Peds is NOT easy!

Specialties Pediatric

Published

I just had to post this in response to the dozens of posts I see from nursing students or new graduates that want to work in peds because "kids are so cute," and "I want to take care of babies," and "I don't want to change adult diapers."

As anyone who has worked in pediatrics could tell you, peds nursing is not easier than adult nursing, and at times it is more difficult.

In peds, you might be assigned 5 patients, just like on a med surg floor. But your patients can't all speak for themselves. They can't press their call button to tell you when they are in pain, can't breath well, or their IV site is burning. You have to constantly be alert for these, and many other problems because our patients can't report them.

In peds, you have to care for the patient and the family. Some family members are great. Others are incredibly anxious, questioning everything you say and do and constantly asking you to check on little Jimmy because they are positive something is wrong. Other families are demanding. They think that because their child is in the hospital, so are they. They want meals, blankets, pillows, and expect you to supply them with Tylenol for their headaches and money for transportation home.

In peds, everything is tiny. Those veins you have to stick on an adult? 1/4 the size on a young child. Those urethra's it's so hard to find when cathing little old ladies? Microscopic on a newborn baby girl.

Peds nurses don't just have to know standard adult doses (650 mg of Tylenol), but we have to know mg/kg dosages as well. And we have to be able to calculate them quickly in order to catch a mistake in an order and prevent an unsafe dose.

Giving medications? 95% of your adult population will be more than happy to swallow their pain pill, or all 20 of their medications in one gulp. In peds, you're trying to convince a stubborn three year old to open their mouth so you can get the syringe of medication in them. They cry and kick and fight and more times then not they end up with half the medication on them and half on you. Don't even try to convince a toddler that amoxicillin tastes like bubble gum. They know the difference.

Finally, accidents in peds can be just as big and messy as adults. Spend three hours with a two year old with explosive diarrhea. Change the diaper 6 times, change the bed linen four times, change your scrubs once, and give the child three baths. Trust me, you'll be begging for an adult who can tell you when they need to use the commode, even if they do need help wiping.

Hats off to you! What you do is definitely not easy. I don't think I could handle peds, ever.

Hey anyone had children with mouth herpes? Now those little ones are nightmares when it comes to giving oral meds.

Ugh, HORRIBLE. Popsicles before and after help. :)

It's the Kawasaki's kids that tend to be the worst for me. (Ok, PO Clindamycin is the devil's creation, but I can sympathize as it tastes bad.) WHY DO KIDS NOT LOVE BABY ASPIRIN???? I used to love the stuff! YUMMY!! I liked being sick back in the day because I would get to eat the yummy orange baby aspirins!

But kids these days.... Crush it. Mix it in something. What is up with that???

Specializes in Paediatrics.
Ugh, HORRIBLE. Popsicles before and after help. :)

It's the Kawasaki's kids that tend to be the worst for me. (Ok, PO Clindamycin is the devil's creation, but I can sympathize as it tastes bad.) WHY DO KIDS NOT LOVE BABY ASPIRIN???? I used to love the stuff! YUMMY!! I liked being sick back in the day because I would get to eat the yummy orange baby aspirins!

But kids these days.... Crush it. Mix it in something. What is up with that???

XD Have they changed the flavour?

I find a lot of little ones are babied when it comes to meds though nowdays maybe it's just my area but when I was young. Mum would hold out the med and say 'Take it' all stern and I'd meep and obey. No disagreeing on my end, she didn't sit and explain it all then freak out when I hated the taste. Tough love is dying I think.

Most of the kids you crush things for end up needing to be half pinned in the end anyway as they spit it out (2-4yr olds). Think the worst case I had was a fifteen year old boy wanting his medications crushed and put in jam (they were really small!). We had a long discussion on what his life would be if he couldn't swallow a tablet (I was nice! Not too evil). He learnt to take tablets that shift ^.^;; after a few goes but he got it eventually.

Specializes in NICU, PICU, PCVICU and peds oncology.

osdbmom, thank you for your very articulate posts. I echo the posters who say that those of us who have been doing peds nursing for along time are in it because it's where we NEED to be... even if we grump about aspects of it sometimes. When I orient new staff to my unit I always make a point on Day One to remind them that people who are under stress are not really hearing what is said to them and will ask the same questions a dozen times, maybe in the same day. Eventually they'll remember the answer. What's important it to give the same information every time. I also remind them to utilize ALL of their resources, and that the best resource they'll ever have is usually sitting in a chair next to the bed. I've been in that chair, before I became a nurse, and I could always pick out the "lifers" from the "Idon'twannachangeadultdiapers". I've had some wonderful role models, both as a mom and as a nurse, people who knew how to make everything as good as it could be. One of the nurses who cared for my son on several of his many thismightbehislast days has become one of my best friends. She was another one of those chair-based resources before her nursing career began. I think those of us who come to this profession from that place have something very valuable to offer. Best wishes.

Much respect for those who work with peds! I have children of my own and my heart just breaks. What an emotional roller coaster. I absolutely love children and for them to be illness stricken or a result of a freak accident, i just cannot cope.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
Ugh, HORRIBLE. Popsicles before and after help. :)

It's the Kawasaki's kids that tend to be the worst for me. (Ok, PO Clindamycin is the devil's creation, but I can sympathize as it tastes bad.) WHY DO KIDS NOT LOVE BABY ASPIRIN???? I used to love the stuff! YUMMY!! I liked being sick back in the day because I would get to eat the yummy orange baby aspirins!

It was Chocks Vitamins for me!

But kids these days.... Crush it. Mix it in something. What is up with that???

And what's up with those spoon/syringe combo goodies they sell at CVS and Walgreens? I wanted my mom to chase me around while trying to balance the nasty liquid in a teaspoon from the silverware drawer!

What's up with selling otoscopes in the aisle next to the thermometers??? Next thing you know they'll be selling home tonsillectomy kits! Every kid has them you know----- oh wait. It's not 1964. I forgot there for a sec. :p

I had a 4 year old chronic renal disease patient who insisted on chewing up his pills dry (and there were a lot of them) I'd cringe as I watched the pills crunch, crunch, crunch --- that was his "way". Strange, but what a little trooper.

XD Have they changed the flavour?

Nope. I have some for my dog, so I tried a couple. Wanted to keep eating them!

I just had to post this in response to the dozens of posts I see from nursing students or new graduates that want to work in peds because "kids are so cute," and "I want to take care of babies," and "I don't want to change adult diapers."As anyone who has worked in pediatrics could tell you, peds nursing is not easier than adult nursing, and at times it is more difficult.In peds, you might be assigned 5 patients, just like on a med surg floor. But your patients can't all speak for themselves. They can't press their call button to tell you when they are in pain, can't breath well, or their IV site is burning. You have to constantly be alert for these, and many other problems because our patients can't report them. In peds, you have to care for the patient and the family. Some family members are great. Others are incredibly anxious, questioning everything you say and do and constantly asking you to check on little Jimmy because they are positive something is wrong. Other families are demanding. They think that because their child is in the hospital, so are they. They want meals, blankets, pillows, and expect you to supply them with Tylenol for their headaches and money for transportation home. In peds, everything is tiny. Those veins you have to stick on an adult? 1/4 the size on a young child. Those urethra's it's so hard to find when cathing little old ladies? Microscopic on a newborn baby girl. Peds nurses don't just have to know standard adult doses (650 mg of Tylenol), but we have to know mg/kg dosages as well. And we have to be able to calculate them quickly in order to catch a mistake in an order and prevent an unsafe dose. Giving medications? 95% of your adult population will be more than happy to swallow their pain pill, or all 20 of their medications in one gulp. In peds, you're trying to convince a stubborn three year old to open their mouth so you can get the syringe of medication in them. They cry and kick and fight and more times then not they end up with half the medication on them and half on you. Don't even try to convince a toddler that amoxicillin tastes like bubble gum. They know the difference. Finally, accidents in peds can be just as big and messy as adults. Spend three hours with a two year old with explosive diarrhea. Change the diaper 6 times, change the bed linen four times, change your scrubs once, and give the child three baths. Trust me, you'll be begging for an adult who can tell you when they need to use the commode, even if they do need help wiping.
Absolutely agree and couldn't have said it better. I LOVE peds but wouldn't get into that field for all the points you've mentioned. Peds is hard!!
Specializes in Pedi.
XD Have they changed the flavour?

I find a lot of little ones are babied when it comes to meds though nowdays maybe it's just my area but when I was young. Mum would hold out the med and say 'Take it' all stern and I'd meep and obey. No disagreeing on my end, she didn't sit and explain it all then freak out when I hated the taste. Tough love is dying I think.

Most of the kids you crush things for end up needing to be half pinned in the end anyway as they spit it out (2-4yr olds). Think the worst case I had was a fifteen year old boy wanting his medications crushed and put in jam (they were really small!). We had a long discussion on what his life would be if he couldn't swallow a tablet (I was nice! Not too evil). He learnt to take tablets that shift ^.^;; after a few goes but he got it eventually.

I was just having this same conversation with some of my colleagues last night. I can't stand when taking one medication is a 30 minute process when it's a child on chronic medications. I love it when I have a 2 year old who just opens his mouth and takes his meds. I love it even more if I say to the mother, "he's so good about it" and her response is, "he doesn't have a choice, he needs to take medicine and he's going to do it without complaining." That's how I remember my mother being with me and my brothers growing up. None of us took chronic medications but we all got strep throat several times a year. Liquid penicillin is nasty but it didn't matter- she'd tell us to go take our medicine and we'd do it. There was no fighting, we did it because we had to.

Wow. Your comment made me go back to a BAD time, 20 years ago when I almost lost my son (now age 28 & doing really well.) Also to when one of my closest friends lost her 3 year old grandson.

Peds is a responsibility I could NEVER take on. When my son was in Children's Memorial hospital 20 years ago I was alone, no family at all, all of my close friends had moved out of state. I tell you that I would not have retained an ounce of my sanity if not for the nurses caring for my son, and my friend tells me she feels the same about the nurses who cared for her grandson in his final days. We both knew that they were not there to care for US, but the comfort that they provided to us by caring for our little ones with such skill and compassion can never be adequately put into words.

To all pediatric nurses thank you!

Specializes in Peds Urology,primary care, hem/onc.
Interesting thread.

Im not on your side of the fence yet, but let me say from the other side of the fence, that having a sick kid is really scary. Having a sick kid who isnt going to get better (ever) is horrifying.

Knowing that a nurse can kill your kid with "one little decimal point" but having to trust them anyway, is hard.

Having to ask for help from nurses you don't know when you want, as mom, to be able to fix it and make it all better, but knowing you can't....its tough to swallow.

Being alone in a hospital (esp if its far from home) room with a small, sick child who does nothing but cry, and having no other adult to talk to but the nurse who comes in to check sometimes (bc you'd feel guilty if you rang her just bc you were so incredibly lonely, and you miss your spouse, and you havent seen your other children for days on end, and you don't want to ask for charity/food voucher but you havent got any money on you bc when you came in to ER the other night, you didnt expect to have to stay so long, and you havent gotten to go home).......its HARD. Really, really, really hard.

So for those peds nurses who take care of that kid (and the kids family), thank you. Thank you for knowing that YOU know what meds the kid is allergic to, but listening to a nervous mom repeat, "Did you know he's allergic to PCN? And sulfas?"......thanks for not getting irritated.

Thanks for noticing when mom/dad hasn't gone home, changed their clothes or eaten in two (or more) days.....and thanks for asking if they need something to eat, or showing them where the apple juice is.

Thanks for knowing that parent is scared to leave the room, bc they know if they do, something bad might happen....thanks for patting the shoulder, and promising to watch the baby until mom comes back.

Thanks.

Thanks for being respectful and listening when that mom/dad needs to talk, or cry, at 2 a.m. when they are looking at their child all hooked up to wires, and monitors they don't understand.

Thanks for listening to the experience that brought them to this point.

I'm sure it can be irritating. I know it is hard. I know sometimes you probably have to bite your tongue, and that you are tired, and that sometimes, you might even joke about it with other nurses after work.

But the fact that you do it, and you are kind, and you listen when that parent is worried, and double check everything anyway, even though you know you are already right....you do it anyway, bc you care. I know there is vomit, and diarrhea, and screaming toddlers, and spit out meds; I know you are tired, beyond tired, sometimes; I know you have your own families to think about and you wish you were home with them.

You may not know it; you may not hear it often, but you mean the world to the parents of those kids you are caring for. You make a difference to that mom or dad; you are the difference between a night spent alone and scared, and a night knowing your child is being cared for by someone who is kind and empathetic. Thank you.

AWWWW! Thank you!!! That brought tears to my eyes! Have done peds my entire 14 year nursing career!!!

when my son was 3, he could swallow a whole handful of pills at once...but he had to do it dry, couldn't coordinate swallow pills AND a liquid at once. But, he knew he had to take them.

Now, he's nine, not only does he take his own meds, but he can also show a nurse where a good vein is, and when his IV's are done, he removes his own tegaderm, applies the detachol, takes a gauze and pulls his own lines out. :) lol

I have never understood parents who can't "make" little kids take their meds. My kids knew that either they took them willingly, or we had to force them, which isn't fun for anyone, but has to be done.

They will get a rude awakening when those little kids are 15 (thats where I am now), and trying to force them to take meds they dont want, its a LOT harder to do than tackling a 3 yr old! lol

+ Add a Comment