Advice from a peds nurse?

[ManderRN]

Hello all! I have many questions. I am graduating in less than 6 weeks, and I have just found out I am doing my practicum in pediatrics! I am excited and scared all at once. I love children, and have wanted to do pediatrics from day one. We were able to put our "first picks" down for practicum locations, and pediatrics was my first pick up until about two months ago. However, since then, after having some time to think about it, I have wondered if it was the best choice to make. I am wondering how you all feel about working in pediatrics. Do you regret limiting your skills to such a focused area of practice? Or do you feel that you are able to use everything you were taught in nursing school without any difficulty? And how do you feel about having to start IV's/draw blood in children? (Does it ever get easy?) And also, do you think a new grad should start on peds?

I am hoping to do well enough to get a job interview through my practicum location. And now I guess I'm wondering if pediatrics is a good place to start, or a good place to work towards after getting more experience elsewhere. I do want to work with children in the long run. I want to be the person there to help them. But I am afraid of being inexperienced/incompetent, and hurting them instead. So should I try for this now, or should I work towards it down the road? Thanks in advance!

[NotReady4PrimeTime, RN]

You're definitely not limiting your skills working in peds. Nearly everything you'd do on an adult unit will eventually come up on a peds floor. Kids can have cardiomyopathy and rhythm disturbances, strokes, DKA, cancer, cognitive disorders, lung diseases, you name it and it might show up there on your next shift. Presentation will often be different and treatment may be tailored to peds but you're not going to lose skills. In fact, you'll gain some. Knowing how to convince a 3 year old to take their meds will come in handy when trying to get an 80 year old dementia patient to do the same. If you can get an accurate manual BP on a toddler you can do it with anyone. If peds is where your :heartbeat is, go to peds now. Don't wait!

[Shanlee79]

I asked this same question a year ago when I was deciding where to go for my practicum. I think as students, we are subliminally taught this as evidenced by the lack of pediatric content in our program. But listen to Janfrn...she is wise! I was lucky to have two pediatric rotations in school, both in acute medicine and surgery. The funny thing was before this I would have never considered this area. But after those rotations, I was hooked! You see, I always hated my adult rotations and never really knew why. When I experienced peds, I found there was a greater variety in patients (both illness and range in age), it was not as structured and "cold" like adults and you were encouraged to use your creativity. I loved how resilient kids could be but yet they always kept you on your toes as they can turn on a drop of a dime. I found I learned the most as a student during these rotations!

Anyways, I too asked that question...and after musch research and advice I learned that there is NO disadvantage. I am actually doing my practicum this January at our Children's NICU! Funny, 4 yrs of university and I end up in an area where I will learn everything new. I am not worried though...I am a sponge! Good luck to you!!!!

[NotReady4PrimeTime, RN]

Thank you for those kind words, Shanlee79. Good luck with your preceptorship. You're not kidding you'll be learning a whole new way of looking at things. The knowledge base for neonatal is huge. My first hospital position was in a level 2 nursery (intermediate care) where the babies were still sick but didn't require ventilation. It was a popular place to work and the interview was the equivalent of a 20 page oral exam, brutal to put it mildly. I can still tell you 25 different causes of hyperbilirubinemia in the neonate 15+ years later! I get quite frustrated when the docs in our PICU overlook things with our post-op cardiac neonates that would cause a neonatal nurse to go nuts.

[Shanlee79]

Thank you for those kind words, Shanlee79. Good luck with your preceptorship. You're not kidding you'll be learning a whole new way of looking at things. The knowledge base for neonatal is huge. My first hospital position was in a level 2 nursery (intermediate care) where the babies were still sick but didn't require ventilation. It was a popular place to work and the interview was the equivalent of a 20 page oral exam, brutal to put it mildly. I can still tell you 25 different causes of hyperbilirubinemia in the neonate 15+ years later! I get quite frustrated when the docs in our PICU overlook things with our post-op cardiac neonates that would cause a neonatal nurse to go nuts.

Sorry if this is too personal a question Janfrn...but was this NICU experience in Wpg? I have followed many of your posts and I seem to recall you originted from there. Just curious..

Sorry to hijack OP...

[ManderRN]

Thank you both for the encouragement! It was exactly what I needed. Peds has always been my heart... and I guess I am just getting the last minute jitters! I just found out the other day that the hospital recruiter has sent my info to a local NICU and Peds hospital. If I am getting any interviews, that is where they will be! I am glad to hear you don't lose any skills in either of these areas. And also, that this is a place you can start out and be successful.

Shanlee- I actually spent the majority of my peds rotation in the NICU. I thought it would be a difficult experience due to the possibility of bad outcomes for the babies, but it ended up being my most favorite place in the hospital. I loved being able to love on the babies! Good luck to you, and hope it goes well for you!

[Shanlee79]

Thank you both for the encouragement! It was exactly what I needed. Peds has always been my heart... and I guess I am just getting the last minute jitters! I just found out the other day that the hospital recruiter has sent my info to a local NICU and Peds hospital. If I am getting any interviews, that is where they will be! I am glad to hear you don't lose any skills in either of these areas. And also, that this is a place you can start out and be successful.

Shanlee- I actually spent the majority of my peds rotation in the NICU. I thought it would be a difficult experience due to the possibility of bad outcomes for the babies, but it ended up being my most favorite place in the hospital. I loved being able to love on the babies! Good luck to you, and hope it goes well for you!

I know exactly what you mean!! I thought it would be sad and difficult too but what was more sad for me was dealing with chronically ill older adults who had no family supports and were left alone in the hospital. I know not all the babies stories are happy ones either in NICU but there is just so much more hope and possibilities!!

When do you start??

[ManderRN]

Sometime next week... I will be finding out in the next few days what my schedule will be. Although it will only be short-lived, and I hope I can make a good enough impression to get an interview! And I agree... I have had a harder time with the adult patients, knowing that their conditions most likely weren't going to improve than I did with the little ones in the NICU! I know it won't always be that way... but overall I loved it the most! I think it takes a certain type of person to be able to deal with adults, just like it takes a certain type of person to be able to do peds. We are all made for something, I suppose! :)

[ChristineN, BSN, RN]

I don't think you are limiting yourself at all by doing peds. I did peds exclusively for 2 years prior to starting to do adults. I felt that by doing peds and being used to treating pt's from newborn-20's I was prepared for almost anything.

As far as IV sticks/lab draws you get used to that as well as other "not so nice" things we have to do to kids.