Parental supervision on ped floors(m)

plchavard · May 5, 2006

I guess what people aren't understanding here is that there is a difference between a parent wanting to take a break - which is not a problem - and a parent who wants you to physically sit in the room and watch their child. Of course I am responsible for caring for the child and his response to his illness. But babysitting specifically for one child while the others are unattended IMO is taking things too far.

As far as encouraging the parent to leave, especially in PICU where you can see the child at all times, is okay. But what about the three and four year olds on the regular peds units? The moment the child is left alone they become hysterical. Most of the three & Four year old are okay with healthcare staff until they have an IV put in thier arms or get a blood draw - after that point they lose their trust and really want and need thier parents there. I've seen a four year old get out of bed, peel off his electrodes and pull out an IV in order to follow his mom who went down the hall - in a matter of seconds. I can understand why parents wouldn't want to leave their child alone.

Its sad - but true - that we get quite a few children onto our unit for anorexia. Unfortunately, someone has to be there at all times to make sure they are not purging the moment they are left unsupervised.

The children on a pediatrics unit come from all walks of life, some are drug addicted, some are inmates (they come with a personal sitter), a lot are in child protective custody, some are neglected, many are alone. I'm not a bad person, or a person who doesn't care for the kids, I just simply can't babysit on demand for a parent and feel badly when the parent requests that I do and I must tell them no. (In some cases we have parents who complain to the charge because the tech won't babysit)

We have child life specialists who take the children who aren't on isolation to the playroom or come to the isolation rooms to color or do puzzels with the kids. The parents should leave - if they must- during those times. We also have social workers who are willing to come in if there is a dire need for a parent to leave and the child must be watched. We also have "sitters" for extreme cases where the child is at risk of hurting themselves.

There are other avenues that may be taken in extreme emergencies that don't involve asking the nurse or tech to provide one on one supervision.

P.S. We also have fold-out beds in the rooms.

Trauma Columnist · May 5, 2006

I have been a military wife also for many many years (my sons are now 25 and 20). My older son was hospitalized multiple times in multiple hospitals (both military stateside and overseas) and civilian hospitals stateside. I rarely left him alone especially when he was in ICU. Most peds hospitals that he was at had no problem with me or hubby being present. I would never expect staff to babysit my son. However, I do expect that my son's needs would be attended to. When he was little (toddler) I would not leave him alone ever. However, as he got older (6 and up), yes, I would leave him alone occasionally as I too had to work and hubby and I would rotate our time with him with regards to our work schedules.

What bothers me the most about this thread is those staff that feel caring for these kids is an inconvenience. If that is the case, please consider getting another job.

My son has a chronic disease process and we have truly been fortunate that he is alive and well today (and getting married in November). The care that he received in ICU and in other units of these hospitals has allowed him to live and flourish.

Most parents (even those that are poor and not well-educated) love their children deeply. They may need re-enforcement that their child needs them to be present if at all possible versus they need to stay for the convenience of the staff.

Sorry for this long diatribe but I feel very strongly about this subject.

BTW thanks to all the pediatric nurses who helped my son and continue to care for all our current children. You guys rock!

HididiScribbler · May 5, 2006

Just putting my 2 cents worth in here...

I'm a nursing student and plan on being a pediatric nurse once I graduate. Before getting into the nursing program, I volunteered at a large children's hospital near me. As a volunteer, a lot of what I would do is sit with the kids when the parents needed to go get something to eat, get some air, etc. I loved doing it, all the other volunteers loved doing it, we had quite a lot of training for volunteers so we knew what to do and what not to do with the kids. The nurses were busy and although a lot of them would've liked to be able to sit with one kid for a while, it was difficult sometimes to do that, so having me and the other volunteers who had nothing else to do BUT that made it a lot easier. So, if there are volunteers around at your hospital, most of them would probably love to sit with kids for a while.

**canoehead, BSN, RN** · May 6, 2006

I am missing the conflict here. We can all probably agree that sitting with a child for 5 minutes shouldn't be a problem. I think the problem comes when someone answers a light and is expected to stop all other activities for an hour while a parent goes out.

If the child only requires someone to look in one them every 15min or so, no problem. If they need 1-1 care, and start crying as the parent is leaving, that is a huge issue.

Back in the day....when I was in peds I had settled my charges, somewhat, and the ER was on the way up with a new admission. The mom of a 2 month old called me in to complete a feeding so she could make a phone call. If she hadn't been there, or had told me she needed to leave even 5 minutes beforehand I could have juggled enough to have worked it out. And what phone call suddenly needs to be made immediately. I tried to suggest politely that she make the phone call after she finished what she was doing, but it went over like a fart in church. I said I could help in about 15 minutes, but right then I had someone who needed me- and she accused me of leaving her child hungry, and reported me to the supervisor. I still don't know, after 15years, what management or the mom thought I could have done to handle it better. (We had no techs and all the other nurses were just as busy as I was)

vamedic4, EMT-P · May 6, 2006

I am missing the conflict here. We can all probably agree that sitting with a child for 5 minutes shouldn't be a problem. I think the problem comes when someone answers a light and is expected to stop all other activities for an hour while a parent goes out.
If the child only requires someone to look in one them every 15min or so, no problem. If they need 1-1 care, and start crying as the parent is leaving, that is a huge issue.
Back in the day....when I was in peds I had settled my charges, somewhat, and the ER was on the way up with a new admission. The mom of a 2 month old called me in to complete a feeding so she could make a phone call. If she hadn't been there, or had told me she needed to leave even 5 minutes beforehand I could have juggled enough to have worked it out. And what phone call suddenly needs to be made immediately. I tried to suggest politely that she make the phone call after she finished what she was doing, but it went over like a fart in church. I said I could help in about 15 minutes, but right then I had someone who needed me- and she accused me of leaving her child hungry, and reported me to the supervisor. I still don't know, after 15years, what management or the mom thought I could have done to handle it better. (We had no techs and all the other nurses were just as busy as I was)

Manipulative parents aren't the norm, but they're out there. And it may only take one thing to set them off, as was perhaps the case in the above situation. I'm almost positive that the woman above has done something like that before, acting as if her baby should have the nurse's undivided attention.

IMO...and this is true anywhere...If you're the parent...it's YOUR responsibility to care for the "basic" needs of your child..even while they're in the hospital. Get up off your ass and change the diaper. Feed your baby. YOU ARE THE PARENT...that's YOUR JOB. Our job is to provide for the medical/nursing needs of your child while they're here. Sometimes our duties overlap, and most of the time we have no problem assisting you. But if your child is stable enough to be on the floor..assuming no immediate issues...you need to be the parent and get busy parenting. Again, if your child is in a critical care area...the rules are a little different. But if not...you need to get busy practicing those parenting skills.

As stern as that sounds...I do understand that there are times when parents need a break!!! Lord knows many of them deserve it. I, too, know exactly how hard it is to have a child in the hospital and the stresses it entails. But that's no excuse for abandoning your parental responsibilities.

I would hope you had management's support in the matter, and I apologize if you didn't.

Have a great day, all.

vamedic4

Children's Medical Center Dallas

steffibee · May 9, 2006

My unit has no techs and the nurse-patient ratio varies from 1 - 6-9 so having most parents there 24/7 is a big (and very appreciated) help for us nurses, doctors and most of all the kids!

However, I totally understand when a parent just needs to get out for a while for whatever reason!

Having a child in hospital is a very extreme, overwhelming experience for a parent and taking breaks even very short ones is just necessary to keep them sane- we always encourage that!

Most parents go for a break when the child's asleep and they always tell us when and how long they stay away.

Also good teamwork and communication with coworkers is key in busy situations!

@ BSN hopefully: your attitude towards the parents concerns me a bit ("if I like the parents I babysit the kid") you should be more aware of the parents needs! They need to rest too! and having a more relaxed parent makes work with the child a lot easier too!

A parent asking us to sit next to the bed watching the child longer than 20 minutes happens very rarely. Most times we leave the door open and drop by a few times to make sure everything's ok.

lpnstudentin2010, LPN · May 19, 2006

In my 18 years of life I have had 6 surgeries. I had them at 2, 4, 5, 12, 17, 18. the first four I had someone with me all the time. i mean my mom would sometimes run down the hall to get something from the kitchen. the last two she was there during the day but i was alone at night. in this case i had to rely on the nurse to care for me. at one time i needed water and i did not get it for 30 mins, now i am NOT blaming the nurse I dont know what was happening elswhere so i do NOT resent this, and my roomates friend got it for me (it actually turns out that she was a doc knew one of the resedents who works with my surgeon from medical school). this same roomate when ever her boyfriend or friend was going to the kitchen to get her something they would always ask if i needed anything and would bring it back for me. People just need to band together and help one other.

BRANDY LPN · May 19, 2006

I had a problem with this when my dd was little, and as a parent who was then a nursing student I want to add my story and opinion.

My dd was in PICU for one week with RSV and while in the PICU I slept in a chair at her cribside, there wsa no bathroom, no shower, I did not recieve a tray I did get a voucher for the cafeteria. The day shift nurses in the PICU were awful, would not even watch her while I went to the bathroom down the hall to relieve myself, let alone actually leave the floor to shower or get food, so i would wait everyday for my mother to bring my son to see me and I would take him to a fastfood rest. and get food and have lunch with my son, smoke, use the restroom and be back in 30 min. to an hour. The night nurses were wonderful and would sit with my dd while I went to another floor to shower (that they gave me directions to, in the hospital fitness center) I never used that oppurtunity to smoke or do anything other than shower and brush my teeth.

When they moved her to the floor the nurses would also not watch her not even for 5 minutes for me to run to the cafeteria for food, and also would not pick up food for me with the voucher, so again I waited for my mother to come and got 30 min to an hours break q 24.

Same nurses tried to bypass the pediatrol(sp) on her IV pump on a kid that was already borderline CHF and when I called her on it she said "these are really not needed, this pump cost the hospital (insert ridiculus amount of money here, but i think she said 200,000$) and I am sure it wont malfunction".......well sweetie I dont give a good gosh darn if the thing cost 200 million dollars its still a machine and can break, you WILL use any and all safety precautions available to you when you are dealing with MY dd. They also woke her up from a deep sleep to weigh her at 2 am, then left our room (isolation) and went directly to room next door with scale did not stop to clean it, and then just as I got her to sleep again at 4 wanted to wake her again to do V/S, which I wouldn't let them do, told them they could count resp and pulse without waking her and would have to come back for temp and b/p.

So for two weeks I ate once a day and spend a total of maybe 14 hours more than ten feet away from my dd.

It was my opinion that these nurses were LAZY(and possibly stupid) not busy. Like several ppl have said parents need (and deserve) a break and need (and deserve) the piece of mind knowing someone is there with their child not at a nursing station down the hall to feel comfortable enough to take one, even if you can only spare 5 minutes that 5 minutes might make all the difference in that parents day, it may be the only time they have to stretch their legs, get food, relieve themselves, practice basic personal hygiene or to just get out of the room and away from their kid who is most likely being tearful, whiny, and clingy. Noone should be expected to stay in a small room with a sick child 24/7 for numerous days without any type of break even if it is their own child.

msgm · May 20, 2006

I want to be a nurse like the majority that we encountered. As the mom of a former, chronically-ill child, I am so thankful for the nurses that cared for us! My dh or I was with him all day and every night, except for the 6 month NICU stay. However, in PICU, I needed to go to the bathroom, shower, or cafeteria. Since they usually had two patients, it wasn't a problem. On the floor, we were frequently in a room down the hall and no one was near. We were eight feet from the elevator and I didn't feel comfortable leaving him alone. I only needed help when I ran to the cafeteria when meals weren't provided. I LOVED having the hospital volunteer "Grannies" come in to take care of him. They were wonderful and we had no family nearby to help. They spoiled him rotten and would stop by and ask me to "go have some fun" for an hour or two. There were also student nurses who would volunteer to help. Since we were in so frequently and for long periods of time, it was so nice. It's been 10 years, but I haven't forgotten their kindness. I'll never forget David in PICU, who practically ordered dh and I to go out to eat and to a movie. He had one patient "knocked out" and wasn't scheduled to get any new admit. He wanted to watch a football game. Dh and I returned to find him rocking our son and watching the end of the game. LOL! We also had wonderful nurses who grew close to our other son who was three years older. I also remember the nurses who made us feel like a request for anything was a bother. We had the rep of being devoted parents who never complained, so it wasn't that we were constantly a problem. Those nurses didn't remain in pediatrics very long.

Working with kids and dealing with their parents can be a challenge!

bookworm1 · Jun 1, 2006

I, too, am just studying to be a nurse. As a mother of a chronically ill son that requires frequent hospitalization, I appreciate the nurses that offer to help so I can go home to shower or change clothes. I live in an area with many hospitals, but the only ones that are willing to care for my son are located in Chicago...at least 45 minutes from my home in good traffic.

It is extremely painful for me to think that nurses may avoid giving my child good supervision just because he/she doesn't like me. Even more of a reason for me to neglect the rest of my family while my son is hospitalized. Please remember that even overworked nurses are given opportunities to go home and freshen-up. If 'now' isn't a good time to give the parent a break, offer an alternative solution. If there are volunteers, recommend them. If a parent is truly neglectful, call CPS. When he is hospitalized, we are often placed in one of the rooms with a 'boarder-baby'. I always assist staff with that child and any other child that I can help with but greatly appreciate the nurses that work together to make sure my son can be supervised while I go home to visit the rest of my family! I dream of working in pediatrics after I graduate. Attending to the children will a pleasure with or without the parents help and I hope to never suffer from burn-out.

kiminco · Jun 7, 2006

I feel as a peds nurse although the child comes first, you are taking care of the whole family. If a parent wants a break, I make sure I can get them one. Whether it be me sitting with the child for a few minutes while I have someone else watching after my patients, working a deal with the parent to find the best time for both of us, getting a volunteer to come and sit with the patient, if it is an infant and they can come of out the room, but them in a wagon and bring them to the desk where all the nurses can keep an eye on them. I agree, unless it is impossible for the family to be at the bedside, they should be there as much as possible, but everyone needs a break and were are there to take care of everyone which gives the child the best care possible.

LiveZen · Nov 2, 2006

As some of the other posters have mentioned...use your volunteers.

I am a volunteer (just got back from my shift actually) and that is the whole reason I am there...to help you all out with your families. I rock babies, feed bottles, sit with kids (a LOT!) so mom can go get lunch, etc. See if your hospitals has them available. At my hospital, Child Life is in charge of the on-the-floor volunteers. We wear pagers, and the Child Life Office can page us if a family requests a volunteer. If we haven't been "Requested," we spent our time doing rounds to see if anyone needs anything. Just today, I stopped by the room of a 13 y/o who had a room (we'll call it 57) full of family, so I politely left the room to give him his privacy. As I was walking by the nurses station (not two minutes later), one of the PCA's said, "If you're not busy, room 57 decided they do want you!" Don't hesitate to get your volunteers involved. Our hospital had a crazy day today (tons of new admits yesterday...very suddenly) and I am glad that I could help them out!

And yes, the volunteer "Grannies" are great...we have some of them too...All the other volunteers on my shift are a the very least twice my age...I'm 20. :)