Starting PEDS rotation - nervous/ need advice

NurseFirst · May 3, 2005

Thanks to all of you for the great advice. Turns out this was supposed to be my first day on PEDS but the beds are almost all empty. So maybe tomorrow I might get a patient. Wish me luck!
Angie

I am 55, have never had children, was the youngest in my family, hadn't been around children. When my instructor asked who didn't want to have an infant the first week, I was the only one in my class to raise their hand!

Before peds rotation (in winter), I went on a kids' movie binge: I saw The Incredibles and Lemony Snickett. Harry Potter is probably good, too--but I definitely like the idea of seeing current kids movies--cuz that's what they have in their minds. I asked the kids I took care of what character they liked most, what they liked about the character, etc.

Definitely concur with getting on eye-level with the child--it was the thing that I saw least done by other HCP's, and I found it made a big difference--not only for the child, but for me too; I can't imagine doing it any other way. One 15 mo old would scream if he saw the stethoscope--so I would distract him and sneak it under his gown--no problem. A nine year old was also resistant, but then I asked her if she'd ever heard her own heart. She said no (and this was a child who had already been in the hospital for 2 weeks, and previous hospitalizations)--I asked her if she'd like to--and she was definitely in favor of that! I don't know that it's specifically "have you ever seen the inside of" that's needed (but I sure like that as a general idea) but more if they can get to experience something new (that's not unpleasant, of course.)

The 9 year old ended up having abdominal surgery for bowel obstruction--and the docs put lots of stickers along the bandage over the incision. Lots of kids love those stickers--you may want to get some and put them in your pocket. Also--praise them! Tell 'em their the "best" (whatever, patient you've had -- most cooperative; most brave, etc.) I always try to think of things that will make hospitalizations positively memorable--if there's something I can say that years from now the parents will tell their kids "Remember how that nurse said such and such?" (Something positive, obviously!).

Choices are almost always good, unless it's "Do you want to _______ now?" that pertains to even innocuous-seeming medical procedures. In that case, give them the choice of alternatives--"Do you want to take your bath before or after breakfast." (The "presupposition" is that they want to --or will--take a bath. This is a very effective technique, one that I learned in hypnosis training!)

Yes, definitely know the Erikson stages--most peds books should have descriptions of the different stages. Also know that kids who have experience with hospitalizations due to disability or chronic illness will be somewhat delayed in achieving resolution of the "crisis" they face at that stage. It may be helpful to push them a bit--for instance, I had a 17 year old who told me her Mom comes in to bathe her (who didn't show up)--I told her that she could do her bath--and, basically, that I expected her to do it (nicely). She acquiesed fairly easily.

Good luck--and have fun! Our instructor told us that "play is the work of kids" and that they have to be awfully sick not to want to play. She even told me she wanted to see me in there playing with my patient!

NurseFirst