenting with fever) all these things under the best of circumstances do take alot of time and while you are attending to one patient whose taking care of the others, a nursing assistant is not an acceptable option especially if a child needs to be medicated or another emergency develops. My advice to you as a peds nurse for 15 yrs in a childrens hosp and community hosp, is if you want to switch to peds switch hospitals and get a couple of years exp, but to be honest as an exp peds nurse I would not be at all comfortable with that situation. I worked at a small comm. hosp. where our unit was small ( in the summer we sometimes had 1 pt) but we always had 2 nurses . I wish you well in your quest!!!

nurseforever30 · Jun 14, 2006

Thanks for the advice! I was already felling the same way about being alone on the peds unit. I found out last night at work that the position has already been filled. I guess God works in mysterious ways. I think that I would really enjoy doing peds nursing but the closest children's hospital is an hour away from where I live. I don't know if I want to make that drive everyday since I am less than 5 minutes from work now. especially with the price of gas these days.

Again, thanks for the advice!!

MissJoRN, RN · Jun 14, 2006

Oh you sound so much like me, LOL. I did a position like that right out of school and it really wasn't a smart move. No-one told me I would be the only RN on the floor until I noticed the staffing on orientation coming in in the AM. I had been told there were always 2 RNs, in theory that was true... there was always supposed to be 2 RNs on the sched. Doesn't mean the 2nd didn't get pulled or put on-call status. Then I was told it would be at least a year before I would be left alone... lasted much less than 6 mos. But I "didn't know what I didn't know" and so much wanted to do peds! You don't need to be at a children's hosp but are there local hospitals with larger units that are within driving distance to you? Even if the other nurse working with you is fairly new, it's a real assest to have a second pair of eyes when you're unsure. And forget about counting on the house super or anyone else. You'll find most of your "backup" doesn't really "like" peds, isn't comfortable with it and cannot recognize the difference between adult and pedi distress. I even found that with resp therapists who assured me my babies were fine b/c they were pink and 98%... just oblivious to the retractions, flaring, and high resp rate! I added on even though your decision was made because I know many other nurses are in the same boat when they're looking for a new job and I'm sure right now some new grads are looking for a peds position.

Good Luck!

Josie

pedsrnjoe · Jun 15, 2006

:monkeydance: Don't be afraid to try the job. I came out of nursing school and got my first job as a nightshift nurse on our small pediatric unit. After about 2 months of orientation, I am often the only nurse on the unit, and have not run into any problems. One resource we have is that we can always call our manager for any questions, no matter what time, and she is glad to help. Don,t worry about the IV issues, those skills will come in time. Just make sure the orientaion will be enough to make you comfortable. It really just depends on the nurse, some will be comfortable being the only nurse, some will not.

pierce27rn · Jun 18, 2006

Oh you sound so much like me, LOL. I did a position like that right out of school and it really wasn't a smart move. No-one told me I would be the only RN on the floor until I noticed the staffing on orientation coming in in the AM. I had been told there were always 2 RNs, in theory that was true... there was always supposed to be 2 RNs on the sched. Doesn't mean the 2nd didn't get pulled or put on-call status. Then I was told it would be at least a year before I would be left alone... lasted much less than 6 mos. But I "didn't know what I didn't know" and so much wanted to do peds! You don't need to be at a children's hosp but are there local hospitals with larger units that are within driving distance to you? Even if the other nurse working with you is fairly new, it's a real assest to have a second pair of eyes when you're unsure. And forget about counting on the house super or anyone else. You'll find most of your "backup" doesn't really "like" peds, isn't comfortable with it and cannot recognize the difference between adult and pedi distress. I even found that with resp therapists who assured me my babies were fine b/c they were pink and 98%... just oblivious to the retractions, flaring, and high resp rate! I added on even though your decision was made because I know many other nurses are in the same boat when they're looking for a new job and I'm sure right now some new grads are looking for a peds position.
Good Luck!
Josie

I totally forgot about the respiratory therapists, and considering alot of peds involves a resp issue that's really important. Please don't rule out peds like Josie said a larger peds unit in a community hosp with other Peds staff around would also be good. You just need to have that back up for safety reasons I don't care who you are an emergency can happen at any time and nurses are human things can be missed it's always good to have back up . I've had some really nice experiences in community hospitals but safety has got to come first for everyone's sake. Best Of Luck

tlp12 · Jul 10, 2006

hi, I just recently graduated and am now working on the PEDS/elemetry floor at our hospital. It too is very small and all "bad" patients are shipped out. Most of our pts. are T & A's so they come from OR with their IV already in. Good luck on your decision. I Love it.

tchinn · Jul 26, 2006

I can relate to what nurseforever30 was saying about begining not to enjoy her job. I work In a med/surg unit and the staffing is terrible, which burns the nurses we do have out. I love what I do, but hate where I work. My true love is working with children. When I graduated 2yrs ago everyone told me to get my med/surg experience and I can go anywhere after that, but now that I have that experience I find it is hard to get my foot in the door with working with kids. every place I have applied says they want someone with more experience. How am I suppose achieve experience if no one will give me a chance. Does anyone have any advice for a compassionate nurse who's first love is working with children? TchinnRn

mydesygn · Aug 27, 2006

hello. i graduated in may 2005 from a adn program. i have been working since on a med/surg floor. i am getting to where i really hate my job (not really the pts as much as all the drama with other nurses). i think i am ready for a change. i am looking for some advice on pediatric nursing. there is a peds position open at the hospital i am currently working at on the night shift (btw...i work night shift on the med/surg unit now). the position on peds would be every mon, tues, and wed night--no weekends. i was offered this peds position a couple of months ago and turned it down. the position is still open. i love children and think that i would enjoy working with the pediatric population. the only thing that it holding me back is the fact that b/c the peds unit at our hospital is very small, i will be the only nurse on the unit on my shift. b/c our unit is small, we do not keep the really "bad" children..they are transferred out to a children's hospital about 60 miles away. i am just afraid that i would come upon a situation that i really needed a second nurse even if only for advice on what to do with a patient. but there is a telemetry unit right across from the peds unit and of course, there is always an overhouse supervisor available. is it normal for me to feel this way? how much experience would you say one needed to handle a peds unit alone? also, how hard is it start ivs on babies and children? i have no experience with ivs with peds. any advice would be greatly appreciated. i just don't want to make a move that i will regret.thanks!!

no no no!!! i am a seasoned pedi nurse (16 years). i took a position in an adult facility with a small peds floor. the only nurse there and the adjoining unit was geriatrics. let me tell you about that night i quit: r/o sepsis (the physician wanted the septic workup on the unit not the er) admitted an adult post-partum, an asthma that was not improving with treatments, called for another admit, needed to re-start an iv that came out when i called the nurses on the sister unit, i was told that none of them were "comfortable" with peds. every facility i know of keeps at least 2 nurses on the unit regardless of census and the fact that as new grad you are left to be fully responsible for peds patient is dangerous. this is a dangerous sitution, do not accept this postion. the hospital is irresponsible for staffing a unit that way and you will eventual risk your license and the safety of child by working under those conditions. having worked for many years in a standalone pediatric facility, i would never advise you to assume care of peds without mentoring and orientation. like any population, you need staff to assist you. do you think you should have cared for the patients in med/surg alone. no matter what you know from working adult med/surg, peds is very different. you have to have strong assessment skills because kids can't tell you what's wrong and they go down hill fast.