6 Months on the Job ... Unsafe Practice?

[TXRN2012]

I am blessed to have landed a job right out of college. Graduated 12/11 and started my job 02/12. I went through a great residency, had preceptors, I work with pretty nice people...BUT..

here is the problem. I work in a small community hospital, so I am a pediatric nurse but work in several other areas. We are not a pediatric hospital so our peds census is generally low. This means that at times I WORK ALONE as the only pediatric nurse in the entire hospital. I work nights, so we have no doctors, no other pediatric nurses, or any medical response teams for children. We are hardly equiped to care for peds. Other night nurses, including charge nurses will have nothing to do with anyone under 18. I have enormous anxiety and stress being the ONLY PEDIATRIC NURSE in the entire hospital as a new graduate. I only have 6 months experience. IS THIS SAFE? I have a three yr contract I signed but I am miserable most nights fearing I will have to work alone. I fear I will lose my license and worse, harm a child. I have communicated this concern with SEVERAL management people and it has got me nowhere. I am scheduled to work alone a couple times this coming month. I get sick at the very thought. So my question is...is this considered SAFE NURSING and if not, is it something I could use to get out of my contract?

Thanks for reading.

[tokmom, BSN, RN]

Did they give you any extra peds training like PALS or PEARS? Who responds to any pediatric codes or an RRT? I would think if you have kids on your floors, then ALL the nurses should be educated to take kids.

What is your age range? We don't take under 5 yrs of age. We mostly get T&A complications, appys, pneumonia.

As for your contract, go back and read it again. I have no idea if you could use it, but if you don't feel safe and there is no back up or any education, could you buy yourself out?

[Lynstat1]

How stressful for you. What happens if a child needs intubating, that is who is responsible for stabilising a critically ill child before transfer to a facility that can better look after sick children?Who prescribes IV medication if there are no doctors available eg a 2 year old presents with probable meningitis needs IV antibiotics ASAP? There are so many scary scenarios, and to have to deal with this on your own with limited experience is unacceptable.I'm a paed nurse in Australia and unless I was a nurse practitioner or working in a remote setting ( ie the nearest major hospital was like 500km away) I have the right to say that this job is beyond my scope of practice, and I would be taking this to the executive level as well as the Unions. At a practical level, if an ill child was to present to your hospital while you are on nights, and you had any doubt in caring safely for them, I would be organizing to have them transferred to the closest major hospital that have the resources to care for them ASAP. I really hope you get some support where you work soon :)

[TXRN2012]

Well if the child needs intubating I would have to rush them back down to the ER and of course they would then be transfered out. We usually get the more lighter patients, but we get a lot of respiratory cases. And as any peds nurse knows....that can go south very quickly. I am PALS certified, but I am so new and I just really would like the support and knowledge depth of a seasoned nurse. I feel comfortable flying solo...just need the back up during emergent situations....which can happen anytime..I honestly am miserable and extremely anxious when I go to work. The fear of working alone! :/ Thanks for the responses.

Oh and age range is 0-18....we take all children...and when I say we..I mean ME. : ) All the other nurses act CLUELESS..yes even with 18 year olds twice my size.

[NurseCard, ADN]

Allright, so let me get this straight. If you have a child and that child goes south, you

have NO ONE to call to help you??? No other nurses on the floor that are trained to

help with children? No rapid response team? No ICU nurses that can come up and help?

How many children do you typically take care of? Are you on a stand-alone unit, or

are you actually part of a med surge floor with a peds section?

It sounds like a bad situation but I'm not sure that I'm understanding it correctly.

[Kidrn911]

I have worked in a similiar setting, and if you call a code you should have people responding, it doesn't the matter the age. as for intubation, most hospitals won't even allow nurses to intubate, the ER md should be able to do that, as well as ER nurses should be able to help with peds, because they have to be prepared for anything that walks in the door. Call the ER charge nurse or house administrator if you are concerned.

I understand your frustration, I just left a facility where I was the only PICU RN many times in a level 1 trauma hospital with a second year resident on nights. We see lots of GSW and MVA during trauma season. I have many many years experience in a pediatric level 1 ER, but still was uncomfortable with the situation.

[sauconyrunner]

I'm not really sure how you could use this to get out a this contract. Did you not know you would be the peds nurse when you signed the contract. If you knew that and signed, then you are rather stuck.

I also think there are a slew of Emergency Nurses right downstairs who are also trained to take care of all ages, who would come and assist you with a difficult situation. I would like to say though, if you have a peds patient go south, you would not run the patient to the emergency department- you would have them run to you.

What would happen if they had to admit, say 6-8 peds patients. I know in a small hospital like that it would be rare, but its something you could bring up. In addition, ALL nurses that work where there might be peds present need to be certified in at the very least PALS.

[TXRN2012]

Okay, okay..so maybe the ER has experience and maybe the NICU...but wow....AS A NEW GRAD I would love an eperienced pedi nurse helping me run the wing just for back up and to help admit the patients (no admin or techs at night)....getting back to back admissions can be very difficult to do all alone. I am new...just hoping it will get better I guess. I signed the contract knowing I would be a peds nurse and working scarce...but I didn't realize they would lave me alone fresh out the gate....thanks for listening to my rants...just praying everyday for strength. God has a plan for me : )

[wooh, BSN, RN]

This is why I left the community hospital that I used to work at. They thought PALS was sufficient training to be a pediatric nurse. Even then, not knowing what I didn't know, thought it was dangerous. Now that I actually DO know what I didn't know back then, one of those RSV babies or asthma kids could have been dead (or worse) so fast it's scary.

I at least had some adult experience to build on, but as a new grad, that would have been even more dangerous that it was.

[CrunchRN, ADN, RN]

Is there a nursing supervisor you can call when you are concerned?