% infants in Peds? Male RN in Peds?

adventure_rn, MSN, NP · Sep 21, 2018

I've only worked in NICU and PICU, so I can't speak for the floor nurses, but I have really enjoyed having male nurses on the team in both units. Even though we all have the same skill set, it can be very helpful to have people who come from diverse backgrounds (including gender). I find that sometimes patients (some pre-teen boys, for instance) actually feel more comfortable around male nurses than female nurses. Most of our little kids love Mickey Mouse, and one of our male nurses does a spot-on Mickey voice, which is a huge crowd-pleaser with the tots, and consequently the parents.

The proportion of babies depends on a lot of factors (whether or not you're a Children's Hospital, what your floor specializes in, etc.) For instance, cardiac usually has a large number of babies since so many repairs are done in the first year of life. In contrast, bone marrow transplant units and heme/onc units have very few neonates (though you will see infants). You'll also see some random variation depending on admits; my peds cardiac unit is usually 50-60% infants with congenital cardiac defects, but every so often we'll get a random onslaught of school-aged to teenage kids with cardiomyopathy that throws off that proportion. When you interview, you can ask about the patient population on the unit.

IMHO, once you learn to understand their cues, babies are actually much easier to understand and placate than bigger kids--their needs are so much less complex (food, diaper, swaddle, repeat). As for breastfeeding, some moms may feel uncomfortable, and you may have to phone a friend. Many hospitals have lactations services, so for some feeds you may be able to 'tag out.' However, if you approach it professionally and give the impression that you know what you're doing (even if you don't), I think that a lot of moms would feel ok about it. I'd just ask your coworkers, lactation consultants, or preceptors if they have any breastfeeding tip suggestions (I have a ton I picked up in NICU that I'd be happy to share). You could also see if there are some videos online to help walk you through it (I know that sounds weird, but surely there are resources for new moms who are learning about it, too.)

Unless you work on a unit that accepts babies immediately after birth (i.e. NICU, congenital cardiac, mom/baby overflow) then you will probably never have to teach breastfeeding, since the moms will presumably already know how. Similarly, if you work in an ICU setting, the kids will probably be too compromised to do any breastfeeding (since it takes a bit more effort than bottle feeding).

This is good practice for all patients and nurses (regardless of gender), but I'd be very deliberate about explaining what you're doing before you touch a patient. For instance, if you're about to do Foley care on a teenage girl, it's important to explain what you're doing and why before you start (even if the patient is intubated/sedated). Same goes for explaining what you're doing before you do it during breastfeeding (I still always ask "I'm going to touch your breast, is that ok?" before I do it).

For whatever reason, respiratory therapy tends to have more men than women, and we always have a ton of RTs around in the ICUs; if you choose to work in an intensive care setting, you may feel a little less outnumbered, lol.

Unrelated PSA: Whatever you do, for the love of all things good, please don't date or hook up with anybody on staff. Most people know better, but every peds/NICU unit I've worked on has had one guy (either nurse or RT) who dates and breaks up with a bunch of different people on the unit (including some failed engagements). It is terribly awkward if exes have to work together, especially if one starts dating other people on the unit. Don't be that guy. It does not end well for anyone.

Pediatric Critical Care Columnist · Sep 21, 2018

adventure_rn, that's great advice!

I work with a lot of amazing nurses who are also men. I'm really uncomfortable with the double standards I see so often... why is it SOP for a young female nurse to care for male patients who are her contemporaries, but it's not SOP for a male nurse to care for a female patient who is a contemporary? What the heck?!! Years ago when I had a hysterectomy, I was wheeled into the OR to be greeted by a male nurse who made a point of informing me that the team in that OR at that time on that day were all men. He asked if that was going to be a problem for me. And I turned it around: I said, "You are ALL professionals and as long as you behave professionally, does it matter if you only have one X chromosome?" I honestly feel that pediatrics NEEDS men in nursing, not only as educated and skilled professionals, but also as role models for our children. They need to see that men are nurturers, are care-givers, are compassionate. There are already too many of the more negative "gender" models out there. Please! Work in peds!!

adventure_rn, MSN, NP · Sep 22, 2018

adventure_rn, that's great advice!
I work with a lot of amazing nurses who are also men. I'm really uncomfortable with the double standards I see so often... why is it SOP for a young female nurse to care for male patients who are her contemporaries, but it's not SOP for a male nurse to care for a female patient who is a contemporary? What the heck?!! Years ago when I had a hysterectomy, I was wheeled into the OR to be greeted by a male nurse who made a point of informing me that the team in that OR at that time on that day were all men. He asked if that was going to be a problem for me. And I turned it around: I said, "You are ALL professionals and as long as you behave professionally, does it matter if you only have one X chromosome?" I honestly feel that pediatrics NEEDS men in nursing, not only as educated and skilled professionals, but also as role models for our children. They need to see that men are nurturers, are care-givers, are compassionate. There are already too many of the more negative "gender" models out there. Please! Work in peds!!

YES! Well said.

NotReady, you reminded me of a really touching encounter I had a few months ago. I was caring for an infant who was coded, then passed away. The baby passed in the middle of the night, and his parents couldn't be there. After we called the code, all of the other staff (all female) cleared out, but one of the nurses (who happened to be male) stuck around. He held the baby's hand and sang to him while he passed so he wouldn't be alone. Afterward, while I performed post-mortem care, he set up the room for the parents with photos and holiday memorabilia (i.e. footprint cards) our Child Life folks had made during his stay.

I was so impressed by the care that he provided, and also taken aback because it was so far from my normal gender expectations. He went above and beyond simply providing medical care in order to also meet the patient and family's emotional, psychosocial, and spiritual needs. Truly excellent work.

elkpark · Sep 22, 2018

When I was in school 30+ years ago, one of our two peds instructors was a young man who was making his career in pediatric nursing. He was great! I wasn't aware of any issues related to his gender coming up during the time I was in clinical with him.

KelRN215, BSN, RN · Sep 22, 2018

The number of infants on a pediatric unit is highly variable and depends on a number of factors. At the pediatric hospital I worked at, 2 floors probably had a higher percentage of infants than other floors- cardiac and the infant/toddler surgical floor. On the floor I worked on, we had new baby myelomeningoceles, congenital hydrocephalus, ex-preemies who had IVHs and resulting neurological issues, infantile spasms, any number of congenital brain deformities and then, worst of all, we had the shaken babies. We also had plenty of toddlers, school aged children, teenagers and adults who never left pediatrics.

Oncology has fewer infants than older children but there are still infants who get cancer and for some cancers, they have a much worse prognosis. The general medical or general surgical floors could get anyone. During RSV season, they may have more infants on general medicine than at other times.

We had 2 male nurses on my floor when I worked in the hospital. It presented the biggest issue for Arabic patients.

FolksBtrippin, BSN, RN · Sep 22, 2018

I worked peds psych at my last job. Never met a male nurse I didn't like. Literally never-- and I didn't like a lot of the nurses. If you don't want to work with babies, consider peds psych-- usually called child adolescent mental health. We had kids 5 to 17 on our crisis unit and 13-17 on our longer term unit.

Male nurses are highly valued in psych (and everywhere really). Don't worry about it.

humerusRN, BSN · Sep 22, 2018

I have worked with many male RNs over the years in pediatrics. :) They all did well, and got along great with everyone, and were always a nice addition to work with when we had to move that 100kg kid up in the bed at 0300. LOL!!! As for babies - you'll get used to babies. No fear. Just like anything else, the more you work with them, the easier that it will become. That being said, I still don't overly enjoy taking care of kids

**NICU Guy, BSN, RN** · Sep 22, 2018

it's just that I can't speak to them like I can speak to older children, and they have teeny tiny veins!

I speak to my babies like they are older kids. They may not be able to talk back, but I still talk to them as if they understand me.

At that time on this particular Peds unit, nearly all of the patients were new mothers with babies, overflow from the Labor & Delivery unit. The RN supervising me would not let me care for her patients, nor be present in the patient's room during teaching and discharge instructions. The RN told me that one of the patients had specifically asked that no men provide care for her. Another patient had not insisted on no men, but was being giving instructions on breastfeeding, and the Peds RN told me that it would be too awkward to have a man in the room.
My questions are: In your Peds unit, what percentage of the patients are infants or mothers with infants, as opposed to toddlers and school age children? Also, are male nurses shunned by nurses and/or patients in Peds units generally?

Mother/baby unit (adult unit attached to L&D) is the only unit with both Mom and baby together, but that is not a pediatric unit. I work at a pediatric hospital and there are no postpartum patients. I work in a very large NICU (300 nurses in unit with 35-40 nurses per shift) and there are only two male nurses that work in the unit (I work day shift and the other male works nights). I am fully accepted by my coworkers, parents, and doctors. I have had parents request me as their baby boy's nurse because they think the male bonding will make their boy stronger. I have helped mothers Kangaroo Care their premature infant (the baby in only a diaper is laid on the mother's chest). The mother is usually topless except for her bra. I have yet to have a mother ask for a female nurse.

Johnson & Johnson has a campaign for nurses and the video for Pediatric Nursing features a male nurse.

Lemon Bars · Sep 22, 2018

Thanks everyone! I'm feeling better about Pediatrics. I guess the bad experience I had was not typical.

applewhitern, BSN, RN · Sep 23, 2018

I worked for years in Pediatric ICU in a teaching hospital. We had one male RN. He was a great nurse and most parents had no issue with him being male. That said, there were a couple of instances where the mother accused him of being inappropriate with their child. Unfortunately, that happens to male healthcare professionals and male teachers alike. In the PICU where I worked, we had children from infancy to age 18; you will develop iv skills on the teeny babies, so don't let that deter you. Good luck.

hawaiicarl, BSN, RN · Sep 23, 2018

I did 10 years in peds loved it. There were a decent amount of men working the unit, and PICU as well. The unit you described sounds like post-partum, I would never work there, so much man hating for having them pass a bowling ball through their hu-hu. Good luck!