Pediatric ANXIETY!!!!

[ladnewnurse]

Hi! I have been out of school since last December. From what people tell me, I have been doing a good job...I really hope so!!!! I work on a med-surg unit in a smaller hospital. We get it all, infants to elderly. I have some very bad anxiety about taking care of pediatric patients. I didn't, but then I went to a class given at the hospital by a specialist in the pediatric area. Ever since that class, I see a patient with a pedicatric doc's name beside it, or a pt. with an age below 17 & I start to sweat a little, the nausea begins, and I really start to panic. This started the day after "the class". I took care of an 18 month old baby, he was so sweet and I was being REALLY vigilant of his IV site, because I had just learned how severe an IV infiltrate can be in a child that size. WELL...(you know what happened), within the hour, it infiltrated and his little had got so puffy. I, of course, paniced (not in front of the mom, thank goodness) & stopped the IVF, then removed the IV. The mom said "I know you've been checking it, but it didn't look like that the last time" Which made me feel so much better, because of course I was doubting myself, that I hadn't checked it good enough, that I had been negligent, etc!!!! I had been working a long week & it was my 5th day in a row, (4 12 hr shifts & "the class"), so of course I'm in tears & thinking of the pictures they showed in "the class" of the IV infiltrates in pediatric patients & imagining this little baby boy without that limb...BECAUSE OF ME!!!! Of course, my charge nurse & house supervisor told me that this was not a big deal, but in my head it was a mountain out of a mole hill, I couldn't help it!! BUT, basically, ever since that pediatric class & that pt. I have horrible anxiety when a pediatric pt. is assigned to me!!!!! It's comparable to the anxiety I felt with each exam in nursing school (though not quite as bad as the anxiety that went along with the N-CLEX!!)!! I'm serious cold sweats, serious self doubt, nausea, so far no vomiting. What can I do about this? Any suggestions would be so helpful, because I have to take care of them..... Noc before last I took care a 4 year old with horrible asthma, horrible lung sounds, moderate retractions SAO2 of 86%, all right as I took him over....I mean seriously, is this just my luck!?!?!?! I say that part in humor, because I have to!!!! Suggestions anyone??? I'd love the help.

[IzzyTheRN08]

Honestly, you did the right thing by frequently checking the IV site.. I'm a picu nurse and in our unit, we are supposed to check IV sites q 1 hr...sometimes IV's (especially on babies) just go bad, the important thing is that you recognize it early, stop the infusion, notify the doc, etc. Most pharmacy's have a list of the "vesicants" so you can look to determine if anything running through the line would be more caustic, etc. So don't beat yourself up about the IV!

I can understand why peds makes you anxious, but I think that good assessment skills and trusting your gut go along way (especially w/ kids). Dont ever be afraid to ask questions of your docs and fellow RN collegues. Also--don't be afraid to involve the parents in the patient's care as much as possible...no one knows their child as much as they do!

Hope that helps...

[PostOpPrincess, BSN, RN]

The more pedi patients you take, the easier it gets.

That's the bottom line.

[PAERRN20]

Do you have kids? I ask this because I am childless and I have peds anxiety too! I especially don't like putting IV's in little ones either. It helps if the parents are supportive though. I agree with JoPACURN that it gets easier after you care for many of them.

[OCD_Mom]

IZZY is really right. As the mom to a chronically ill child it can really help you in asking the parents. Parents often know something is "off." It sounds like you did everything right and with little ones anything can happen they are wiggly by 5 year old can blow is IV with a little "flip" of his arms. I am sure you have been told over and over THEY ARE NOT LITTLE ADULTS. The class shows you worst case scenarios with caretakers who were negligent. As long as you do your assessments and continue to check your patient you will be fine.

[nursel56]

It seems like this really took off after "the class". So the worst-case scenarios are dominating your mind to a much greater degree than they will happen in real life.

Kinda like when I have flying phobia. My mind jumps right to the few actual plane crashes, in all their gory detail, when in reality (so I've been told:wink2) thousands of planes take off and land every hour without incident.

Agree with JoPACURN, it gets easier the more you do it.

[tencat]

I so hear you! I worked in a small hospital, too, and freaked out every time I had a peds patient. This is part of the reason why I quit there, because it caused me so much distress. Some of us are not meant to be peds nurses. I love kids, but it causes me so much distress to hurt them in any way, even though I know it's to help them. Some people can handle it fine, but I'm not one of them. Don't feel bad about it if you are feeling that way.