Joining your ranks!

[~Mi Vida Loca~RN, ASN, RN]

Hello Fellow Peds nurses. I start my first nursing job on Monday and I will primarily be on the Peds. Unit. I am extremely nervous and excited. Anyway I got to thinking and wanted to ask about a topic. I am sure I will find out soon enough but it's like to get a heads up and see how it is at other places.

What happens when a young child has no family present. Like is there a policy that says that for someone lets say 2 has to have someone present at all times? If not and family has to go to work or tend to siblings or maybe a bad home situation and they can't remain at the hospital the whole time, what happens to the child. I imagine the nurse can't take the child with them into every room to look after them and at that age they probably can't be left in the room alone with no one looking after them.

Anyway, I hope I am making sense. I am sure I will find out how it is in my hospital soon enough but was curious how a situation like this is usually handled. I know at the hospital I am working at it is a locked unit coming in, you have to be buzzed in or have a special badge to protect the patients, but this wouldn't keep a child from wondering off if there was no one around. I don't think you have to be buzzed out, only in. This would only be one of the many concerns.

I only did clinicals there for 2 days during my peds rotation and I do remember a time I took care of an 8th month old so the mom could go down to the cafeteria and show the babys daddy how to get up to the floor.

Peds wasn't where I "saw" myself, I considered it during peds rotation. I am good with kids, I have worked in childcare for 5 years so I am comfortable with kids, I have 4 kids of my own. But I worry how I will handle abused and neglected kids because it's an area that hits home. But when I realized I had a very good chance of getting this position it all really grew on me and I am really looking forward to it. I see a lot of pros of working on peds with the cons being more on an emotional level. I also worry about doing procedures on kids. The peds nurses in our hospital often get called to the ED to do the procedures on kids down there too.

I look forward to learning from you experienced Peds nurses!

[xstarsfallingx]

Times like that can be both situational and dependent on your hospital's policies. I have worked peds at two facilities and neither had written rules on what to do in this situation. More often than not, parents stay. Sometimes they do leave for the reasons you mentioned, and we highly encourage them to have someone come take their place...not only for safety but the anxiety that comes with being in an unfamiliar place.

When this just isnt possible (dcfs involvement, other children at home) we base our behavior on the child. A small baby can be left alone in between care. A toddler is a bit more difficult, and if you are lucky enough to have a CNA or a tech, usually the two of you can trade off being in the room when the kiddo is awake. Unless they are in a regular bed, you should hopefully have cribs that are age-appropriate that the child cannot climb out of. Depending on the size of your unit and the amount of time a parent will be gone, wagons at the nurses station are a great daytime option.

If you use cardiac monitors and they are transmitting to your nursing station, I always ALWAYS have unattended kids on the monitors. That way you can clearly see when they are awake or asleep...the rest is just nursing improv. :)

[~Mi Vida Loca~RN, ASN, RN]

Thanks for the feedback.

[ShantheRN, BSN, RN]

I realize this is a little old but I just now caught it! I've been too busy doing job apps to keep up on posts :)

I just accepted a peds position, but I've been at this facility for almost 2 years as a PCA. Does your hospital have patient attendants/sitters? I work in hem/onc, and there are plenty of times our kids are left alone. It's usually overnight, but there are some kiddos whose parents/caregivers I've never even met Our average length of stay is pretty long - I'd guess 14-20 days but don't quote me - so that probably makes a difference. The few times I've been floated to the short stay unit I've noticed there is a bigger family presence.

If the child is young and/or isn't safe to be alone (pulling at lines, IV sites, dressings etc) we have a dept that provides PTATs for them on all shifts. It has to be ordered by the doc. As far as kids getting PTATs just because they're young and bored.....we don't do that. It sucks, and I feel awful whenever a toddler is just crying because they're scared and alone. We don't have a policy stating anyone has to be there - we just encourage it.

You'll also find, there are some kids that seem to be better off without the family being there. I treat my cat better than some of these "parents" It was my biggest issue when I first started working there. It's an awesome hospital, and we do great things there....but the social situations for some of these kids break my heart.

[NurseLoveJoy88, ASN, RN]

I'm not a peds nurse in a hospital but I asked the same question in clinicals. I took care of a 1 month old and the parents were not able to be present at the hospital due to other younger kids and work. The nurses did not say there was a policy in place but said considering the circumstances they still care for the child. The nurses basically take turns going in to hold and feed the baby. Its sad but I have seen this a few times in clinicals. Atleast the hospital is a safe place and hopefully the children are kept an eye on.

[hiddencatRN, BSN, RN]

At my hospital, parents don't have to be present on the med-surg floors. We have cribs with tops for up to 2/3 years old, have volunteers who can come and sit with children, have nursing students, and have distraction things like TV (Baby Mozart for the babies, cartoons and Disney channel for older kids), toys, there's a playroom older children can go to during specific times.

In the ER, parents are required to stay with their children. Some leave anyway, and we call them and tell them they need to come back and contact social work if they don't come back quickly. If a parent needs to move their car or go to the restroom, depending on the age of the child we either stay close by or in the room, or with babies hold them at the nursing station.

[~Mi Vida Loca~RN, ASN, RN]

Well since making this post I found out our policy and I have encountered this a few times. One case I took the kiddo from the parents and played with her in the hallway and did my stuff with her while the parents slept in the room. I didn't do it for their convenience but instead for the little girls safety. I was worried with how frustrated the mom was getting and things were calm so it was no problem to take the little girl.