PedsED-RN

Esme, I figured you would post this =) I need to actually remember where I post to be able to copy from previous. =) great info there!

If you can, take ENPC, that is a helpful class. Will help narrow down the things you should watch for, true emergencies. Our #1 CC is fever, so for 85-90% of our fever patients, that is something that could have gone to their PCP. Try not to let the...

Our Procedural Sedation policy is very specific. Defines Anxiolysis/Moderate/Deep sedation differences, including required monitoring, and gets into each drug, and the specific routes/doses that constitute each level of sedation. For example, nasal v...

This is exactly it for many of the kids we see with it!

I know for our Transport team (peds hospital), they are all trained in IO, intubation, etc. I know they maintain tubing skills in the OR each year to keep current, not sure about the rest though?

Good point! We have many RNs that started with us as Student Interns, loved our department, applied, and are RNs with us. Home-Grown! =) it can definitely be a good In!

In a Peds ER, this kind of thing is our bread-&-butter. Also love any complaint that has since stopped before bringing them in: baby wouldn't stop crying (as the baby looks up and smiles at me), nose bleed, headache, anxiety attacks in pre-teen ...

US for trauma, looking for free fluid in abd help identify internal organ damage, as either something is bleeding (and how much based on amt of fluid), or perfed bowel leaking bowel contents into the peritoneum, etc. Gives an idea before something mo...

Agreed. If you are already a proactive personality willing to take initiative, you will be fine. Get the feel for the flow and pace in your ED, and jump in with what you can, that you are safely able to do. ED is a different beast than inpatient, but...

"Her nose was bleeding yesterday, but it stopped. We just wanted to get her checked today". Smh.....

Peds ER, staff often wear something, but are pretty conscious of it being something easy to remove if in the way of a critical situation. The vast majority of our kids are fine, and live the costumes. Definitely some settings where it would not be ap...

Agreed =) I more often say the same as you, but sometimes ask what is the emergency more because they usually seem to stop for a second to realize "oh, yeah, this isn't an emergency". Probably comes out more when I am to the point of being "over" a...

When I start with "what is your emergency this morning" and the reply begins something like "oh, it's not really an emergency....." Smh I know you are scared about whatever brings your child to me today, but that doesn't require your entire extended ...

When we have to fill a bladder for pelvic US we actually fill while in US, and the tech lets us know when it's full enough. Looks pretty cool on US, can see the fluid swirling like confetti. Works for eliminating guess work. One of my least favorite ...

We see it regularly in our ER (Peds only). Sometimes it seems like the diagnosis for "I have no idea why your kid keeps vomiting every week/month/fill-in-the-blank, since every test under the sun has come back normal". At least 1/2 the time it seems...

For initial overall assessment, pay attention to what the kid is doing in the waiting room before you call their name. Young kiddos may be playing around, jumping off the furniture, but once they are in a room are ****** and want to leave, so will be...

The most recent nurse actually did communicate with CDC before flying when she realized she had a low grade fever, but since it was under their threshold of 100.4, they gave her the green light......

seriously, why would we not take a page from the procedures of those who have been fighting this already for years, and have a track record like that?! We know common sense isn't always the strong suit of our higher-ups. Even so, I read somewhere t...

I always hate when parent say "No, I didn't want to give anything so you could see (how high the fever is, how much pain,etc). I make sure to say next time, definitely help them feel more comfortable, we will take your word for it! a week or so ago w...

We do this sometimes too, in a pediatric ED. Usually if lower pelvic abd pain, they are NPO and want to r/o torsion, which would be surgical, and a smaller deal window for getting the to OR. Not sure if torsion is more common in pre-teen/teen girls a...

My first job was and adult med/surf ortho/neuro unit, while waitin for an open position at our Children's hospital. First open position was in the ED so I figure I would give it a shot. Almost 7 yrs later, can't imagine working anywhere else, I love ...

Wow, and already triaging when new to the facility? We haves bit of a process to go through before being triage "certified", usually 6-12 mos after hire, have to have ENPC an take a hospital triage class granted, I'm in a pediatric hospital. Definite...

"She mentioned meeting her study group to celebrate passing their first Theory exam. Think it will be that big of a deal for each exam?"

In my ED we have numerous male RNs, as well as many throughout our less hospital and on our Transport team. No one thinks it is at all odd, they do an awesome job with kids and are great at helping ease kids' anxiety often. I say go for it! It's rewa...

Sit down with your kids, and talk to them on their level. We tower over them when we are standing, and are scary or intimidating. =) make anything you can a game or competition, that is often helpful. Like already mentioned, explain things to them, s...