New job in peds clinic!! What to expect?

linguine · Dec 10, 2010

You may be doing vital signs, triaging for the provider (and maybe phone triaging), childhood injections, assisting with short procedures.. also depends on what kind of outpatient clinic. I work at a clinic and this is what the nurses do.

Good luck!

mtngrl, ASN, RN · Dec 10, 2010

I don't know what type of clinic you're axactly talking about..but my first job was in a peds office. Children can of course be hard to deal with. Its hard to hold down a screaming flailing kid and give them an injection at the same time. Sometimes another nurse could help but they were usually busy. Parents sometimes help but sometimes are NO help. I had one parent holding a little girls hands and as soon as i brought the needle close she let go and the girl smacked my hand...the needle scraped across her leg, I felt really bad. I just hated when the Dr wrote an order for an injection (I only worked sick visits so no immunizations). Oh kids also freak out like crazy over finger pricks! Basically they dont want ANY procedure done so unless its a baby that doesn't realize what youre doing it can be a difficult job.

chingy1206 · Dec 10, 2010

Thanks for the response so far. I was explained that the clinic I will be working at is a general peds clinic that sees well child checkups as well as sick visits. They said that it is a clinic where the medical students and PA students go for their rotation along with certified physicians, so their used to a lot of teaching, which sounds like a good learning environment...i hope. Oh, and it is not a specialty clinic.

Butterfliesnroses · Dec 10, 2010

I did clinicals at a clinic. This didn't specialize in children but it had alot of kids come in. I think the key is getting on the childs level and making sure they are rewarded. When a child would come in I would interact with the child making him/her as comfortable as possible. We had a vibrating bee for the older kids. We'd put it on the area (it was said to numb the area) for a certain amt of time and give the child the injection. Another thing is having 2 nurses for immunes and do it on the count of 3 (unless the parent is opposed).

DogWmn · Dec 10, 2010

I worked peds and family practice sooo lets see. You'll see a ton of sick kids who'll cough, spit and puke on you:rolleyes:. As a previous poster stated some parent are OK with helping holding the kid...but you best bet is to learn some good holds that don't rely on the parent. Sigh and speaking of parents..ugh, some are OK the majority are bad to worse, their little angle is sick and they want and instant fix. You become the evil witch of the clinic when you come at their little angle with a needle:rolleyes:. Then you will also be doing a LOT of pt/parent teaching that for the most part will go in one ear and out the other...make sure there are plenty of education handouts, otherwise you'll field additional calls. Of course there is the "nurse call" and no matter what you say they don't want to bring little johnny in to the clinic but as you've yet to develop your telepathic skills and you'll need an Rx from the Doc. After that goes over like a lead balloon, you'll get "well Dr. so and so ALWAYS just called something in":mad:.

You will become supper proficient in giving shots very fast...LOL.

And if this doesn't scare you off, you'll have a good time, you'll develop a ton of skills that were not covered in nursing school, you'll do lots and lots of shots, education and phone screening. I worked in a very fast paced peds clinic and there were lots of "nurse visits" as I lived in a strep belt and we'd assess (gasp LPN's doing assessments;)) for strep, per protocol and take a throat culture and usually go ahead with a PCN shot. You'll also become an expert on rashes, types of crying - anything from really ****** off to really sick. If you don't have the best people/communication skills - you will develop them, parents are prickly things. You'll learn when to ask a parent to leave while you stab little sheila because she WILL sound like your killing her with the shrieking. You'll also see abuse cases hopefully not to often. I had one come in with a case of "ring worm" per her mom but come to find out the boyfriend was putting cigs out on the baby:devil:. We also had lots of newly discharged premies that required lab work so that's another skill you will develop.

Over all you will develop some great skills, I know what I've written sounds a little jaded but I did enjoy my peds clinic and I learned a ton of things that still work for me today.

Good luck and let us know how it goes.

anurseatlast · Dec 10, 2010

I worked in a peds clinci for 9 months as a brand new nurse. The clinic was in a large university hospital so we saw some interesting cases (rare genetic disorders, short gut, kids with chronic problems like heart problems). Much of what I did was routine. In clinical, I had only done a few shots so I had to learn the fine points of injections. The other staff (we had some great MA there who knew a lot) helped me as I learned. I went and watched how they postioned the child, etc and then they came with me while I did some. It didn't take long to get the hang of it. I also learned to do some procedures like washing out ears and breathing treatments. I never did enough blood draws to get good at it (the MA had been there for many years and did most of the draws). Had I stayed there longer, I would have made a point of learning to do blood draws.

I also learned lab stuff like how to run a UA, pregnancy test (too many came back positive), strep tests, hemoglobin,etc.

I imagine you like kids or you would not be going to a peds clinic. It is fun to work with kids most of the time. Some of the kids act out their anxiety but I found that if you talk to them, it helps a lot. We did lots of finger pokes for hemoglobin. I would talk the kids through what i was doing. "Okay, can you be my helper? Can you hold this for me? I am going to wash your finger? Is that too hot? Oh, it's cold? Huh! " i would go on the whole time. they would usually cry or fuss with the poke but then I would ask them if they could help me find "the bubble" etc. (I think the other nurses and MA thought I was a little nuts. My own children would dispute that - they would say I am totally nuts!) . I got a kick out of the big tough high school football players who would say, "Are you going to poke me? is it going to hurt?" I would say, "Wait a minute. You just told me that you are here for a football physical. You mean you let another guy who weighs, what, 180, 190, run into you full on and you're worried that I am going to stick you with this little poker?" They would usually start laughing. It did not take any longer and I enjoyed making it less traumatic for the kids, big or little.

Overall, it was a positive experience for me and I could see doing it again in the future perhaps. No matter what you do as a nurse, you will have the opportunity to learn new things. Ask lots of questions and volunteer for opportunities to learn new skills. It can be a great experience.

evolvingrn, BSN, RN · Dec 10, 2010

nevermind :)

allnurses Guide · Dec 10, 2010

I've worked in clinics, done allergy testing on kids and inpatient peds and I can say what my usual tasks were but as stated the distribution of work may be different where you are. If it's a general peds clinic you will be giving lots of immunizations, which means you will be doing a lot of teaching about side effects and adverse reactions, weighing, measuring height and head circumference and plotting the growth percentiles on the graph for well child visits, possibly doing vision and hearing tests.

The well child visits can actually be more difficult as they are healthy and wiggle and squirm and don't want to lay still or stand on a scale so there are some tricks of the trade we used to use to get that as accurate as possible.

Sometimes we would pick up on something unusual when they came in for a WCC or a garden variety tummy-ache. I remember one little three year old girl who came in for tummy troubles and the doctor (rip :-(-) just felt something was off and ordered an ultrasound where she was discovered to have a 3rd kidney! I think doctors call that a "zebra" diagnosis.

You learn to keep your antenna up for situations that don't seem right in the child's environment that could herald trouble at some point especially repeated Failure To Thrive and I don't mean as a cause for blame but as a cause for parent education and referrral. If you are working at a teaching hospital your intuition is oftentimes more spot on than the MD at that point and attendings are very busy running around most of the time.

Other than that as suggested be prepared to be plastered with all manner of fluid substances and make sure your hair is tied back as those little drool soaked hands can get a death grip on your hair before you know it! :)

linguine · Dec 11, 2010

I worked in a peds clinci for 9 months as a brand new nurse. The clinic was in a large university hospital so we saw some interesting cases (rare genetic disorders, short gut, kids with chronic problems like heart problems). Much of what I did was routine. In clinical, I had only done a few shots so I had to learn the fine points of injections. The other staff (we had some great MA there who knew a lot) helped me as I learned. I went and watched how they postioned the child, etc and then they came with me while I did some. It didn't take long to get the hang of it. I also learned to do some procedures like washing out ears and breathing treatments. I never did enough blood draws to get good at it (the MA had been there for many years and did most of the draws). Had I stayed there longer, I would have made a point of learning to do blood draws.
I also learned lab stuff like how to run a UA, pregnancy test (too many came back positive), strep tests, hemoglobin,etc.
I imagine you like kids or you would not be going to a peds clinic. It is fun to work with kids most of the time. Some of the kids act out their anxiety but I found that if you talk to them, it helps a lot. We did lots of finger pokes for hemoglobin. I would talk the kids through what i was doing. "Okay, can you be my helper? Can you hold this for me? I am going to wash your finger? Is that too hot? Oh, it's cold? Huh! " i would go on the whole time. they would usually cry or fuss with the poke but then I would ask them if they could help me find "the bubble" etc. (I think the other nurses and MA thought I was a little nuts. My own children would dispute that - they would say I am totally nuts!) . I got a kick out of the big tough high school football players who would say, "Are you going to poke me? is it going to hurt?" I would say, "Wait a minute. You just told me that you are here for a football physical. You mean you let another guy who weighs, what, 180, 190, run into you full on and you're worried that I am going to stick you with this little poker?" They would usually start laughing. It did not take any longer and I enjoyed making it less traumatic for the kids, big or little.
Overall, it was a positive experience for me and I could see doing it again in the future perhaps. No matter what you do as a nurse, you will have the opportunity to learn new things. Ask lots of questions and volunteer for opportunities to learn new skills. It can be a great experience.

I work in an adolescent clinic and a lot of what you have mentioned here is exactly what we do too. A crucial skill for clinic nurses is really communication and a lot of patient teaching. I also like working closely with the providers and learning from them.