Pediatric Clinical Rotations

TexasPediRN · Jan 4, 2006

My peds clinical was a while ago, but I do work with peds patients so I'll give you my best advice.

Speak softly to these children. They are in the hospital, and scared.

Medical Terms and kids dont mix.

Instead of saying "I'm going to take your blood pressure" say " I'm going to measure your muscles now!"

IV's are the scariest thing for a kid- but an IV is just a straw and its giving your hand a drink :) Isnt that silly? (most kids i've dealt with got a kick out of this..and usually stopped crying)

To listen to bowel sounds/heart sounds/etc - What do you think your tummy/heart is going to tell me?? Then I normally proceed to make up things that its telling me. Silly things mind you.

Get down to their level. Nothing is scarier then a 5 foot 6inch or so person standing over a 3foot little kid.

Sometimes you need to take out a little more time for a peds patient..patience is key..

If you like kids, I think you'll love your peds rotation. You arent hurting kids, you're making them feel better. Even if it does hurt a little bit..

My last word of advice: Carry around some cute bandaids with you- spiderman, care bears, etc. Bandaids make everything so much better :)

Most of all- be yourself :) Enjoy it, and you will learn lots.

Its amazing what a small child can teach an adult.

If you have any questions- dont hestitate to ask!

mitchsmom · Jan 4, 2006

Mine was ok... I have three kids and have always been around kids so from that standpoint I was comfortable. If you are looking for advice on being around kids, I say just be genuine - kids pick up on insincerity easily and become wary. I have heard people say that the parents are the hardest thing about peds but I guess I was lucky, all the parents I worked with were great.

We weren't allowed to pass meds to them so we missed that whole experience. I saw a lot of patients with sickle cell anemia, cystic fibrosis, and former premature babies still having problems as toddlers at 1-3 years (lung problems, hydrocephalus/ shunts, etc.), with a mix of other stuff. Most of my patients were used to being there.

We played a lot and I held a lot of little ones (some of them don't have parents/visitors there much). Of course, sometimes they have to have painful things done and I would say that is something that you should be prepared for, it's hard to watch little ones hurt.

The staff on that unit wasn't one of the friendliest so most of the students weren't too keen on the rotation as a whole... as a result I don't think I've heard a single student say they want to go into peds after that rotation! But I didn't think it was that bad. Going into it I didn't think I was going to like it at all and I liked it a good bit in spite of the tone of the unit. I don't know if that's what you were looking for or not but that's what came to mind. Have fun... it's one rotation you'll probably be ordered to play in!!

PS.... Oh yeah, our instructor gave us a supply of stickers to have handy for the kids.

Also, when my son recently had to get an IV for a CT scan, the nurse had this whole cool routine something along the lines of "there's this crazy mosquito in here that likes to come in here and tickle" (maybe do tiny skin pinches/tickles at this moment &/or feel for veins)... also.... "do you like Spiderman? Well we are going to put a web-shooter on your hand today!!" -or in our case, my son is into Star Wars- "I have this awesome laser that I'm going to put on your hand!" (believe it or not my 3 year old son totally fell for this and thought it was so cool... of course she was awesome with the IV and got it in as fast as a shot)... anyway so when he went into the CT machine he felt like he was at Disney World because there really were lasers and stuff and he was in hog heaven! LOL

truern · Jan 4, 2006

Kinda like mitchsmom, I didn't find the peds staff well....helpful.

They're very protective of their patients, as they should be, but it would have been nice to be more involved in their care. Mostly I hung IV meds...gave a few POs...no procedures, etc.

I did, however, love the experience. My clinical was at a large peds hospital...not your everyday appy patient there. We saw a lot of interesting cases.

LeesieBug · Jan 5, 2006

I'm heading into peds this rotation, too:) .

I am not looking forward to it. I really, really, really don't like working with the kids. When I did my senior practicum we had kids in the PACU, and I discovered I would rather have a root canal than work with them as a nurse! Maybe it is because I have three of my own, and every time I work with a child I get that little emotional DING, and picture mine going through whatever the child I am working with is going through. I also have trouble focusing on what I am doing if they are crying...too distracting for me....gotta' work on that. Did I mention that I really don't like working with kids?:wink2:

As someone else mentioned, I don't think we will be doing much with the patients, as I just read the clinical expectations packet they posted on the web......as we are dealing with kids we will be VERY restricted in what we do (understandably)....to the point of being reminiscent of first semester, having to get the instructor to even hang a new bag of NS. After reading all the restrictions, honestly my biggest concern is boredom.

I don't know what my point is, except that I'll be hanging in there with you, this rotation . Thanks to all who posted their Peds experiences...its helpful to get an idea of what to expect.

TexasPediRN · Jan 5, 2006

As someone mentioned, you may not be allowed to do much with this patients, which is true, but- you will still be their nurse and I do think you need to know how to relate to them. (in my previous post I posted different ways of saying things).

Now- the first hospital I worked at was a Peds/MegSurg floor, so I took care of adults and peds. When we had students (one group particularly), it drove us nuts. This group would only take Peds patients, and if we didnt have enough- their instructor had them sit in the breakroom and make up a patient.

Thats what I call bordem. (not to mention it really made me mad- what was the point of clinical then???)

I hope that you find a lot of peds nurses nice and compassionate, and I know I would gladly take a student with me to help with all of my patients. Ask the nurses- it seems new grads are more willing to do this- and see if you can shadow one. Ask what you can do- I know it may not seem like nursing, but even reading a book to a child or staying with them while the parent runs home is truely helpful.

Best of luck to all of your starting clinical, and to those starting your pediatric clinical.

:nurse: Meghan

RN and Mommy · Jan 5, 2006

I just finished up Peds last semester and I was not fond of it. I agree with the previous posters, bring things down to their levels. I mostly cared for babies, so that was hard. The parents were very observant (as they should be). I am not much of a child person. I have one and she's awesome, but I have never been fond of other peoples children and I know Pediatrics isn't for me. I did see some interesting things and learned a lot. It wasn't terrible, but not my cup of tea. Some of my classmates loved it and it made them sure that they want to be pediatric nurses. I do have to say, the RN's that were there treated us the best of all the other rotations I have been in. I can't say if it's that way everywhere, but these RN's were great! Encouraging, knowledgeable, available, and helpful! :) Good Luck!

maledi · Jan 6, 2006

I did my peds clinical last semester and I loved it so much. Having a child my self has made me an emotional basket case. Every time I see a kid sick on TV I can barely handle myself. So, I thought I would not be able to handle Peds, BUT, I found that 1.) The music they play on those shows always make every darn turn of events so much more dramatic and emotional and 2.) when you are actually in the situation and have some control of the outcome, it is a lot easier. I really enjoyed it and met some wonderful, very strong, children.

det01 · Jan 6, 2006

You have had some wonderful advice. It is important to get to the child's level , make the child comfortable, play with the child, etc. However there is one more thing - the parents. They are probally terrified. In any case they are having really high levels of anxiety and the whole family process has been interupted....this is only increased if there are other children involved besides the one that is sick. You will see cases where the family does not live anywhere close to the hospital..especially if you are in a hospital that is just for children. Even if they do have a place to stay (like Ronald McDonald House) it is still not home and not where their base support system is. I think that should also be taken into consideration when caring for the child.

Examples:

Try to explain what is going on to the parents. Work with them on things they can learn to do for the child - so they do not feel so helpless and/or useless.

Show some attention to the siblong if he/she is in the room.

Sometimes the parents may just need to vent. (Especially if the child is out of the room for tests) Be a listner. Let them do most of the talking. Avoid saying "I know how you feel". Even if you have been through the same thing you do not know how they feel because they are not you. (Saw lots of people say that and I just thought it was wrong) I think "I have also been through _________. I know it is hard. How are you feeling about it, if you would like to share." or something like that anyway.

If the parents are short with you, be understanding. It is not you they are mad at. (most of the time anyway) It is the situation their child is in.

Oh and another thing for the children - if they are scared of procedures like BP, temp and they have a favorite teddy bear...do it to teddy first. That might make them more comfortable. (Of course this only works if the child is not on strict isolation from anything on the outside. YOu can't use your equipment on these children. They have their own disposable equipment that is used only on them.

Singing to kids works well too. If you can't carry a tune it really doesn't matter to a lot of them - they just like the singing and the attention.