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Do you have to hate adults to love peds?

Posted

Hi everyone, I spent a while searching for this specific topic, so forgive me if it's been addressed already.

I will be a new grad in May and am looking at the types of jobs I want to apply for. I requested that my practicum be in pediatrics because I grew to love the specialty during school.

However, I kind of feel like I'm getting cold feet. I am a CNA on a surgical floor for adults and I like it a lot, and can see myself working there too :/

So I feel anomalous, as it seems that nurses who like peds hate working with adults, and nurses who work with adults dislike peds. I am in the middle. I like both worlds and appreciate their differences.

Nursing school makes us all so familiar with adult care and comorbidities, while we only get half a semester working with pediatric patients. Perhaps this is part of my problem--unfamiliarity. But pediatrics has interesting congenital issues and the kids have the most beautiful spirits; I love teaching and interacting with the patients and their parents. Getting yelled at by parents and feeling like you could so easily hurt a kid sucks though. But healthy kids turn into healthy adults (hopefully) and that's so important. I'm able to communicate well with young children all the way to teenagers, I've noticed. The amount of knowledge peds nurses must have about newborns to age 21 is vast and I look forward to that challenge as well.

On the other hand, I love teaching adults themselves, as well as their family members. I like the knowledge gained from working with adults and find it applicable to daily life. I love learning about new medications, skills, evidence-based practice for adult care, and more.

Do any pediatric nurses feel (or have ever felt) this way? Did you always know you wanted to do peds? Do you feel limited in your skill set, or do you feel as if you'd be able to work with and teach adults if you decided to ever change specialties? I know there are many threads here with questions about transitioning, but I didn't see any from nurses who actually started OUT loving both worlds and kind of just "picked" one to start.

Being the extremely practical person that I am, I feel like if I jump straight into peds, even tho I want to work there, I will not have a wide enough knowledge base about adult comorbidities. But I don't want "practicality" to overshadow my desire in this way. My ultimate plan is to be a public health nurse (after working at the bedside for manyyears)--a specialty which encompasses skills from both pediatric and adult worlds.

I did see a couple of threads where nurses said they worked in one specialty full time and per diem in another. Is this still a thing? Do any peds nurses here work per diem in the adult world??

Thanks in advance for the responses. Any questions that could help me think this through better are welcome, also.

-SP

(edited for clarification)

Edited by SweetPotatoes

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

This is a new subject for me -- and I never thought of it before. My observation is that people who work in pediatrics tend to stay in pediatrics and people who work with adults rarely venture over to pediatrics, but I'm not sure about HATING one or the other.

I work adults; always have. I was never around children -- my sister and I were about ten years younger than all of our cousins, I never babysat and none of my friends had younger siblings. I wasn't able to have children -- the idea of pediatrics never even entered my mind. When I had to float to the newborn nursery, I was so anxious I nearly cried. It was awful -- the nursing supervisor made me go back to my floor and sent someone else instead, because "most people LOVE babies."

I'm thinking that if you can handle pediatrics with the med calculations and the family, you'll be able to handle adults. If your ultimate goal is family health and taking care of both adults and children, take the job you can get out of school. In a couple of years, you'll have experience and can take a job with the opposite population.

Thanks for the interesting question.

LoveMyBugs, BSN, CNA, RN

Specializes in Pediatrics.

Well you do have to teach adults in pediatrics, you have to teach the parents.

everyone is different, but I know a couple of nurses who work peds as their main job and then work a mixed ER, so they are caring for adults as well.

Me personally I worked adults for 11 months and that was enough for me. I loved taking care of the little elderly but there was too much of the other middle aged angry crowd for me.

Now working where I do and seeing the amount of child abuse I am jaded against adults.

However that is just me.

if your goal is family care then try to work in mixed areas

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

I have done adult, peds and neonatal ICUs. I have colleagues who flip back and forth- I certainly did.

I don't hate working w/ adults. Never did. I prefer kids is all. (Better snacks)

I have done adult, peds and neonatal ICUs. I have colleagues who flip back and forth- I certainly did.

I don't hate working w/ adults. Never did. I prefer kids is all. (Better snacks)

Cool! When you say flip back and forth, do you mean worked peds for a while, then adults, then peds, etc? Or did you work one as your main job and do another PRN?

Well you do have to teach adults in pediatrics, you have to teach the parents.

everyone is different, but I know a couple of nurses who work peds as their main job and then work a mixed ER, so they are caring for adults as well.

Me personally I worked adults for 11 months and that was enough for me. I loved taking care of the little elderly but there was too much of the other middle aged angry crowd for me.

Now working where I do and seeing the amount of child abuse I am jaded against adults.

However that is just me.

if your goal is family care then try to work in mixed areas

That's a good point about teaching adults and working in mixed ER. I would love to be able to work peds as my main job and work an adult med surg PRN. I used to do social work jobs and understand what you mean about child abuse. I learned to separate myself because it can be traumatizing if you're not careful.

Did you find that 11 months with adults helpful, or do you feel as if you could have jumped straight into peds and been ok?

NICU Guy, BSN, RN

Specializes in NICU. Has 6 years experience.

I requested that my practicum be in pediatrics because I grew to love the specialty during school.

I like both worlds and appreciate their differences.

Nursing school makes us all so familiar with adult care and comorbidities, while we only get half a semester working with pediatric patients. Perhaps this is part of my problem--unfamiliarity.

Then you made a good decision choosing Peds as you Practicum. Nursing school and your job has given you a considerable amount of exposure to adults. The practicum will give you more exposure to Peds. When you graduate, you will be in a better position to decide which direction to head.

Edited by NICU Guy

This is a new subject for me -- and I never thought of it before. My observation is that people who work in pediatrics tend to stay in pediatrics and people who work with adults rarely venture over to pediatrics, but I'm not sure about HATING one or the other.

I work adults; always have. I was never around children -- my sister and I were about ten years younger than all of our cousins, I never babysat and none of my friends had younger siblings. I wasn't able to have children -- the idea of pediatrics never even entered my mind. When I had to float to the newborn nursery, I was so anxious I nearly cried. It was awful -- the nursing supervisor made me go back to my floor and sent someone else instead, because "most people LOVE babies."

I'm thinking that if you can handle pediatrics with the med calculations and the family, you'll be able to handle adults. If your ultimate goal is family health and taking care of both adults and children, take the job you can get out of school. In a couple of years, you'll have experience and can take a job with the opposite population.

Thanks for the interesting question.

Haha glad it was an interesting question! I guess I've just seen so many strong feelings from nurses in my short school career about loving one specialty and really hating the other.

I am like you in that I am the youngest in my family and I am never around children. I did not want to do peds until I was actually exposed to kids and loved it. I am good at the weight based med calc; my instructor was very good about not allowing us to give a med unless we could say if it was a safe range or not. I also like remembering developmental nuances..like ok this 3 year old needs to be given choices so he feels like he has some autonomy in this situation. This 8 month old should be able to sit up on her own etc. I guess I just worried that I'd be too limited if I started in peds but like you said I can always switch or try to get adult experience in another capacity. I think since I genuinely enjoy both populations, I'd like to keep that flexibility in my career. Thanks for the input.

LoveMyBugs, BSN, CNA, RN

Specializes in Pediatrics.

That's a good point about teaching adults and working in mixed ER. I would love to be able to work peds as my main job and work an adult med surg PRN. I used to do social work jobs and understand what you mean about child abuse. I learned to separate myself because it can be traumatizing if you're not careful.

Did you find that 11 months with adults helpful, or do you feel as if you could have jumped straight into peds and been ok?

I initially wanted to go in the ED right away, due to the market when I graduated I went into adult SNF. I don't hate adults, just don't care for them if given a choice I choose peds.

I work peds ED at a level 1

Peds is specialized and while I have my CPEN and TNCC, I do not have ACLS. A few of my coworkers do as they have other jobs in mixed (mainly adults) EDs

I think you have a good plan of full time peds and per diem adult med-surg.

For me I grew tired of adults throwing tantrums and feeling like I could not do anything right. Like being 5 min late on their PRN oxycodone. Or being spread so thin with patients that one of my patients expired alone.

Peds when my patient who is an actual 2/3 year old throws a tantrum, I can give stickers or blow bubbles or make it better with a special bandaid.

ratios tend to be better in peds. When working peds LTC and my pt was dying. The pts family and myself were at the bedside.

I can see the positive and negatives of both peds and adults. I don't think you have to hate one to work the other.

brownbook

Has 36 years experience.

I don't think it is hate or dislike. I think it fear. Most nurses are afraid to work out of whatever field of nursing they are familiar with, comfortable with. Instead of admitting that they are afraid, it scares them, they say, "Oh, I don't like working with kids".....or...."I don't like working with adults".

You may be able to get a position that floats between med/surg and peds.

I have always floated, I love it. I think it is just my nature, I always like to go new places, try new things, go off the beaten track.

I don't think it is hate or dislike. I think it fear. Most nurses are afraid to work out of whatever field of nursing they are familiar with, comfortable with. Instead of admitting that they are afraid, it scares them, they say, "Oh, I don't like working with kids".....or...."I don't like working with adults".

You may be able to get a position that floats between med/surg and peds.

I have always floated, I love it. I think it is just my nature, I always like to go new places, try new things, go off the beaten track.

Being able to float sounds awesome. Are there limits to floating? Like would a med surge floor take a L&D nurse? Or would an icu take a med surg nurse?

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

Cool! When you say flip back and forth, do you mean worked peds for a while, then adults, then peds, etc? Or did you work one as your main job and do another PRN?

I have a friend who does PICU as her main gig, and adult ER at a different facility PRN. I've almost always had a side gig in peds PDN during my entire career- no matter what population I'm working with.

BeenThereDoneThat74, MSN, RN

Specializes in Pediatrics. Has 26 years experience.

Being able to float sounds awesome. Are there limits to floating? Like would a med surge floor take a L&D nurse? Or would an icu take a med surg nurse?

In most facilities, nurses float within their general department: adults tend to stay with adults, peds nurses float within peds or the maternal/chld department- so maybe Post Partum or L&D (but that requires more expertise than a peds nurse has). Peds may float to PICU or NICU (usually the most stable kids) NICU may float to Peds (and are given the "babies" (who are giants in comparison to their usual patients!).

I have worked both; started in adult, then went to Peds about 5 years into my career. Then I finished my masters and started teaching, so the dual experience was a plus (I taught in an ADN program, where there is not enough peds content to justify a full time professor, so I had to teach Med Surg as well). I consider myself to be a Peds nurse, but I do not 'hate' adults. 20+ years into my career, the thought of being a Med surg staff nurse scares the poop out of me (just the physical and emotional rigor, the poor staffing ratios and the acuity), compared to Peds. Not saying kids aren't as sick (they deteriorate much quicker), but staffing and conditions are almost always better! When I taught M/S clinicals, I saw the differences, as did my students. It breaks my heart to see the disparities with how we treat elderly adults, most of which don't have people to advocate for them (most kids do- their parents may drive you up the wall, but they get what they want, and that's quality care for their kids).

I currently am a staff educator in a Peds LTC facility (like a nursing home for kids). The kids are sick, staffing isn't great, but it is much better than the adult equivalent. And the atmosphere is much more fun (imagine Chirstmastime :) ).

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

I'll bite. I hate adults. I never want to work with them as a nurse.

Last week, I saw one of my patients driving a toy car around the lobby of the hospital with his parents. Days before his 2nd birthday, he is stuck in the hospital, on multiple cardiac drips while he awaits a heart transplant. But, this small child does not know that what he is going through is not normal, he does not know another life. I can't imagine an adult in the same position just accepting this and going about his day as if it were any day.

A couple years ago, when I was a home care nurse, I was at the house of a 7 year old with leukemia. I was there to access her port and give her chemotherapy. Her baby sitter couldn't stop talking about how difficult it must be to work with children who are sick. I told her that I find working with adults difficult, that they complain more and that ill children typically handle their illnesses much better than their adult counter parts. My patient said "we do?" and I said to her "can you imagine your Dad dealing as well as you have with everything you've gone through?" Her response? "Good point."

I have former colleagues who have gone on to work with adults. There are fewer pediatric jobs out there. I'll hold out for peds. I never want to work with adults.

*Side note, I do have a large population of young adult CF patients (20s-30s mostly) at my current job. I like them. But, as they have been sick their entire lives, they're a little different than the average adult population. And they're my easiest patients. They're home on IV therapy so often that it's almost no work to set them up to go home with it again.

la_chica_suerte85, BSN, RN

Specializes in Pediatric Hematology/Oncology.

Ooh ooh ooh...settle in. I hope to be brief but that is unlikely.

When I was in nursing school, I had the vaguest of ideas that I would be working with adults, maybe in a CCU or med-surg or something like that. I didn't mind working with adults. I was fine with it. I also enjoyed the teaching aspect and geriatrics was nice -- old people like me for some reason. Whatevs, not too exciting, not really clear on what my future would really hold. I knew that I would never work with peds. Never! Hah! Me with kids and babies and, ugh, teenagers?!?!?! NEVER!

Lol.

And then I had my first day in my peds clinical and I had hemonc patients (which I was totally freaked out by because cancer was something I had 0% experience with) and IT WAS AWESOME and I knew exactly what I wanted to do. I still did health coaching with adults and that annoyed me to no end. Imagine: patients we try to keep from going to the ED who are homies with everyone in the ED and like going and waiting for 8-9 hours in the ED for dumb stuff that the primary medical doctor could easily deal with but can't because the patients don't trust their PMDs. Adults. So much disappointment.

Anyway, my first job is in a top hospital for pediatric hemonc. I couldn't be more thrilled. I actually am sad because I had to call of work today because I am quite sick and can't really mask it as well as I wish I could. I love my hospital. I love my patient population. I love my patient's families. I am in the best possible place to do this type of work. However, there are some drawbacks that make me look back to the adult world. I drive very far (80 miles one way in terrible traffic) to work. People think I'm nuts but I'm not moving closer in the near future. I worked on the unit I am employed as an RN as a nursing assistant about a year prior. This summer had quite a terrible string of deaths -- nothing really unexpected, most brain tumor-related (not coincidentally, brain tumors overtook leukemia this year as the top cause of cancer-related deaths in pediatric oncology). I was already emotionally wrecked going into my new position as an RN (textbook case of moral distress over here). I always say that, when I'm tired of working with a broken heart, I will seek work elsewhere.

Now, I am getting platinum class training at a world class hospital. I look forward to, maybe, one day, a long time from now, bringing my expertise and training to a hospital closer to where I live. Where I live, kids in the hemonc population are terribly underserved and burdened to travel to better treatment. Maybe I can help make that less awful one day.

Then again, maybe I'll go to hemonc for adults. Or, ICU.

There are a lot of times where I think, "If this was the same situation with an adult, I would be out." But, I don't hate adult nursing. It's not something that I count out completely. I seek versatility in my experience. Many of the nurses I work with work per diem at the hospital a block away with an adult population.

The long and short of my story is that, ultimately, I cherish versatility (because I hope to teach at my nursing school one day and they always need someone for something) and being well-rounded as a nurse. I will never say no to adults. Pediatrics, unfortunately, is kind of a money pit where medicine is concerned. I have been told that a peds unit in a hospital is meant only to increase community access but ultimately runs at a loss for the hospital (because kids don't have jobs and don't have awesome insurance like middle aged adults). The hospital I work at is only peds and we run on donations and grants and are lucky to be based where celebrities love us and love to give gobs of money to us. However, we are still a money pit. So, finding work in peds is not easy and it's better to maintain versatility and be able to work with the wealthier, ever-growing adult population.

So, I guess all I can say is, no, you aren't alone. If you want to work with adults, you can. If you want to also work with peds. You can. I may one day switch to a per diem position at the hospital I'm at and work full time with adults. It depends on where the currents of life take me.

Good luck!

I'll bite. I hate adults. I never want to work with them as a nurse.

Last week, I saw one of my patients driving a toy car around the lobby of the hospital with his parents. Days before his 2nd birthday, he is stuck in the hospital, on multiple cardiac drips while he awaits a heart transplant. But, this small child does not know that what he is going through is not normal, he does not know another life. I can't imagine an adult in the same position just accepting this and going about his day as if it were any day.

A couple years ago, when I was a home care nurse, I was at the house of a 7 year old with leukemia. I was there to access her port and give her chemotherapy. Her baby sitter couldn't stop talking about how difficult it must be to work with children who are sick. I told her that I find working with adults difficult, that they complain more and that ill children typically handle their illnesses much better than their adult counter parts. My patient said "we do?" and I said to her "can you imagine your Dad dealing as well as you have with everything you've gone through?" Her response? "Good point."

I have former colleagues who have gone on to work with adults. There are fewer pediatric jobs out there. I'll hold out for peds. I never want to work with adults.

*Side note, I do have a large population of young adult CF patients (20s-30s mostly) at my current job. I like them. But, as they have been sick their entire lives, they're a little different than the average adult population. And they're my easiest patients. They're home on IV therapy so often that it's almost no work to set them up to go home with it again.

Thanks for the response. I too have noticed, over and over again, how much more adults seem to complain sometimes than children. You're right--it's their normal. I have congenital conditions myself that have caused me to be a staple in doctors' offices over the years but I don't know anything different.

Ooh ooh ooh...settle in. I hope to be brief but that is unlikely.

When I was in nursing school, I had the vaguest of ideas that I would be working with adults, maybe in a CCU or med-surg or something like that. I didn't mind working with adults. I was fine with it. I also enjoyed the teaching aspect and geriatrics was nice -- old people like me for some reason. Whatevs, not too exciting, not really clear on what my future would really hold. I knew that I would never work with peds. Never! Hah! Me with kids and babies and, ugh, teenagers?!?!?! NEVER!

Lol.

And then I had my first day in my peds clinical and I had hemonc patients (which I was totally freaked out by because cancer was something I had 0% experience with) and IT WAS AWESOME and I knew exactly what I wanted to do. I still did health coaching with adults and that annoyed me to no end. Imagine: patients we try to keep from going to the ED who are homies with everyone in the ED and like going and waiting for 8-9 hours in the ED for dumb stuff that the primary medical doctor could easily deal with but can't because the patients don't trust their PMDs. Adults. So much disappointment.

Anyway, my first job is in a top hospital for pediatric hemonc. I couldn't be more thrilled. I actually am sad because I had to call of work today because I am quite sick and can't really mask it as well as I wish I could. I love my hospital. I love my patient population. I love my patient's families. I am in the best possible place to do this type of work. However, there are some drawbacks that make me look back to the adult world. I drive very far (80 miles one way in terrible traffic) to work. People think I'm nuts but I'm not moving closer in the near future. I worked on the unit I am employed as an RN as a nursing assistant about a year prior. This summer had quite a terrible string of deaths -- nothing really unexpected, most brain tumor-related (not coincidentally, brain tumors overtook leukemia this year as the top cause of cancer-related deaths in pediatric oncology). I was already emotionally wrecked going into my new position as an RN (textbook case of moral distress over here). I always say that, when I'm tired of working with a broken heart, I will seek work elsewhere.

Now, I am getting platinum class training at a world class hospital. I look forward to, maybe, one day, a long time from now, bringing my expertise and training to a hospital closer to where I live. Where I live, kids in the hemonc population are terribly underserved and burdened to travel to better treatment. Maybe I can help make that less awful one day.

Then again, maybe I'll go to hemonc for adults. Or, ICU.

There are a lot of times where I think, "If this was the same situation with an adult, I would be out." But, I don't hate adult nursing. It's not something that I count out completely. I seek versatility in my experience. Many of the nurses I work with work per diem at the hospital a block away with an adult population.

The long and short of my story is that, ultimately, I cherish versatility (because I hope to teach at my nursing school one day and they always need someone for something) and being well-rounded as a nurse. I will never say no to adults. Pediatrics, unfortunately, is kind of a money pit where medicine is concerned. I have been told that a peds unit in a hospital is meant only to increase community access but ultimately runs at a loss for the hospital (because kids don't have jobs and don't have awesome insurance like middle aged adults). The hospital I work at is only peds and we run on donations and grants and are lucky to be based where celebrities love us and love to give gobs of money to us. However, we are still a money pit. So, finding work in peds is not easy and it's better to maintain versatility and be able to work with the wealthier, ever-growing adult population.

So, I guess all I can say is, no, you aren't alone. If you want to work with adults, you can. If you want to also work with peds. You can. I may one day switch to a per diem position at the hospital I'm at and work full time with adults. It depends on where the currents of life take me.

Good luck!

thank you so much for your story! what dedication you have to travel so far! i am also looking at pediatric heme onc positions here in baltimore.