advice on peds

[smartassmommy]

I just interviewed for a pca (pct) job at a local hospital. They had me look over the skill sheet for orientation to get a better idea of what I will have to learn. On the list are IV start, lab draws, and IM injection. I want to learn these skills, but I am nervous because the unit is a peds unit with overflow med-surg. How do you get used to sticking kids? How do you handle hovering parents?

[WoosahRN, MSN, RN]

I'm not sure where you are at but I don't know any techs (PCTs or CNAs) that do medication administration or IV starts. Especially in Peds. We had techs in ER who were trained to do lab draws but they couldn't start an IV. I guess I would get clarification first. And any tips you're going to need or get will be more through hands on experience. And every kid and situation is different. You could have a two year old that tolerates a poke versus a 16 year old that freaks out.

[smartassmommy]

I'm not sure where you are at but I don't know any techs (PCTs or CNAs) that do medication administration or IV starts. Especially in Peds. We had techs in ER who were trained to do lab draws but they couldn't start an IV. I guess I would get clarification first. And any tips you're going to need or get will be more through hands on experience. And every kid and situation is different. You could have a two year old that tolerates a poke versus a 16 year old that freaks out.

No med administration. Lab draws and IV start. I know that when both are ordered the IV gets placed and labs drawn from it before anything goes in

[WoosahRN, MSN, RN]

Well as far as learning how to deal with pediatric patients, a lot of it is going to be that hands on. The families too you will adjust your care on a case by case evaluation. I've had some legit tough 4 year olds who can handle more than I expect while the 16 year old football player is freaking out. We have parents that can be very difficult to work with but you learn real fast who they are and what works (or doesn't work) with them.

With any of them, if you don't feel confident or see anything (for a blood draw), don't go blind. If I don't see anything, I go and find someone else to try. I don't blind stick and I know my limitations. I love hands, feet and forearms; I hate ACs (but know many others are strong there); I don't have luck typically with under one year olds or extra chubby toddlers but I'll still look. Stuff like that. Know your limitations and parents will respect that over you just trying (and there's no need to add extra trauma in a situation for the child or the family). You still need to gain experience but many times just being able to look and get that practice is what is going to help you build skills. In the beginning, just help hold, look with other people, etc. Regardless though there will be times where you have a family up in everything but learning how to speak to them is key. If I know they are going to be too anxious I'll ask if they want to take a walk. Honestly a lot of these parents realize they are too stressed out to be there and take you up on that offer. But other times I use them. They can hold the child or comfort them up at the head.

Also, each unit is different too. I found out our unit, a PICU, told a recently hired tech that the techs do lots of procedures and blood draws, etc. But it was nothing that we had our techs do and I don't know a lot of units that have their techs do those kinds of skills (in ER, yes). He left shortly after because he was looking for skills...ended up in an ER.

Good luck!