Kunzieo

I remember a lot of developmental stage questions- like a mom is concerned because her 3 year old has an imaginary friend, or a teenager asks if a shot will hurt so which answer is best to give him and stuff like that.

I just like kids better than most adults. I've always liked working with kids- I babysat, volunteered in the church nursery, etc from the time I was 12. While I was in school, I worked as a CNA on a tele/step-down unit. Every shift further cemented my desire to work with kids. Adults have chronic illnesses that are often self-induced, or at least exacerbated by habits. Adults are incredibly whiny and want to complain and make excuses about why they can't use their IS or walk to the bathroom. Adults malinger and demand narcotics. Adults refuse their meds for various and sundry reasons that have no basis in fact. Adults will put their call light on to complain about the beeping from the monitor, or to ask you to hand them a tissue from a box that was 3 inches from their call light. (Note, not all adults and not all the time. But enough that I just knew I don't have the temperament to work with them.) I can excuse all of those behaviors in kids, because they are kids and have the right to be whiny and petulant when in the hospital, and spit out meds because they taste horrible and cry because something hurts. I expect more from adults, but don't often get it. plus... kids are small. There is very little heavy lifting during turns or changes. And we have tiny cute equipment. And we get to motivate our patients by challenging them to a game of foosball or a race down the hallway on a plasma car. And stickers and bubbles help solve problems. And we get to listen to Disney soundtracks in our patients' rooms. Peds is awesome.

Ugh, I typed out a comment and now I don't see it- so sorry if this posts twice- I don't work at a standalone children's hospital. We have 3 such facilities within our metro area, so most children with chronic conditions have established care at one of those facilities, as they have WAY more peds specialists than we do. Our specialty is trauma, acute care, and med-surg. So although we do get chronic kids occasionally, it's more the exception than the rule in our PICU.

For toddlers- the sillier the better. "ok, I've got medicine here? Where do I put this? In the pillow? Nooooo! In your belly button? Nooooo. Should we give some to your bear? Yeah? Ok, num num num (fake feed it to bear) .. now your turn! (put in a few drops) Now Bear's turn!" For stressed out parents, I'm not a real touchy feely person. I deal in facts, and give them facts. Lot of parents freak out when the monitor dings, when it's usually just artifact. I look them straight in the eyes and tell them "that thing is going to ding and beep all night. If you jump up every time it does, you will give yourself a heart attack. Listen- I will tell you when it's time to worry. Right now, I'm not worried. I WILL tell you if there is something to worry about." I will offer to go over every line and cord and number and piece of equipment in the room, both so they realize I know what I'm talking about and that we are doing things, even when it looks like nothing is happening- and it gets them more comfortable with everything and they start to realize that not everything is panic-worthy! I don't work with many chronic kids, I work PICU/acute care. But I let them tirade a bit, then try to boil it down to the basic problem. What exactly would they like me to do (or not do.) Then we work from there. A lot of time these parents have a lot of frustrations built up, and get exasperated easily within a system that doesn't acknowledge them as an expert. Talk to the family- what are their expectations, and what can we do to accommodate them? Usually if you can get something to go the way they want, then they are more willing to allow other things that they refused at first.

I don't think you need to do anything other than apply. I've worked Peds for 5 years, we get transplants from the adult world all the time! The basics of nursing are still the same. The numbers are a little different, and we approach the patient a little differently, but I don't know that there's really a way to prep for it- just jump in and learn!

Hi, I work in a PICU, and we do have CNAs, but they have more of a desk position. They answer the phones and let people in and out (it's a secured unit) and do daily safety checklists, restock the galley and nurse servers and isolation carts, and sometimes serve as a second (or third) pair of hands during a linen change or bath. They don't do vitals, or give baths or help people to the bathroom. But the ratios in our PICU are pretty good, 1:1 or 1:2, so the nurse usually has time to do all of that, and most honestly prefer to do so, because the charting is so intensive so it's important to keep track of everything and know everything that's going on.

Hey parents, why did you even bring your kid to the hospital if you're going to refuse labs, an IV, urine spec, etc.? No we can't "just give him some Tylenol." Now, not only is he still sick, but he has also been exposed to every microorganism that was lurking around our ED today. Great work!

I do it every 3rd week! My hospital won't allow more than 40 hr/wk, even though our pay periods are 2 weeks. So, when it's my weekend, I do Thurs, Fri, Sat (week 1) and Sun, Mon, Ties. (Week 2.) I get 6-7 days off before AND after this stretch. I love it. Honestly, by day 3 you've really hit your stride. You know all the patients, their general plan of care, and the mood of the unit that week. You're a better nurse because of the great continuity of care you provide. You're a better charge because you KNOW what's going on and can predict how the next few days will go, barring some freak tragedy. It works if you can do it right. "Doing it right" for me means: for those 6 days, I ONLY work. I don't cook, I don't clean, I don't watch movies, I don't go out with friends, I don't even go out to dinner. I wake up, work, go home, unwind for 90 minutes, and go to bed. Full stop, end of story. And I hope I can continue to do it for years to come :)

We use both the J-tips (lidocaine injectors like Anon456 was talking about) and Synera patches (lidocaine/tetracaine medicated patches.) For almost the same reasons Anon described, I HATE the J-tips! They're loud, messy, can blow the vein or just make it disappear, and are pretty frightening to smaller kids. Adolescents like them, though. I LOVE my Synera patches. We slap 2 on each kid (in case we aren't having a lucky day.) the older kids like it because it's non-invasive and easy for them to understand. The parents of small kids like it because it makes them (the parents) feel better. Although it's quite important to explain to these parents that their 2 year old is going to cry, despite all the Synera in the world!

The last pre-employment physical I had to do included the questions- -are you on any medications -have you been treated by a physician for any medical reason in the last 1 year? -the clinic name/address/phone number to your pcp. What it did not include- a drug test. What would you do with those questions? The prospective employer seems to feel you DO need to inform them. For the record- I listed all my meds, medical conditions, and visual impairment. After verifying with my md that I did not have any restrictions or need any special accommodations, I was offered the job.

Getting complete sets of vitals on most of my kids without waking them (or if they do wake, it's not all the way, and they fall back asleep instantly.) Also drawing labs from a PIV or PICC without waking the kid... Or hooking up abx... Sticking my head in the door at least once an hour and not waking the parents! And I'm the baby whisperer of my unit. Got a kid 2y or under that won't sleep? Give me 15 min with them!

Peds/PICU- 1 charge for both. Total of 25 beds. Usually have 5-6 nurses (but really depends on census), 2 nursing assistants, 1 HUC. Charge differential is $1.50/hr.

We had a 14 month old boy choppered in to our PICU. Beautiful little guy, blonde hair, blue eyes, the longest eyelashes I've ever seen. Story was that he fell off a bed. No way. Skull xray looked like an egg that had been rapped on a countertop. Pupils fixed and dilated. So much inter cranial bleeding, that neurosurg basically signed off as soon as they saw what they were dealing with. Couldn't even donate organs, couldn't get his body temp up or maintain anything close to normal with his blood gases. Withdrew life support within 5 hours of arrival. Will never forget that little guy with those beautiful eyes, laying on the bed in our PICU, motionless, with his eyes wide open, but so far beyond seeing anything.

I don't know, from the way the OP describes it, it doesn't sound pushy at all. She works at a hospital affiliated with a religion, and prior to surgery, informs the patient/family that one of the services they offer is a group prayer at the time-out, directly pre-op. The patient/family is well within their rights to refuse, they just have to say "no, thanks" to the nurse. To me, this sounds no different than nurses offering any other adjunct services- heating pad or guided imagery for pain, an offer to speak with chaplain or social services. The nurse is just informing the patient of the options available at this particular hospital. Honestly, I'd be a little surprised if I were inpatient at a place call "The Sacred Heart of Mary Hospital" or whatever and there was NO mention of prayer or offer of religious comfort. I'm not Catholic, but I wouldn't be taken aback or offended by being offered these services while at a Catholic institution.