really vague pediatric nursing questions

Pediatric Critical Care Columnist · Nov 18, 2008

1) What are some really positive components of your job?

Children are very forgiving. They might be hard to get a long with at the beginning of the shift, but by the end they've decided you're best friends. They're much easier to distract than adults. Of course, they're smaller. They typically don't have lifestyle-related illnesses like coronary artery disease or type 2 diabetes for which they refuse to comply with treatment, like many adults do. They have such great compensatory mechanisms that they don't really look "sick" until they're REALLY sick, but usually once they start getting better, they're rock stars. They don't adopt the "sick role" like so many grown-ups do; they just want to feel good enough to play Nintendo.

2) What are some really negative components of your job?

There's a significant disrespect for children's health needs as compared to adults' and neonates'. When a children's hospital is within an adult facility, the staff of the children's hospital often have to make do with adult-sized equipment and supplies, kids take a back seat to adult patients' needs no matter how sick the child is, and they maybe receive substandard care because the staff is not adequately trained in pediatric care. It's sometimes difficult to develop a working relationship with the child's parents due to unrealistic expectations on either side. And it's never easy to watch a child die.

3) In what ways is being a pediatric nurse more appealing/rewarding than being a different kind of nurse?

Kids are very resilient and overcome almost insurmountable odds. They come back to visit and are visible proof that what we do matters. To know that I've been part of a child's recovery from a near-death experience and to see them grow up and thrive is a gift. Kids can be just as ornery as grown-ups, but they don't stay mad for long and they don't hold grudges. They are much more appreciative than many adults for even the smallest kindness. They haven't learned how to manipulate people and they often only need the simplest of explanations about what we're doing and why.

4) In what ways is it more frustrating/difficult than other types of nursing?

Non-accidental trauma is always a heart-wrenching experience for the nurse. Babies don't deserve to have their brains turned into scrambled eggs just because crying is the only way they can communicate. Toddlers don't deserve to be locked in a cold garage in just a diaper because they've wet their pants again. And then there are the unrestrained passenger head-on collision at highway speed ejected school-aged kids and the slightly older ATV riding severe head traumas... preventable injuries always make me angry.

5) Why did you choose to become a pediatric nurse?

I'm the parent of a medically-complex young person who spent a large aprt of childhood in hospitals. I wanted to give back.

6) What are some characteristics or qualities of what you would consider to be a good pediatric nurse?

Patience. Patience. Patience. High threshold for frustration. Highly-developed assessment skills. Calm approach to every situation. Excellent understanding of growth and development. Sense of humour.

7) What kind of people should not go into pediatric nursing?

People with no patience!! Those easy to anger and those who get into a tizzy about everything big or small. Those who don't know how to talk to children and don't want to learn. Those who can't imagine discussing the merits of SpongeBob or Dora or who would never be seen sitting on the floor. Those who don't like to have spit-up on their shoulder for 12 hours.

T123G123 · Nov 18, 2008

1) What are some really positive components of your job?
Children are very forgiving. They might be hard to get a long with at the beginning of the shift, but by the end they've decided you're best friends. They're much easier to distract than adults. Of course, they're smaller. They typically don't have lifestyle-related illnesses like coronary artery disease or type 2 diabetes for which they refuse to comply with treatment, like many adults do. They have such great compensatory mechanisms that they don't really look "sick" until they're REALLY sick, but usually once they start getting better, they're rock stars. They don't adopt the "sick role" like so many grown-ups do; they just want to feel good enough to play Nintendo.
2) What are some really negative components of your job?
There's a significant disrespect for children's health needs as compared to adults' and neonates'. When a children's hospital is within an adult facility, the staff of the children's hospital often have to make do with adult-sized equipment and supplies, kids take a back seat to adult patients' needs no matter how sick the child is, and they maybe receive substandard care because the staff is not adequately trained in pediatric care. It's sometimes difficult to develop a working relationship with the child's parents due to unrealistic expectations on either side. And it's never easy to watch a child die.
3) In what ways is being a pediatric nurse more appealing/rewarding than being a different kind of nurse?
Kids are very resilient and overcome almost insurmountable odds. They come back to visit and are visible proof that what we do matters. To know that I've been part of a child's recovery from a near-death experience and to see them grow up and thrive is a gift. Kids can be just as ornery as grown-ups, but they don't stay mad for long and they don't hold grudges. They are much more appreciative than many adults for even the smallest kindness. They haven't learned how to manipulate people and they often only need the simplest of explanations about what we're doing and why.
4) In what ways is it more frustrating/difficult than other types of nursing?
Non-accidental trauma is always a heart-wrenching experience for the nurse. Babies don't deserve to have their brains turned into scrambled eggs just because crying is the only way they can communicate. Toddlers don't deserve to be locked in a cold garage in just a diaper because they've wet their pants again. And then there are the unrestrained passenger head-on collision at highway speed ejected school-aged kids and the slightly older ATV riding severe head traumas... preventable injuries always make me angry.
5) Why did you choose to become a pediatric nurse?
I'm the parent of a medically-complex young person who spent a large aprt of childhood in hospitals. I wanted to give back.
6) What are some characteristics or qualities of what you would consider to be a good pediatric nurse?
Patience. Patience. Patience. High threshold for frustration. Highly-developed assessment skills. Calm approach to every situation. Excellent understanding of growth and development. Sense of humour.
7) What kind of people should not go into pediatric nursing?
People with no patience!! Those easy to anger and those who get into a tizzy about everything big or small. Those who don't know how to talk to children and don't want to learn. Those who can't imagine discussing the merits of SpongeBob or Dora or who would never be seen sitting on the floor. Those who don't like to have spit-up on their shoulder for 12 hours.

Thanks for a really detailed response! I'm a teacher and though I don't think that dealing with kids in a classroom setting is what I want to do with my life forever I do like working with them so I'm considering becoming a nurse and am looking into pediatric nursing as one of the fields to check out.

T123G123

Pediatric Critical Care Columnist · Nov 18, 2008

Knowing how to interact with kids is a huge step up. And so much of peds nursing is teaching... teaching parents about their child's illness, teaching them how to manage their child's health care after discharge, that you'd be a shoe-in!!

T123G123 · Nov 19, 2008

Thanks, Janfrn.

When I volunteered in Children's ER I remember seeing this little guy who I would see every time, he was getting some kind of treatment that involved a lot of injections. I didn't see much since they usually kept the curtains closed but I would hear him screaming like crazy each time. Out of curiousity, what are some things that are done to help a kid calm down? Also, how do you do it that you don't accidentally hurt him with the needle while s/he's struggling?

Thanks.

T123G123

kessadawn, BSN, RN · Dec 26, 2008

thanks, janfrn.
when i volunteered in children's er i remember seeing this little guy who i would see every time, he was getting some kind of treatment that involved a lot of injections. i didn't see much since they usually kept the curtains closed but i would hear him screaming like crazy each time. out of curiousity, what are some things that are done to help a kid calm down? also, how do you do it that you don't accidentally hurt him with the needle while s/he's struggling?
thanks.
t123g123

the more help you have, the better. sometimes you can papoose a small child with a blanket, leaving free the extremity your going use for the injection or iv start. occasionally you can talk an older kid down, but when they get to a certain level of anxiety, you just have to do it fast and get it over with.

kessadawn, BSN, RN · Dec 26, 2008

hi everyone,
for those who are pediatric nurses, some really general questions i'm curious to hear you share your thoughts and experience:
1) what are some really positive components of your job?close relationships with an amazing group of educated women, watching that kid who hung a death's door for so long walk out of the hospital and go back to a normal life, letting a mommy hold her baby for the first time since birth, and he is now 3 weeks old, learning something new and completely unexpected every new shift i work

2) what are some really negative components of your job?death. especially a death that could have been prevented, like and abuse case or trauma. slowly watching the only spark of hope a parent has left fade as the child's picu stay just goes on and on, working your butt off doing somersaults to bring them back, but they still die

3) in what ways is being a pediatric nurse more appealing/rewarding than being a different kind of nurse?i love the innocence of the pediatric population, the 5 year old that holds so still and watches with fascination when you start her iv, knowing that what you are doing today can possibly make a difference 20 years down the road when you patient becomes the important person they are meant to be, and lastly, kids whine much less than adults, that's for sure

4) in what ways is it more frustrating/difficult than other types of nursing?nothing is cut and dry with peds. doc wants a dose of lasix? okay, let me weigh the patient and do some algebra, don't have standard dosing of meds like adults do. kids with chronic conditions may not always have supportive families, and you can't just teach a 5 year old how to manage their diabetes and send them on their way. nothing makes me madder than stupid parents...not uneducated and needing teaching, i mean plain stupid, uncaring and undeserving parents. you can take bets on when the kid will be readmitted for mismanagement at home.

5) why did you choose to become a pediatric nurse?my youngest daughter was a picu frequent flier due to a chroninc medical condition, and i remember just watching her nurses and thinking, i want to be like them!

6) what are some characteristics or qualities of what you would consider to be a good pediatric nurse?patience, flexibility, an ongoing desire to learn, good communication skills (for both staff and families) and foremost, compassion and empathy.

7) what kind of people should not go into pediatric nursing?if you don't like kids, have no patience, are easily irritated by the smallest things, can't communicate well, and can't compromise, find another specialty.

thanks!you are welcome, hope that helped!

TexasPediRN · Dec 26, 2008

jan: couldnt have said it better myself...!

ChristineN, BSN, RN · Dec 26, 2008

Hi everyone,
For those who are pediatric nurses, some really general questions I'm curious to hear you share your thoughts and experience:
1) What are some really positive components of your job?

Pro's would include working with kids, seeing unique disease processes (I enjoy that we sometimes see unusual genetic diseases and such that would be much more uncommon in adult world), smaller pt loads that adult world,

2) What are some really negative components of your job?

Less autonomy, at least at my hospital, for nurses than adult nurses have.

3) In what ways is being a pediatric nurse more appealing/rewarding than being a different kind of nurse?

Well obviously, if you want to work with kids, it's more appealing. I also find the family centered care seen in peds very appealing (ie including family in care). I wish that could be done more with adults.

4) In what ways is it more frustrating/difficult than other types of nursing?

It's frustrating because there is a much smaller number of sick kids than there are sick adults, so you often end up seeing pts over and over again, espcially if they have a chronic illness. If the family isn't being supportive, child's not being cared for at home, etc that can get frustrating, feeling like your just temporarily fixing the child, until he gets home.

5) Why did you choose to become a pediatric nurse?

Wasn't really sure what kind of a nurse I wanted to be. When I was in school I couldn't make up my mind. Then, I took a job on a medical peds floor as a PCT. I fell in love with the kids, and was hooked. :)

6) What are some characteristics or qualities of what you would consider to be a good pediatric nurse?

You need to have patience (because 3 year olds never want to do what you need them to do), be resourceful, and most of all, try to keep your bias from coming into your work (I see alot of drug/STD type things).

7) What kind of people should not go into pediatric nursing?
Thanks!
T123G123

Those just looking for a "job," anyone who thinks it'll be easier than adult world, because it's not easier, kids can turn on you fast! Good luck!

lpnstudentin2010, LPN · Dec 31, 2008

I can not answer all your questions...I am not a nurse, however I have been a patient at a peds hospital since I was 3 and still am and here is my take on the nurses there:

They care so much. They take time to talk to you about what you like, dislike, what is going on in your life. They will talk to the child about what is important to the child, or something that the kid wants to. I was once told by my nurse that her mom had caught the tooth fairy and she went on to describe what she "looked" like. I do not remember the tooth fairy nurse, I do not remember most of my nurses, there are a couple who stick out.

Once when I was getting ready to get braces and I had a surgery. My nurse talked about what they were like, she needed to leave to go care for a patient, and then CAME BACK to finish our conversation. That meant alot to me.

Another time I needed blood drawn and I was not letting the phlebotomist anywhere near me. My nurse told me "oh, I needed blood taken yesterday and he is amazing so I asked him, I did not even feel it" and nervously I let him do it.

So from these stories you can see, if you are caring you can be a good peds nurse

Smiler3 · Jan 17, 2009

Hey I'm a PICU nurse in England...my answeres to your questions are:

1) What are some really positive components of your job? The work we do to save lives of children, being around children. Children even when sick are still able to smile and crack jokes, they take illness is their stride and have a positive outlook.

2) What are some really negative components of your job? Always sad when a child dies, child abuse and non accidental injuries, children don't always understand why or what you are doing and can be difficult to explain.

3) In what ways is being a pediatric nurse more appealing/rewarding than being a different kind of nurse? Children always find a way to stay positive, I find the childrens hosital I work in is a happy place than a general hospital.

4) In what ways is it more frustrating/difficult than other types of nursing?

5) Why did you choose to become a pediatric nurse? I had always wanted to be a nurse from a young age, and I chose to go into paeds because I was a patient on a childrens ward and a patient on an adult ward and the difference in nursing care and attitude I received made me want to be a childrens nurse. I found them more caring, had more time for their patients and had lots of smiles for their patients!

6) What are some characteristics or qualities of what you would consider to be a good pediatric nurse? Patient, understanding, caring, able to look past the illness and see the child and remain positive and happy with the children.

7) What kind of people should not go into pediatric nursing? People who don't like children.

I know there isn't much here but just a few pointers.

Hope it helps.

Lisa x

ChrisLady · Jan 17, 2009

Thanks for the post I also want to go into pediatrics if not maternity. {I love kids}