New to Paeds - HELP! :)

[rachelgeorgina]

I'm a third (& final) year nursing student. In Australia it's the beginning of the academic year so we've just started third year. In my degree so far we've had no exposure to a clinical paediatric setting. We did an introduction to children's health subject and a one week placement in a special school for kids with disabilities in second year and for most students that's all the paediatric exposure they'll get. In third year we can choose one elective in first semester that includes two weeks of placement and a sub-major in second semester that includes five weeks of placement. I'll be doing the paediatric sub-major next semester, which starts in August so I won't have any formal instruction in paeds until then.

Paeds has been my dream from Day Dot. Nursing adults has been really difficult at some points during my degree for so many reasons, largely because I just know that it's not what I wanted to do or where I wanted to be. More recently I've started to feel more comfortable and confident with it, it's not where my heart lies. I can't wait for second semester and for all my work to be paeds focused.

Over the last two years I've been working as a nursing assistant in a very small hospital for kids with disabilities. It's largely personal care for very, very disabled kids who visit us on a regular basis for respite because they have very high care requirements. I've also been volunteering in a special school for kids with disabilities, which I adore. Obviously it's not clinical at all but I've loved it all the same.

However I have been given an incredible opportunity. The major kids hospital here (one of the biggest and most prestigious in the country) runs a program for third and final year undergraduate nursing students. They hire 20-odd students as undergraduate nursing assistants each year to their casual pool, train them up and then leave them to pick up shifts anywhere in the hospital on a casual basis. It's my dream job. I've been dying for the opportunity to apply since first year. Obviously when applications opened I applied. & I got the job. So did 19 other girls from my year at uni and two students from another uni. As you can imagine it's incredibly competitive. On Thursday I'll be commencing supernumerary ward training on my 'home ward'. I visited the ward today to meet the CNE and the NUM and get the grand tour and I'm suddenly overcome with the fact that I have absolutely no experience in real paediatric nursing and have no idea how to do this job! There are so many differences - big, obvious things as well as small, subtle things - between nursing kids and nursing adults and I'm totally overwhelmed. I'm scared I won't be able to do this job at all.

What advice is there for someone in my position? I imagine there's only so much a textbook can teach you about this job. This is where I want to be and I want to excel at my job - but I don't know how to or even if I'm capable!

[NotReady4PrimeTime, RN]

Congratulations! This is a gold-plated opportunity for you that lots of others wish they could have had. Your worries are valid, but I think you're probably undervaluing your experience and overestimating the expectations that will be placed on you there. First, nursing children has a LOT in common with nursing adults. Getting vital signs is getting vital signs, although with kids you might have to distract them first, or let them get yours first, or get Mom's first. Giving meds is giving meds - with paeds the biggest difference is in the doses... and getting them to take them. Actually, paeds is all about relating to kids. As an employed nursing student, you're not going to be expected to "be the nurse" and you'll have lots of time and opportunity to learn how to relate to your patients. You'll have solid skills in that regard when you're done, you'll have a foot in the door and you'll have the perfect chance to become an excellent paeds nurse. Best wishes, you're going to be absolutely fine!

[myfavouritescar]

I actually went through the same program you are talking about and I am now a RN on one of the wards at the hospital. Which ward is your home ward (if you feel comfortable saying so)? All of the staff are really friendly at the hospital and the program has been running a long time so the staff know that you are new and likely have no experience.

Don't be scared but embrace the fact you have a lot to learn. Be enthusiastic, ask lots of questions and make the most of it. The fact I had the oportunity to be part of this program made a huge difference in how I survived my first year as an RN.

[remoteareanurse, LPN, RN]

I really endorse all that janfrn and myfavouritescar have said. You've already got some invaluable experience, and most importantly, you're passionate about it.

The only thing I'd add is that always remember you're not just nursing the child- half the battle is establishing a trusting relationship with the parent/caregiver. I see lots of nurses struggle with this. If you have kids, you'll know that there is NOTHING more stressful than having one of your children be sick or in pain, and often this causes parents to react in ways that can seem quite inappropriate. Never take the behaviour personally, yes there are some dreadful parents out there, but the vast majority love their kids and just want them to be better. Treat them with respect, communicate openly and respectfully with them and let them see that you're all on the same team with the one aim- to help their child.

Congratulations on this fantastic opportunity, relax and enjoy yourself, there are few things more fun than paeds, and you'll get loads of hugs and undying gratitude from kids and parents, its so rewarding.

[jnrRN]

RachelGeorgina,

There is no need to worry. People who work in paeds understand and know that although you have been at uni you haven't been exposed to enough about their specialty. They KNOW what they do is a specialty and that there will be a lot to pick up however they will be more than happy to take you under their wing and guide you to be the best that you can be. They will teach you their little tips and tricks in everything medication preparation and delivery to settling and patient and parent interaction.

Look at it this way: you need to be a special kind of person to work with children. The people who you work with will be happy to see that you are "one of them" and share their passion, skills and experience with you.

[rachelgeorgina]

Hi All,

Thank you very much for your responses. They were really helpful going in to my first few days. I still have a lot to learn (counting a RR on a writhing, screaming child, a HR on a teeny baby... I never would have thought I'd have trouble doing a simple nursing task like taking observations!) but so many people in the hospital have been willing to point me in the right direction. & I appreciate it so, so much.