Starting PEDS rotation - nervous/ need advice

  1. I am starting on PEDS this week. I feel kind of weird about it. I do not have any of my own children. I haven't been around kids in a long time. I am just not sure I will do a great job. Kind of nervous about it, will they react or will the parents react!

    Anybody got any advice or tips on how to handle the children. I am just coming off med-surg. Anyone have any transitional advice?

    Greatly appreciate it,
    Angie
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    About Nrs_angie

    Joined: Apr '05; Posts: 173; Likes: 53
    RN on Post-Surgical unit
    Specialty: 2 year(s) of experience in Med-Surg, Tele, Vascular, Plastics

    12 Comments

  3. by   All_Smiles_RN
    With kids, general rule of thumb is to smile a lot, make eye contact, and make a game out of whatever you're doing. If you get down to their eye level, you'll have their attention. Talk to the child, not just the parent. If the child is happy with you, that will gain the respect of the parents. This is just my experience as a parent and someone who feels very comfortable with children. And I'm sure your peds instructor will have tips for you. Good luck to you.
    ...Jennifer...
  4. by   twinmommy+2
    And remember your erikson. That will help bunches.
  5. by   Nrs_angie
    Quote from twinmommy+1
    And remember your erikson. That will help bunches.
    Thank you Jennifer... GOOD tips! and Twinmommy, it has been like 4 semesters since I had psychology. All I remember about erikson is something about life crises or something like that and stages... but I dont remember them. Can you tell me which I need to know about???

    Thank you both so much,
    Angie
  6. by   Montessori Mommy
    Although I'll be starting nursing school this fall, I'm the mommy of two little girls - ages 3 and 6. Here is what they like about the nurses & doctors in their peds office: They ask them what they like to do, what books they like, what they watch on tv, etc. If a child has a stuffed animal with them, ask about it and ask if you can listen to its heart, look in it ears, etc. Also, brush up on what little kids are into these days. My girls like Strawberry Shortcake, Dora the Explorer, The Wiggles, etc. I'll be fine with girls during my Peds rotation, but I know nothing about little boys!

    When my three year old had a recent visit, the doctor claimed he could feel a PB & J sandwich in her tummy. For some reason Sophia found this hysterical!! She told him it was just peanut butter since she doesn't like jelly.

    Best of luck to you,
    Beth
  7. by   Aneroo
    Quote from Montessori Mommy
    Although I'll be starting nursing school this fall, I'm the mommy of two little girls - ages 3 and 6. Here is what they like about the nurses & doctors in their peds office: They ask them what they like to do, what books they like, what they watch on tv, etc. If a child has a stuffed animal with them, ask about it and ask if you can listen to its heart, look in it ears, etc. Also, brush up on what little kids are into these days. My girls like Strawberry Shortcake, Dora the Explorer, The Wiggles, etc. I'll be fine with girls during my Peds rotation, but I know nothing about little boys!

    When my three year old had a recent visit, the doctor claimed he could feel a PB & J sandwich in her tummy. For some reason Sophia found this hysterical!! She told him it was just peanut butter since she doesn't like jelly.

    Best of luck to you,
    Beth

    I do this too with a kid I would babysit! I would tickle him and say "I feel a chicken nugget! I'm gonna eat it!" and then I'd try and blow on his tummy. He loved it, and his big sis got involved with trying to play too.
    As far as assessment...do what you can while they're asleep- it's harder to concentrate and hear once they start crying. In my EMS class, we were taught to start assessment at their feet, and work up (instead of the usual head to toe, it was a toe to head approach). This way, you're not right up in their face to begin with...play with their toes or something while doing assessment.

    I was terrified on my peds rotation, until i got there. We were partnered up our first week, and it was an older guy and me, both with no children of our own, taking care of a 3 mo old baby (developmentally about 1 mo-he was a preemie) with hydrocephalus. We finally got it down, and my "momma" instinct kicked in (as my partner called it). I dropped my first NG tube on a 6 pound baby (it's much easier than an adult), did my first IM and SC injection on that same child with hydrocephalus (he was getting to go home and needed immunizations). Later on when I went to give shots to an adult, I remember thinking "If I can do that to a baby, I can to this to a grown man". Made things much easier for me. Keep us posted on how it goes! -andrea
  8. by   mitchsmom
    Quote from Montessori Mommy
    .... brush up on what little kids are into these days. My girls like Strawberry Shortcake, Dora the Explorer, The Wiggles, etc. I'll be fine with girls during my Peds rotation, but I know nothing about little boys! Beth
    I have three boys: Star Wars (particularly good fodder right now since III is about to come out! But better know your Bounty Hunter from your Emperor from your Darth Vader ; superheroes- esp. Spiderman & Batman, SpongeBob, Rescue Heroes, Legos, & like your girls, my three year old also likes Dora. Building & tearing things apart are always good (have you ever seen the inside of a _____________ ? (ink pen, remote control, you fill in the blank).
    You can also talk about any other kid movie that's out lately or ask what's your favorite movie, toy, etc. I would say to just be yourself and playful but down to earth because I think kids pick up on insincerity easily and then shy away. And some will shy away no matter what so don't take it personally. Just some more ideas!

    PS... I have heard that for ticklish people, it supposedly helps if you have the patient put their hand over yours as you palpate or do whatever you're trying to do. I have done that with one of my sons who is super ticklish and it does help a little. It may make also have the benefit that a little one may feel more in control too if they feel like they have a hand in things (no pun intended
    PPSS... in my own experience I've found it helpful as a nursing mom to immediately be able to nurse the baby after or during shots, etc- it chills them right out and quiets them in a hurry! Also worked GREAT for my newborn's hearing test/PKU, I breastfed while the nurse did it and she said it was the easiest one she'd ever done
    Last edit by mitchsmom on May 1, '05
  9. by   Ami_J
    As a peds nurse a few things I find that work are:
    1. don't talk to children like they are babys (I've watch nurses talk to 16 y/o like he was 2!)
    2. tell the child what you are going to do before you do it ex. "I am going to listen to you breath"
    3. Pay close attention to a teen's privacy
    4. Don't lie and say something tastes good when it doesn't... if you know it tastes awful have something to wash it down with right after.
    5. Never ask the young child if you can do something "can I look at your tummy?" (the anwer is usually NO) tell them what you are going to do "I am going to look at your tummy."
    6. When giving meds to a young child its usually easier to ask the parent to give it and for you to just watch it being given, if it is a toddler I usually ask the parent, "would they take it easier if you squirt it in their mouth or if I do?" or if the child is a little older I give them options, "do you want mommy to give you this or do you want me to?"
    7. With babies squirt the meds in the side of their cheeks
  10. by   Indy
    Always take respirations first. At 0700 you can watch a baby/kid breathe and count, but after you take the other vital signs and do your assessment, you won't be able to get 'em to be still or quiet again.
  11. by   nursie79
    angie,
    try to make a game out of everything when working with children. the kids are not the hard part it is the parent's. be confident in what you do parent's can sense if you are nervous and so can the kid's. if you are confident in yourself the parent's will be confident in you! walk in that room like you are an old pro and everyhting will work out fine. when i did my peds rotation i was the same way because i do not have kids of my own.... good luck
  12. by   EyesForward
    Many kids will start crying as soon as they see a uniform come through the door. I tell them right away "no boo-boos!" if there aren't going to be any, and most quiet right down.

    Empathy and caring is perceived by most parents as competence, so be kind to them and to the kids, and understand how miserable most of the kids are, and that alone will help you know how to deal them.
  13. by   Nrs_angie
    Thanks to all of you for the great advice. Turns out this was supposed to be my first day on PEDS but the beds are almost all empty. So maybe tomorrow I might get a patient. Wish me luck!
    Angie
  14. by   NurseFirst
    Quote from Nrs_angie
    Thanks to all of you for the great advice. Turns out this was supposed to be my first day on PEDS but the beds are almost all empty. So maybe tomorrow I might get a patient. Wish me luck!
    Angie
    I am 55, have never had children, was the youngest in my family, hadn't been around children. When my instructor asked who didn't want to have an infant the first week, I was the only one in my class to raise their hand!

    Before peds rotation (in winter), I went on a kids' movie binge: I saw The Incredibles and Lemony Snickett. Harry Potter is probably good, too--but I definitely like the idea of seeing current kids movies--cuz that's what they have in their minds. I asked the kids I took care of what character they liked most, what they liked about the character, etc.

    Definitely concur with getting on eye-level with the child--it was the thing that I saw least done by other HCP's, and I found it made a big difference--not only for the child, but for me too; I can't imagine doing it any other way. One 15 mo old would scream if he saw the stethoscope--so I would distract him and sneak it under his gown--no problem. A nine year old was also resistant, but then I asked her if she'd ever heard her own heart. She said no (and this was a child who had already been in the hospital for 2 weeks, and previous hospitalizations)--I asked her if she'd like to--and she was definitely in favor of that! I don't know that it's specifically "have you ever seen the inside of" that's needed (but I sure like that as a general idea) but more if they can get to experience something new (that's not unpleasant, of course.)

    The 9 year old ended up having abdominal surgery for bowel obstruction--and the docs put lots of stickers along the bandage over the incision. Lots of kids love those stickers--you may want to get some and put them in your pocket. Also--praise them! Tell 'em their the "best" (whatever, patient you've had -- most cooperative; most brave, etc.) I always try to think of things that will make hospitalizations positively memorable--if there's something I can say that years from now the parents will tell their kids "Remember how that nurse said such and such?" (Something positive, obviously!).

    Choices are almost always good, unless it's "Do you want to _______ now?" that pertains to even innocuous-seeming medical procedures. In that case, give them the choice of alternatives--"Do you want to take your bath before or after breakfast." (The "presupposition" is that they want to --or will--take a bath. This is a very effective technique, one that I learned in hypnosis training!)

    Yes, definitely know the Erikson stages--most peds books should have descriptions of the different stages. Also know that kids who have experience with hospitalizations due to disability or chronic illness will be somewhat delayed in achieving resolution of the "crisis" they face at that stage. It may be helpful to push them a bit--for instance, I had a 17 year old who told me her Mom comes in to bathe her (who didn't show up)--I told her that she could do her bath--and, basically, that I expected her to do it (nicely). She acquiesed fairly easily.

    Good luck--and have fun! Our instructor told us that "play is the work of kids" and that they have to be awfully sick not to want to play. She even told me she wanted to see me in there playing with my patient!

    NurseFirst

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