Pediatric Nursing (pros, cons, and everything else??)

Pediatric Critical Care Columnist · Mar 26, 2016

Have you taken a little wander through the threads in this forum? There are lots of detailed posts that pretty much answer all of your questions. If, after you've had a look, you still have questions, come on back and we'll chat.

Double-Helix, BSN, RN · Mar 26, 2016

I agree with searching for pre-existing threads on this topic. Both the PICU forum and Pediatric forum will have lots of information for you, since your question is very commonly asked.

I'd also caution you against being "positive" of any nursing specialty before completing school. Many nursing students begin school thinking they want to work in a certain area (particularly peds, NICU and OB) only to reach those clinicals and realize it's not really what they expected. Keep your mind and options open as you go through school. There are areas of nursing available to you that you don't even know exist yet.

Futurenurse98 · Mar 27, 2016

Thanks! I know that many people find a different area that they end up loving. I'm not closing myself off to other areas, but based on multiple volunteer experiences, job shadowing, and clinical experiences, I'm VERY interested in peds.

Julius Seizure · Mar 27, 2016

I have worked in peds for me entire career, and I would never want to do anything else. I will say that sometimes the hardest part of my job is the psychosocial/family part. You have to be able and willing to teach the parents (or caregiver), because that is who is taking care of your patient when they go home. They might be at the bedside 24/7, or they might not even visit every day. It is important to not make assumptions about if they are "good" parents without knowing the whole situation. A lot of times I will hear nurses asking, "where are his parents? do they ever visit?" And sometimes the answer is that yes, they do, but it is usually at odd hours because they don't have their own transportation/they work odd hours/they are a single parent with other children at home. Sometimes there are major family issues that need to be addressed by social work (one of my favorite groups of people to work with). Even then, you need to try to have a good working relationship with the family because it isn't about judging them...its about giving the best to the child who is your patient.

Some random thoughts...never wake a sleeping baby without good reason! A wet diaper isn't always a good reason :) In kids you don't assess system-by-system or head to toe. You assess in the order of saving the worst parts for the end so that if they are going to cry or fight, you have most of the assessment already done. In babies, you take their temp first after unswaddling (before they get cold)...and you always try to keep them warm. Give kids choices when possible ("which finger do you want to put your pulse ox light on?"). Invite the parents to be a part of their care if they want to - they can take the child's temperature while you get the medicine ready. Might make them feel less helpless (and saves you a little time)(and the kid might cooperate better for them).

You will become attached to some of your patients. Especially in oncology. You will have to learn how to set appropriate professional boundaries while also giving a bit of your heart to the kids that you take care of.

Pediatric oncology can be a hard field to get into because the nurses that work there often stay for their entire careers (its a love it or hate it area). So you might need to take a gen peds job and wait for the chance to get in. Just FYI.

Is there a children's hospital near you? Volunteer! You will probably get next to NO time with pediatrics in your clinicals. Get your foot in the door and learn what the peds world is like by volunteering if you can.

Futurenurse98 · Mar 27, 2016

Thank you so much!! I live very close to Vanderbilt Children's Hospital, and I plan on trying to volunteer there sometime soon!! Everything you said was extremely helpful and I really appreciate it!

Kitiger, RN · Mar 28, 2016

Some random thoughts...never wake a sleeping baby without good reason! A wet diaper isn't always a good reason :) In kids you don't assess system-by-system or head to toe. You assess in the order of saving the worst parts for the end so that if they are going to cry or fight, you have most of the assessment already done. In babies, you take their temp first after unswaddling (before they get cold)...and you always try to keep them warm. Give kids choices when possible ("which finger do you want to put your pulse ox light on?").

Excellent advice for private duty, especially the part about giving choices. If I have a child who needs a routine therapy that he doesn't like to do, I often give the choice of "when". "Do you want to do it in half an hour, or do you want to do it now?" Yeah, he'll usually say he'll do it in a half hour, NOT now! But when it's time, he is often much more cooperative that he would have been when given no choice.

Murse1975 · May 27, 2016

I've spent my entire short (4 year) career in Peds as well, on an inpatient peds med-surg unit. Julius gives a lot of sound advice, though make sure to adhere to the policies and procedures of your facility, as well as following Dr. orders and DOCUMENT EVERYTHING. Peds is a love it or hate it field I think. It was very tough the first few times I had to stick a kid, especially babies, but when you get one that barely fights when you're trying to get a line in them because they're so ill, and in a few days they're back to being a normal playful kiddo, it makes it worth it. Also, know you're going to deal with some exceptionally poor parenting, especially nowadays with the "all about me" generation, as well as some heartbreaking issues. You're not going to get just ill children, but also physical abuse, sexual abuse, suicide attempts, psych issues, and the like. Can you handle these issues as well? Things to think about. Learn to get down to the kids level, and remember things about your childhood.. some simple tricks I've found effective that help kids is after any needle sticks, hold one end of the tourniquet let them pull the other back and snap you and ham up the pain a bit. "Payback" works wonders from turning tears to laughter. Let a kid squirt you with a saline flush syringe, and when you use a pocket penlight, let them "blow it out" like a birthday candle. You'll find little things that help you connect with kids, and know that some are so fearful or come from such an undisciplined environment that you're just going to have to muscle some things on them and it's going to be a war every time you do something with them, and that not factoring in issues like autism and such. If you can set up some shadowing on a unit, it would be beneficial. Best of luck!