Is there a field specifically for the pediatric disabled population?

quazar · Apr 27, 2016

Well, my developmentally disabled child spent a lot of time in occupational therapy and speech therapy clinics, and there were a lot of physically disabled children there. However, most of them also had a co-morbid diagnosis of some sort of developmental or cognitive delay, which you do not want to work with. I really don't know how you can avoid working with that one particular subset of patients unless you go straight to private duty nursing and hand pick your patients.

May I ask why you don't want to work with children with cognitive disabilities? Is it because you don't feel comfortable?

nevergiveup2016 · Apr 27, 2016

I'd be ok with it. Say for instance children with autism they just make me feel uncomfortable. I don't know how to interact with them or make them laugh or happy as other nurses do. It is really disappointing (I'm a CNA) to see one person walk in and they just know how to make them smile. It makes me happy to see that but then when I walk in they give me the look of get out of my room... it makes me uncomfortable because I want to make them smile that way too... It's such a silly reason but it's not due to their disability in any way.

~PedsRN~, BSN, RN · Apr 27, 2016

I am on a general med/surg floor, and see SO Many of these kiddos. :) They are often in for orthopedic or GI surgeries.

However, many of them are also cognitively delayed.

I love them all.

You know, the more you work with the population, the more comfortable you will become. I had the coolest guy with autism just recently.... he really made my night. (was in for an unrelated diagnosis!)

dishes, BSN, RN · Apr 27, 2016

@nevergiveup, Is it possible that you are making generalizations about all children with cognitive disabilities based on exposure to a few and a lack of knowledge?

nevergiveup2016 · Apr 27, 2016

I think it is possible that due to not being around them so much may cause me to feel uncomfortable. Then instead I am going to embrace this and take it as a challenge to learn how to communicate with them better. I'm currently on a med surg more general such as diabetes, flu, and things like steven johnsons syndrome and lots of cellulitis.

nevergiveup2016 · Apr 27, 2016

Hopefully people read this. I want to restate my question where are places I can work to get more exposure to the pediatric special needs population?

dishes, BSN, RN · Apr 27, 2016

Hopefully people read this. I want to restate my question where are places I can work to get more exposure to the pediatric special needs population?

Pediatric rehab centres.

quazar · Apr 27, 2016

I'd be ok with it. Say for instance children with autism they just make me feel uncomfortable. I don't know how to interact with them or make them laugh or happy as other nurses do. It is really disappointing (I'm a CNA) to see one person walk in and they just know how to make them smile. It makes me happy to see that but then when I walk in they give me the look of get out of my room... it makes me uncomfortable because I want to make them smile that way too... It's such a silly reason but it's not due to their disability in any way.

Ah, okay. Well, here's what I'll tell you about autism, as my kid is autistic. I talk to student teachers twice a year, and I always tell them the same 2 things. #1, special needs kids are like dogs: they can smell fear and they know if you don't like them or are uncomfortable. When they pick up on that vibe, they return it by acting withdrawn/scared/quiet/shutting down etc.. #2, it absolutely does not make you a bad person if you don't want to work with special needs people. It's not for everybody and it's hard sometimes. However, you're going to encounter them, and in increasing numbers now especially with autism. So it's beneficial to you to try to figure out how to work with them as best you can, because you can't really avoid working with that particular population, at least not in pediatric nursing. Unless you go to NICU, then you should be fine.

Autism is scary if you don't live with it or work with it every day, I know. I used to be absolutely terrified of it before I ever had children, so much so that I prayed that if I ever had a special needs child, that it be "anything but autism." God is not without a sense of irony. It's a hard one to learn and it can be really difficult to get comfortable with, but I would encourage you to try, maybe get some continuing education or something, simply because that population cannot be avoided. Shadow the nurses who are "good" with those kids and steal their techniques. I did the same thing when my kiddo was newly diagnosed. I had no clue what I was doing, so I just did what his therapists did. I felt like a fraud. LOL. Eventually, though, you get it, and you start to feel more comfortable, and it clicks.

Anyway, best of luck to you in wherever your journey leads you. :)

allnurses Guide · Apr 28, 2016

Honestly, I think you're going to find it difficult to separate cognitive vs physical delay such that you will consistently have only the latter. It sounds like your difficulty is that you don't think you can develop a rapport with those kids compared to other nurses. I understand that feeling, and it's not all that unusual, but neither is it set in stone or mean that patient population is ruled out for you now and forever.

You will certainly drive yourself crazy watching how other nurses interact with the kids, and determining yourself lacking in some way, but you could talk to them and in an effort to gain their perspective. You might find they didn't always have the instant ability to make kids smile.

I think it will help to realize that while "official diagnosis" (ie autism) is significant, each child is a unique person and there is no one-size-fits-all approach within that.

Anyway, you may not change your viewpoint, but realize this is an aspect of pediatric nursing we can grow and develop just like any other skill. All the best to you!

nevergiveup2016 · Apr 28, 2016

Thank you so much! This is what I wanted to hear! I felt like such a terrible person when I said everything except children with cognitive disorders such as autism. I'm not generally the best with kids. I get kids I'm fantastic with and I love them. However it's because the kids didn't make me feel awkward or they did that one thing that made me feel like a great CNA!!! I've tucked kids in, I've sat with kids while they sit and try so hard to vomit, I've sat and held babies where the parents aren't around, and I've caught vomit in the worst situations. And I am either told by the parent or child how great I am! But I have never got a good response out of autistic children. Sad part is my cousin has Down's and I'm still not used to it but we're related and it's not awkward. It's different for us! I will definitely try and sneak in around the times our great nurses make visits! I want to be better with the kiddos! It's where my heart is but confidence is trailing a bit...

Nurse Leigh · Apr 28, 2016

I wonder if you could find a program for children with a variety of special needs where you could volunteer. Even just playing games with them or discussing favorite hobbies can will increase your exposure and hopefully your comfort level. Most nurses and aides probably look back at themselves as newbies and are shocked at how much more comfortable they are with many populations and ADLs and interventions. I know I've come a long way. You can, too!