Pediatric OR nurses here?

kiki617 · Aug 24, 2017

Hi! I'm not an RN but a CST, so not sure how much help I am. But I recently started in peds after adult OR and I like it way more! The main differences for me is that there is much more time with the patient in the OR. It takes anesthesia much more time to do what they need to do once the patient is in the room. Turnover and start time doesn't feel as rushed as in adults. The patients are obviously smaller so that makes positioning, prepping easier... and for me instruments being smaller is easier to handle. The rooms can get hot. Today I had to change my shirt because I was wearing lead in an 85 degree room while scrubbed and it was pretty gross. Obviously it's not as bad when not wearing lead and scrubbed, but if the case has you running or if you have some hormonal changes happening, it's something to be aware of. I would think the transition from adult to pets and vice versa would not be massive. The equipment and instruments are still the same, the frequent cases may be a little different (on call adults=lap chole, peds=lap appy...etc). Hope that helps a bit and best of luck.

medical_zebra · Sep 12, 2017

i'm brand new as a nurse and to the OR so i'm sure i'm no help, but i noticed you only had one response so i thought i'd tell you what i have observed so far. in my facility (large hospital) we do both. All the adult patients already have IV's in so the nurse doesn't have to do IV's. The pediatric patients are put to sleep beforehand and the IV is started in the OR by the nurse. With the kiddos, I feel like nothing is gross because they're just so cute and sweet, but with the adults there are a lot of things that gross me out haha. With the kiddos, you have to have a special way of communicating to calm their nerves. They are being wheeled away from their parents to a scary room with a bunch of adults who have creepy masks and there is a LOT going on for them. You have the have the energy and the skill to make this as easy as possible for them by doing special things for them. Also, you have to deal with the parents so it is like you have three patients....but in my experience so far, it is not bad....but it was when i had clinicals on pediatric med surg. I like that the pediatric patients are super easy to move to the OR table. Adults can be heavy, even if it is just their leg or arm. kids are also easier to prep the site. Adults can have large fat folds you have to get in between. Kids have different smaller equipment and medication dosages are different so if you already know the adult stuff, that could be a transition for you. For me, so far I like adults. With kids, there is a ton of extra pressure because you don't want to do anything to hurt them...not like you do for adults, but you get my drift. As a new nurse, I find all the new info to learn overwhelming so i don't want to have to worry about having to communicate in a special way for the kids and parents. I also don't like IV's. haha. I have noticed that the pediatric doctors are all very very nice so that is a perk. Hope this info helps.

Loxam10 · Sep 12, 2017

Hello. You have probably already chosen your job opportunity but I figured I could still give you some

info for reference. I have been a pediatric OR nurse for two years now and I absolutely love it. OR nursing is completely different than any other kind of nursing. I started out as a new grad so I cannot really compare my experience to an adult OR. But I can give you my two cents. Adults usually have comorbidities, kids usually don't. As previously stated, in peds you have the opportunity to start IVs. In our facility any child under 10 years will get

PO versed in preop, anesthesia masks them down with sevo (now they are not a moving target!), then you put in the IV in the OR. I would think prepping and set up would be similar between the two. Even as a pediatric facility we do get adult sized patients.

Once you are OR trained you are in the minority of nursing. Nurses from other units cannot float to

the OR for obvious reasons. You are a specialty within a specialty and therefore can expect the compensation that goes along with that.

Schedule- our nurses work either 8,10, or 12 hr shifts.

I do feel fulfilled professionally. I won't lie to you, the OR is a stressful place. Especially a pediatric one. We see kids go thru things that they should never have to deal with. You will probably go home and cry your eyes out at times. But we also see how amazing and resilient kids are. I've watched a child recover from a brain tumor resection when no one thought they could. It's days like that that make all the stress and tears worth it.

ctsurgeryscrubrn · Aug 12, 2018

Hi! I'm not an RN but a CST, so not sure how much help I am. But I recently started in peds after adult OR and I like it way more! The main differences for me is that there is much more time with the patient in the OR. It takes anesthesia much more time to do what they need to do once the patient is in the room. Turnover and start time doesn't feel as rushed as in adults. The patients are obviously smaller so that makes positioning, prepping easier... and for me instruments being smaller is easier to handle. The rooms can get hot. Today I had to change my shirt because I was wearing lead in an 85 degree room while scrubbed and it was pretty gross. Obviously it's not as bad when not wearing lead and scrubbed, but if the case has you running or if you have some hormonal changes happening, it's something to be aware of. I would think the transition from adult to pets and vice versa would not be massive. The equipment and instruments are still the same, the frequent cases may be a little different (on call adults=lap chole, peds=lap appy...etc). Hope that helps a bit and best of luck.

I did a few weeks in the Peds CT OR as a scrub RN and I would have to agree with this. The peds OR has a different vibe, for sure. All patients are equal, but kids having their chests cracked open automatically creates a different tone to the room. I've experienced a number of codes in both Peds and Adult CVOR and the Peds ones are always so much more chaotic. You never want to 'call' anybody on the table, but that takes on different meaning with a child. I can remember a couple cases (both elective, unfortunately) where the team did over an hour of open cardiac massage (futile, after 15 min), but I think it was the only thing that enabled that surgeon to go talk to the family. One image will be burned in my heart forever - walking by the lounge and seeing the child's poor mother crying her eyes out on the floor.

The temperature issue is another thing for-sure! We did some 12-14 hour re-do cases (ToFs, and Norwood's). Norwood's were the worst - just such a complex operation where things go wrong fast even with the most talented surgical team. I remember during some of those, I was literally soaking and in one, I specifically remember scrubbing out to change my scrubs and get a new cap. But, seeing those children after makes it all worth it.