New Change to my Unit

Tweety, BSN, RN · Dec 10, 2004

I like change. You become educated, you learn more, become more well rounded.

I'm sure they realize you can't please all the people all the time and they might loose some people. Personally, I like adults, if I wanted to work peds, I would work peds. But if they decided to add peds to the mix I would be o.k. with it, as long as they sent us to inservices and education. I've forgotten all about peds many years ago.

They've revamped our units from time to time too, changing the patient population, changing the acuity, etc. But I agree with you, unless they do lots of education on the needs, assessment, and potential complications of the pediatric patient it's very unsafe.

Good luck. :)

Nurseboy1 · Dec 10, 2004

I like change. You become educated, you learn more, become more well rounded.
I'm sure they realize you can't please all the people all the time and they might loose some people. Personally, I like adults, if I wanted to work peds, I would work peds. But if they decided to add peds to the mix I would be o.k. with it, as long as they sent us to inservices and education. I've forgotten all about peds many years ago.
They've revamped our units from time to time too, changing the patient population, changing the acuity, etc. But I agree with you, unless they do lots of education on the needs, assessment, and potential complications of the pediatric patient it's very unsafe.
Good luck. :)

But see thats just it, no inservices, no education. The only thing added to the unit was a peds code cart. Most of the nursing staff was unaware of the change until the child was actually brought to the unit.

Tweety, BSN, RN · Dec 10, 2004

:eek: :eek:

Now that is totally unacceptable. Obviously, their sucking up to surgeons and trying to increase their profits.

begalli · Dec 10, 2004

Yikes! I wonder why the peds surgeon resigned.

Sounds awfully dangerous and I really feel for you.

I couldn't imagine a change like that in my ICU (even though when our unit first opened it was an adults/peds combined transplant/open heart unit). They have talked bringing peds back, but I know it will never materialize. I do know one thing though, my unit would have begun preparing us months ago.

Rotten that they didn't give you some preparation. Adult vs peds is two completely different worlds.

I'd have to consider going somewhere else.

Nurseboy1 · Dec 10, 2004

To their credit, my NM did not like the change any more than we did. She was simply over-ruled by hospital administration.

The most common diagnosis we will receive is cystic fibrosis, since that is what the majority of peds, lung transplants are for. Hospital admin reasoned that we have adult CF patients, so pediatric CF patients wouldn't be a large change. My NM disagreed with them citing that most peds CF patients weigh 30 kg or less which results in different drug dosing, for a group of nurses unfamiliar with this to me this sets the stage for disaster.

Other problems that have come up are just simply not knowing who to contact in terms of social work, childlife, etc.

BTW I don't know what happened to the peds surgeon.

rnmi2004 · Dec 10, 2004

That is a completely unacceptable reaction to the resignation of the peds surgeon. There is no way I would want my child to be treated on that unit (no offense, RNWannabe!). This situation is not your average change in policy or acuity of patients.

Children are not little adults--they have different medical needs, different meds dosing, different ways of reasoning and thinking than adults, need different types of equipment and supplies, and they need nurses who have chosen a career in pediatric nursing.

This sounds like a poorly planned change, and I hope your facility gets a clue before a child is harmed.

meownsmile, BSN, RN · Dec 10, 2004

We occasionally get ped surgical patients or traumas to our med/surg unit. We dont really like it either, only in our case its because of our size. Our hospital is a fairly small hospital and if we get pedi patients it usually because the ped unit is closed and they dont want to call in peds staff for 1 or 2 patients that may not be there 24 hours. However,, i feel they should be able to float a pedi nurse to our unit to take care of the little ones. The staff is on call anyway,, so call them in for gods sake. Kids conditions deteriorate quickly and when we have a large census on med/surg we CANT give the pedis the attention they need carewise.

In your case though i dont see why they cant float a ped nurse to your unit if you have ped patients. It's not like they wouldnt have to have the staff there if they were still being sent to the peds unit.

Nurseboy1 · Dec 10, 2004

Children are not little adults--they have different medical needs, different meds dosing, different ways of reasoning and thinking than adults, need different types of equipment and supplies, and they need nurses who have chosen a career in pediatric nursing.

My thoughts exactly, and as I said my NM made these points with the hospital administration and they over-ruled her. No one on my unit has done pediatrics since nursing school. None of us are very comfortable with the change. I agree with my manager, it would have made more sense to simply allow the adult transplant team to have priviledges on the pediatric service. The administration feels that since this is temporary until a new surgeon is located that locating peds patients on the adult unit is the better thing to do:rolleyes: .

RN4NICU, LPN, LVN · Dec 11, 2004

Just wondering - (and forgive me if I have misunderstood what you said), but why would you and your NM have considered it appropriate for adult transplant surgeons to admit to the pediatric service as an acceptable alternative? Because it wouldn't have been your problem? It is the same situation - adults are adults, kids are kids (and babies are babies). Each should have nurses who have chosen to deal with the particular population. I chose not to take care of adults in my practice, just as you chose not to go into peds or neonatal. None of the services should have the other populations foisted upon them.

Marie_LPN, RN, LPN, RN · Dec 11, 2004

Let's see, children on an adult unit. Adults coming to visit other adults, God only knows what their background are, etc.

I doon't like the mix of adults and children on one unit. It's not safe.

Nurseboy1 · Dec 11, 2004

Just wondering - (and forgive me if I have misunderstood what you said), but why would you and your NM have considered it appropriate for adult transplant surgeons to admit to the pediatric service as an acceptable alternative? Because it wouldn't have been your problem? It is the same situation - adults are adults, kids are kids (and babies are babies). Each should have nurses who have chosen to deal with the particular population. I chose not to take care of adults in my practice, just as you chose not to go into peds or neonatal. None of the services should have the other populations foisted upon them.

Simply because the hospital is trying to find a new transplant surgeon for pediatric heart/lung transplant. They consider this a temporary measure, just for simplicity it seems easier to leave the peds patient on the pediatric unit and send the adult surgeons to them, rather than move the children on an adult unit where the nursing staff is not accustomed to the needs of pediatric care.