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Advice for Peds rotation?

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by FNPhopeful FNPhopeful (Member) Member

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For those that have done their pediatrics rotation any advice on how to be prepared or what to expect?? is there anything I can brush up on that will help? peds physical assessments, peds math, meds.........

I had a horrible teacher for my maternity rotation, she was condesending and intimidating- I hear my peds teacher will be worse. How does everyone deal with harsh clinical instructors as well? I wanna figure out how to work these teachers the right way.......even it means I have to kiss butt. I just dont want them on my case!

Thanks, Jasmine

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Weight based calculations--- HUGE in PEDS!

Also, remember that you essentially have 2 clients...the patient AND the patient's parents. It's very VERY important to make the parents comfortable with your presence. Most of the parents I encountered were just extremely hypervigilant and worried ( can't blame them)...so do your best to ease their fears....a child who sees their parent is comfortable with you is many, many times more likely to be comfortable with you as well.

Also remember that children crash FAST..so if you have some vitals that are borderline worrisome...tell your instructor or their nurse ASAP. I always look at their vital trends before I take my own...so I can see if a BP is wayyyy off what their norm is, etc.

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307 Posts; 4,740 Profile Views

Weight based calculations--- HUGE in PEDS!

Also, remember that you essentially have 2 clients...the patient AND the patient's parents. It's very VERY important to make the parents comfortable with your presence. Most of the parents I encountered were just extremely hypervigilant and worried ( can't blame them)...so do your best to ease their fears....a child who sees their parent is comfortable with you is many, many times more likely to be comfortable with you as well.

Also remember that children crash FAST..so if you have some vitals that are borderline worrisome...tell your instructor or their nurse ASAP. I always look at their vital trends before I take my own...so I can see if a BP is wayyyy off what their norm is, etc.

What are normal vitals for a child?

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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jasmine. . .if you took a course in human growth and development, pull out the textbook. you need to know the normal behaviors you expect to see in children at their various ages. keep in mind that this is a nursing course and the nursing process is the major concept you are learning in the entire course. step #1 (assessment) requires you to know what the normal assessment of a child is. since kids are not fully "cooked" yet, you need to know when certain body systems reach maturity. with kids, as with the very elderly (and animals--no disrespect meant), your observation skills, particularly of their behavior, are paramount because most kids, depending on their age, have varying abilities to give you subjective information about what they are experiencing. then, the nursing interventions for those abnormal symptoms have to be tailored to the age appropriateness of the child. beyond that, kids get the same diseases as adults with a few differences. their immune systems are not as developed. you also see congenital problems as well that are being dealt with.

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What are normal vitals for a child?

You will learn this as probably one of the first things you learn in class. Vitals are age dependent for the most part. At the hospital I did clinicals at we didn't do BP's in a child younger than 3 unless it was necessary for their condition. I wrote down a little sheet of vital norms vs. age and taped it to the back of my badge. Also, remember that some vitals are normal to a condition. ....you need to know their baseline vs. norm in order to assess them completely,..but don't fear you will learn this in class!

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Don't talk baby talk to toddlers and older. Even if your pt is a baby and not verbal, explain what you're doing to the child as well as the parent: "I'm going to take this tape off your arm now," etc. Explain things in terms children can understand: don't say "I'm going to take your blood pressure," say "I'm going to wrap this around your arm and it's going to hug you for a minute and then let go. Can you try and hold still until it lets go?"

NEVER say "Can you take this medicine for me?" Do not give them a choice if you're not going to honor it. You can say "You need to drink this medicine to get better. Do you want to drink water or juice after it?" If there's an injection you can let them choose the bandaid but don't give them the choice of taking the injection.

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I always remembered from my peds instructor (who was fantastic) get down to their level, never look down on a child because it scares them......kneel down or sit down at eye level. Let them also participate ..like when you do blood pressure or lung sounds or heart rate.....I always let the kids listen to my heart & lungs first so they would trust me & see that I wasn't going to hurt them.....I kind of made it a game.....I had one kid I took care of once who always wanted to push the button of the dynamap...I told him he was my official button pusher, that it was his job to push the on & start button......he actually looked forward to having his blood pressure done because of that.

Also...if you care for developmentally delayed kids..and 9times out of 10 you will if it's a big teaching hospital....never , ever, ever just assume because the child can't communicate that they don't even know they are alive......take it from me..a parent of a dd child.......nothing irritates us special kids parents more than a caregiver that "assumes" there's nothing in there & the kids don't know a thing....trust me I can't tell you the number of times I have seen pure stupidity & ignorance from people......just always remember to tell the child everything you are doing......and always talk to the child, not to everyone but the child as if the child isn't a person......and above all...never ever just go up & start poking & prodding kids like that......it's scary...just think if you were lying there with ear plugs in & a thing over your eyes ..and someone came up & just started grabbing & poking & stuff without so much as a hello .......that's pretty scary.Trust me when I say these kids have a clue ......sometimes even more so than most people....... remember those things & you'll be fine........

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