Going back to the Kids

[Pug RN]

I was a pediatric and NICU nurse for the first 21 years of my career. About a year and a half ago I finally jumped into psych nursing on a very acute inpatient eating disorders unit.

I love the psych part of it but so much of eating disorders was not for me, the hyper regimented routines, meal symptoms, etc.

Anyway, I thought I was going to lose it, hated going to work everyday. Then, I was offered a fulltime position on the child psych unit with a new, awesome manager (she has a rep as rhe best) and am being given the opportunity to help with education and other things on the unit.

Give me your tips for transitioning from ED to child psych please.

[hppygr8ful, ASN, RN, EMT-I]

What age range will you be working with Children 12 and under, adolescents 13-17 or both. Each has unique needs.

Hppy

[Pug RN]

Child psych. 4 to 12

[hppygr8ful, ASN, RN, EMT-I]

On 4/7/2019 at 9:18 PM, Pug RN said:

Child psych. 4 to 12

So I have worked almost every patient population in psych. All have their challenges but I think children and adolescents are one of the hardest specialties but not for the reasons you might think . Generally young people are not difficult but you have to remember that whenever you work with the under 18 population you have to deal with the families. In fact in most cases the family is your patient.

Often times you will be reminded of the phrase "The apples don't fall far from the trees. " Many children with psychological issues get them as a result of ineffective parenting.

In the age group you are talking about expect to see a lot of kids on the Autism Spectrum. We are seeing more and more of this population. The parents are often way to permissive (coddling) in order to prevent melt-down behavior. So even the higher functioning ones are rarely taught self regulation skills.

When meeting with families be prepared for parents wanting you to fix their children, parents who refuse to medicate, parents who are blind to the issues at hand. Parents who are separated/divorced and cannot be civil with each other.

I am actually a bit of a parent whisperer and can calm the most aggressive/desperate parents but it can be exhausting.

All that being said Kids and adolescents can be a lot of fun to work with. Brush up on your under standing of developmental milestones and interests and things kids are into (There's a great post on the general nursing forum about a farting contest) Understand you will sometimes has to change you approach so that you meet your patients where they are so you can lure them to where you want them to be. Also read about and understand the concept of trauma informed care and how it works.

I am not the biggest fan of medicating kids/adolescents on their first psych admit. Medications have their place for sure but I truly believe a trial of methods that don't involve powerful psychiatric meds should be the first line of defense.

I hope this helps.

Now go play with the kiddos.

Hppy