how to make the most of my peds clinical rotation?

  1. i just started my peds clinicals, and i was really excited. i imagined it being fun and that i would learn a lot. however, yesterday was my first day on the floor and to my dismay i was bored out of my mind! the census was very low (i think there were only 6 patients on the whole floor), and since it was our first day we each only got one patient. my patient was a 6 week old baby, so i was kind of excited. i was thinking "babies are fun. ill be able to bathe, change some diapers, maybe feed, learn about assessing infants, giving them meds etc.." it didnt dawn on me that when babies are in the hospital, their mother is usually there 24/7 and does everything for them. he has no meds to be given except a prn tylenol for fever, which he didnt need because he was pretty much better. so all i did was his morning and noon vitals and an assessment. i would pop in periodically and ask the mom if she needed anything but she pretty much had it all under control. so i asked my classmates if they needed help and they all had nothing to do as well! i also asked my nurse if there was anything i could do and she said not really, everyone was fine and if something came up shed let me know...

    so is a peds floor always like this? i feel weird not having anything to do. maybe it was just a slow day or something and things will get busier later. we do some other experiences in peds LTC, rehab, school nursing, so its split up nicely, but i just want to get as much of an experience as i can while im on the floor.

    any tips on things i could be doing to make the day go faster? im so used to a busy med surg floor where most of the pts are 55+ and have at least 10-20 meds. Peds is so different! im just looking for some advice on how to adjust.

  2. Visit ashleyisawesome profile page

    About ashleyisawesome, BSN, RN

    Joined: Jun '08; Posts: 808; Likes: 614
    RN; from PA , US
    Specialty: 5 year(s) of experience in LDRP


  3. by   llg
    What did you learn about your patient's diagnosis and reason for hospitalization? Did you talk to the mom about how the baby's hospitalization was effecting her life and the lives of any other children in the family? If this is a first and only baby in the family, how comfortable is the mom providing all of the care? If there are other children in the family, do they have any special needs related to this hospitalization?

    Was it a problem for her to take off work to take care of the baby? Will the baby need any special care after discharge ... and if so, is the mom going to be able to take the baby to day care?

    How much sleep did the mom get last night? Did she need a break? Sometimes you have to actually "push" the moms a little to take a break, get a shower, walk down to the cafeteria and get some food, etc. -- and that can be good for them.

    What resources are available to help the families of hospitalized children?

    Are there different policies/procedures for pediatric patients -- e.g. patient security (to protect from kidnapping) ... to not leave a child unattended ... to prevent little kids from wandering off ... etc. Is there special equipment? Are the monitors different, scales, etc. What about medications. How are they commonly given to babies?

    If you don't know the answer to all of the questions above, you may have missed an opportunity to learn some stuff with that baby as your patient. You could have talked with the mom to learn more about their home situation. As you developed a good relationship with her, she may have trusted you to watch over the baby while she took a break -- or let you help change the diaper, etc.

    The emphasis on an adult med/surg unit is often on the many physical tasks that need to be done in a short amount of time. While that can happen on peds, too ... sometimes, the challenge (and the learning) in peds is the need to look beyond the immediate physical tasks to the care of the whole family and to the protection of the child from things we take for granted with adults. (e.g. kidnapping, wandering off, etc. -- though that can be a problem with adults sometimes, too.)

    Talk to your instructor -- who should be more familiar with that particular patient unit. Make a list of things you could be exploring and learning on the unit when there are not a lot of physical tasks that need to be done immediately. The next time it happens, you'll be ready to make the most of the "down time."
  4. by   ashleyisawesome
    thanks for the info! i will definitely try to push a little more to get involved with the family next time.

    i did go into the room quite a bit to check on the mom and asked her many times if she was tired or hungry, and told her that if she needed a break, he was my only patient and i could stay with him so he wouldnt be alone, but she said she was fine. she did get a chance to shower/eat when the grandparents came in and took over for her for a bit.. i kind of felt like she might not have trusted me with her new baby because i was just a student. not that she was mean or anything, she was very nice and answered my questions and happily let me do my assessment on him, but i can see why anyone would be nervous handing over their baby to someone they dont know. i guess i can make it one of my goals to work on gaining the parents' trust.

    i did spend a lot of my down time exploring the unit so i knew where things were and what kinds of equipment there was and what its for.

    i suppose i need to get more into the mindset of caring for the whole family including there psycho-social needs, etc., instead of being so task oriented.

    at least now i have more of an idea of what im expected to do and opportunities i should take advantage of for next time!
  5. by   sandyfeet
    I am doing my peds rotation too, and for me it's a lot more psychosocial than physical tasks. The big shift has been from treating just the sick patient to treating the entire family. I spend a lot of time talking to parents, and you can learn a lot about your patient that way! For example, I had a young patient who was healthy enough to go home, but kept saying he wasn't ready and didn't want to. I talked to his dad for about 10 minutes before it became clear that the siblings at home got all of the parent's attention, and my patient was enjoying having some one-on-one time with his dad! Have you had your psych rotation yet? I feel like there are a lot of similarities. Hopefully this will help!
  6. by   ashleyisawesome
    i would like to update and let everyone know peds its getting a little better for me now! my 2nd day of clinical, i had ANOTHER baby, except this one had no parents with her (mom was at work all day). So I had to do everything for this little 3 month old who had a tendency to cough until she turned blue.

    my primary nurse gave me a crash course in baby care and set me free. I didnt realize how terrified i was of taking care of a baby! (never even changed a diaper before, let alone feed a baby with acid reflux!)

    by the end of the day i was a diaper changing pro... still not so good with the feeding, but i made some progress.

    i would just like to say: babies are exhausting. haha. and now i have seen the other side of peds nursing, where you can be very busy with tasks. after that day i was wondering how nurses care for two babies/toddlers that dont have parents with them? i would go crazy!

    moral of the story: i am getting the learning experience i was expecting now. its nice to see the different situations you can be thrown into on a peds floor. however it would be nice if my instructor gave me a patient who is not a baby soon... they are cute, and all my clinical classmates are jealous, but i think im ready to move on to toddlers or teenagers now!
  7. by   noreenl
    I think you need to slow down a little and pay attention to the lessons at hand. I am not picking on you but i noticied that your entries alll have a common theme "What's next gimme more." you had 1 day on peds and another nurse tried to show you what you may not have noticied and you didnt even seem to acknowledge the lesson. Just because you had a different patient the next day all the psychosocial things must be done and do matter. Please try to take your time and learn while you only have one or two patients and have the opportunity to really study your patients. There are plenty of med surg floors with not enough staff or supplies in your future. Take the time to learn now please. (Yes I am an instructor)
  8. by   ashleyisawesome
    i do know the importance of psychosocial issues, and i am trying to work on them, again it is hard to make the transistion from a busy medsurg floor where they were giving me 3 patients at a time, to peds, which is totally different. I also only have 5 total days on the regular peds floor so im trying to experience as many skills as i can in this short time. however, i know learning to deal with psychosocial and caring for the entire family are 2 very big skills i need to learn in peds and i am trying. its just kind of confusing at times. i kinda wish we had more days but ill have to continue to make the most of my time there. im used to having at least 20 clinical days on a unit to get into the swing of things, and the patient population in peds is so varied, i have a baby one day, then a 10 year old, then a 17 year old.. they all need different things.
  9. by   noreenl
    that is part of the challenge of peds. you will find that this is part of your education where you have the opportunity to build on your psychosocial skill set. i tell my students there is "Book life" and "real life" and nowhere is that more apparent than in pediatrics. you need to do things by the book especially until you take the boards , but unfortunately real life has a way of making this seem impossible! Parents and siblings, extended family, moey issues, housing , availability and affordability of meds for all family members all play a role in compliance for your littlest patients! just remember we are all here to help you get thru and keep on going!!! the fact that you are recognizing your strengths and weaknesses and working with them puts you ahead of alot of folks in this world!! keep up the good work!!
  10. by   ImThatGuy
    My peds rotation will consist of 12 hours of observation in a children's hospital, and that's it.
  11. by   ashleyisawesome
    Quote from ImThatGuy
    My peds rotation will consist of 12 hours of observation in a children's hospital, and that's it.
    wow, that kinda sucks..

    we get a bunch of experiences, i just went to a pediatric LTC. I kinda like that better, I would actually consider working in a place like that.

    monday i get to be a school nurse! haha
  12. by   ImThatGuy
    Quote from ashleyisawesome
    wow, that kinda sucks..

    we get a bunch of experiences, i just went to a pediatric LTC. I kinda like that better, I would actually consider working in a place like that.

    monday i get to be a school nurse! haha
    I school nursed in my community health class this past Monday. It was kind of cool. It was for grades one through three.
  13. by   ashleyisawesome
    Aww good, im glad to hear it isnt boring, im semi looking forward to it! Ill be with k-5.
  14. by   ~Mi Vida Loca~RN
    It varies. Summertime our census is pretty slow and sometimes we will take low acuity adults. Like Gyn surgeries, Lap Appy's, or observational type adults. But in the winter we will be full of sick kiddos requiring a lot of care and RT treatments Q1hr. We get a lot of burn kiddos too. So some shifts I won't have much to do and other shifts I won't have much time to do anything else. My unit we can also work as a step up unit and can take some pretty sick kiddos with a 2:1 or 1:1 ratio. We just don't do cardiac stuff of vented kids. We airlift them to Denver.

    So it really can vary. 2 weeks ago I had to put an IV in the foot of a 2 year old. Sometimes the parents are very involved and sometimes they could seem to care less. I work nights so a lot of my kiddos will go to sleep but like I had a 4 weeker a couple weeks ago and I went to do her vitals and she was looking wide awake. Mom and Dad were sleeping and I knew they were exhausted. They were very active in her care, anyway, they started to wake up and I told them to go back to sleep and I took her out to the nurses station and cuddled with her for 2 hrs. She was my only patient.

    You just really never know what you are going to get because it's like a mini med/surg so you can get such a huge variety of patients.