Peds is NOT easy!

[Double-Helix]

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.

[audreysmagic, RN]

Let's not forget having to deal with child abuse cases or shaken babies. I would get so depressed. Pedi nurses must be tough as old leather.

One of my first homecare cases was a formerly shaken badly...school-aged at the time in body, but still a three month old developmentally. She would scream for HOURS due to her brain damage, and all I could do at the time was offer as much comfort as possible, but it wasn't enough to get her to stop until she wore herself out and fell asleep. I love peds nursing, but...definitely agreed, it's not easy! And dealing with the parents is ALWAYS an adventure. There are some awesome ones, and others you just have to find ways to deal with.

I also find a lot of people who want to go into peds assume that because you're an adult, the little ones will do as you say...NOT TRUE. In fact, some of the worst issues I've had with co-workers (whether floats from another discipline or simply someone who shouldn't have gone into peds) were power struggles with them trying to enforce their will on the child. Some things, of course, related to safety, are non-negotiable, but much of pediatrics is the art of compromise.

I still love the little buggers, though...at least most of the time, even in peds psych. :) I always say to people who ask me why I have no desire to work with adults, "If you're whining, it had better be developmentally appropriate!"