The fun side of peds

elkpark · Apr 4, 2005

I don't want to burst your bubble, and I'm glad you're enthusiastic about pursuing your interest in child psych, but how did you decide that this is the "fun side of peds"? I've been a child psych CS for ~10 years, and a child psych staff nurse before that, and, yes, it is v. rewarding and often fun, but it is also v. emotionally draining and painful at times.

You will be working with kids who are seriously mentally ill, who have been seriously physically and sexually abused, who are aggressive and violent (and don't be fooled by their small size! :chuckle ), who are seriously suicidal and impulsive -- if you had anything like a "normal" childhood yourself, you will see and hear things it will be hard to believe.

In general, don't plan on bringing things into the unit for the kids unless they have been cleared as being in accord with the unit policies -- for instance, on most every child psych unit I've ever encountered, pens are considered "sharps" and are controlled. I'm hoping that the pens you talk about are for you to write with, and not for you to give to the kids to play with. If you let the kids have them, they will get broken or disappear (and may be used by a child to self-injure). The unit should already have plenty of appropriate games and toys for the kids and staff to use, and additions to that supply should be made as a group decision by staff, not someone just bringing something in one day. Although each of us is an individual and has a personal style, it is very important that the staff be consistent and work together on things, and not have different staff members "doing their own thing."

Nowadays more than ever, kids don't get admitted to an inpt. psych unit unless they have v. serious problems. The best advise I can give you is to be v. consistent about following unit policies/procedures and take your lead from the other, more experienced staff nurses (I hope you will be getting a lot of orientation). Remember that you are there to have a therapeutic relationship with the kids, not to be their "friend". Much of the job consists of setting limits and telling kids things they don't want to hear (or helping them hear things they don't want to hear ...) -- staff members who want to be every child's "buddy" and be the most popular staff member with the kids create more problems on a unit than they help fix.

Just as most nurses don't want to work psych, most psych nurses don't want to work child psych (the same is true of psychiatrists, social workers and psychologists -- most of them don't want to work with kids). Most people find it much more demanding and draining than working with adults. However, it can also be much more rewarding than working with adults (as I've told students for years when talking about child psych vs. adult psych, "the highs are higher, and the lows are lower"). Those of us that love it, really love it. If you were looking for a challenge, you have come to the right place! I hope that your new position will be a satisfying one for you. Best wishes --

Gompers, BSN, RN · Apr 4, 2005

I was gonna say, of all areas of pediatrics, that child psych is probably the LEAST fun side of peds!!! Those kids are there for a reason.

They do have play rooms and things like that, but usually everything is provided and you shouldn't have to bring anything in. From what I remember about child psych, playtime is often part of their therapy. You'll have an extensive orientation, I'm guessing, that will really help with this kind of stuff. In the meantime, I'd definitely avoid buying any white scrubs or jackets. Most psych units I've seen, nurses wear street clothes anyways. Agree about the pens and stuff.

The best way to get through to kids, honestly, is to get down to their eye-level and be sincere when you speak with them. Kids are so intuitive, and I think kids which psychological problems are even moreso.

Good luck with your new job! Don't worry, as long as your heart is in this, everything is going to come together.

Honu0612 · Apr 4, 2005

Elkpark -

"...if you had anything like a "normal" childhood yourself, you will see and hear things it will be hard to believe."

"I'm hoping that the pens you talk about are for you to write with, and not for you to give to the kids to play with. If you let the kids have them, they will get broken or disappear (and may be used by a child to self-injure)."

"Remember that you are there to have a therapeutic relationship with the kids, not to be their "friend"."

I'm sorry I asked, thanks for the criticism, I knew after I typed it that would be the main response I would get. You know nothing about me, as I know and presume to know nothing about you. I know what I'm getting into, as I have worked with kids at a crisis nursery and through DFS. I was not looking for the advice you gave, but I suppose it is your right to give it. I'll be more careful from now on as to what I ask for on this forum. Of course I would not bring things to the unit that I did not know ahead of time were okay, what am I a clown with a bag full of tricks? I also would not give the children the pens I was talking about. They were strickly for fun. Every unit needs more fresh ideas and at times becomes stale, that's truly all I was asking. Instead you went on and on like I'm an idiot, I'm so sorry you are so skeptical and paranoid of people. Chill out a little and don't jump to so many conclusions about people and things you know nothing about. I've never seen so many assumptions made with nothing to back it up. I suppose if I was fresh out of school you'd tell me I was crazy and didn't know what I was getting into and should go to med-surg. Well, that's not why I became a nurse, but it was to work with kids in the field of mental health, and I'm greatly looking forward to it.

Well, now I'm going on and on, I just hope you don't treat your patients the same way. You definitely would not give them the benefit of the doubt and would tear them up instead of healing them.

Maybe I just don't belong here, I'll wait it out and assume most here are not like you.

*PICURN* · Apr 5, 2005

Elkpark -
"...if you had anything like a "normal" childhood yourself, you will see and hear things it will be hard to believe."

"I'm hoping that the pens you talk about are for you to write with, and not for you to give to the kids to play with. If you let the kids have them, they will get broken or disappear (and may be used by a child to self-injure)."
"Remember that you are there to have a therapeutic relationship with the kids, not to be their "friend"."
I'm sorry I asked, thanks for the criticism, I knew after I typed it that would be the main response I would get. You know nothing about me, as I know and presume to know nothing about you. I know what I'm getting into, as I have worked with kids at a crisis nursery and through DFS. I was not looking for the advice you gave, but I suppose it is your right to give it. I'll be more careful from now on as to what I ask for on this forum. Of course I would not bring things to the unit that I did not know ahead of time were okay, what am I a clown with a bag full of tricks? I also would not give the children the pens I was talking about. They were strickly for fun. Every unit needs more fresh ideas and at times becomes stale, that's truly all I was asking. Instead you went on and on like I'm an idiot, I'm so sorry you are so skeptical and paranoid of people. Chill out a little and don't jump to so many conclusions about people and things you know nothing about. I've never seen so many assumptions made with nothing to back it up. I suppose if I was fresh out of school you'd tell me I was crazy and didn't know what I was getting into and should go to med-surg. Well, that's not why I became a nurse, but it was to work with kids in the field of mental health, and I'm greatly looking forward to it.
Well, now I'm going on and on, I just hope you don't treat your patients the same way. You definitely would not give them the benefit of the doubt and would tear them up instead of healing them.
Maybe I just don't belong here, I'll wait it out and assume most here are not like you.

hmmmm....well from what you included in your original post, I would have thought the EXACT same thing that elkpark thought. It sounded to me like you had no background in child psych by the way you worded your post. It came off to ME like you were in it to sit around and play with the kids all day (which is what 95% of your original post is about) WHICH IS NOT totally impossible for someone to think. I know a lot of people who went into peds thinking you could sit around and play all day.....I think elkpark did a decent job of being respectful towards your post (unlike your response) while trying to offer advice.

Instead you went on and on like I'm an idiot, I'm so sorry you are so skeptical and paranoid of people.

I didn't sense any paranoia or skepticism in elk's post.....but hey your the psych nurse.

I just hope you don't treat your patients the same way. You definitely would not give them the benefit of the doubt and would tear them up instead of healing them.

I hope you act more professional and more mature with your new job

Honu0612 · Apr 5, 2005

I suppose this is a battle I will never win, since most people (according to you) will read into my original post and assume things about me that are not true and take this thread to a whole new level of their own personal understanding, so...so be it. I have heard enough and said enough and maybe I'm too sensitive, but darn do you all really know how to make someone feel welcome! (That was sarcasm for all you serious fuddy-duddies.) Maybe I'll come around again sometime, but for now I don't wish to hear your replies and that is my choice.

ER1010 · Apr 15, 2005

Honu,

I think they misunderstood you. Don't take it personally, this is just a forum. You wouldn't judge a whole group of people by one person in real life, so don't leave these forums just because another poster didn't "get" what you were talking about.

jeepgirl, LPN, NP · Apr 16, 2005

I don't want to burst your bubble, and I'm glad you're enthusiastic about pursuing your interest in child psych, but how did you decide that this is the "fun side of peds"? I've been a child psych CS for ~10 years, and a child psych staff nurse before that, and, yes, it is v. rewarding and often fun, but it is also v. emotionally draining and painful at times.
You will be working with kids who are seriously mentally ill, who have been seriously physically and sexually abused, who are aggressive and violent (and don't be fooled by their small size! :chuckle ), who are seriously suicidal and impulsive -- if you had anything like a "normal" childhood yourself, you will see and hear things it will be hard to believe.
In general, don't plan on bringing things into the unit for the kids unless they have been cleared as being in accord with the unit policies -- for instance, on most every child psych unit I've ever encountered, pens are considered "sharps" and are controlled. I'm hoping that the pens you talk about are for you to write with, and not for you to give to the kids to play with. If you let the kids have them, they will get broken or disappear (and may be used by a child to self-injure). The unit should already have plenty of appropriate games and toys for the kids and staff to use, and additions to that supply should be made as a group decision by staff, not someone just bringing something in one day. Although each of us is an individual and has a personal style, it is very important that the staff be consistent and work together on things, and not have different staff members "doing their own thing."
Nowadays more than ever, kids don't get admitted to an inpt. psych unit unless they have v. serious problems. The best advise I can give you is to be v. consistent about following unit policies/procedures and take your lead from the other, more experienced staff nurses (I hope you will be getting a lot of orientation). Remember that you are there to have a therapeutic relationship with the kids, not to be their "friend". Much of the job consists of setting limits and telling kids things they don't want to hear (or helping them hear things they don't want to hear ...) -- staff members who want to be every child's "buddy" and be the most popular staff member with the kids create more problems on a unit than they help fix.
Just as most nurses don't want to work psych, most psych nurses don't want to work child psych (the same is true of psychiatrists, social workers and psychologists -- most of them don't want to work with kids). Most people find it much more demanding and draining than working with adults. However, it can also be much more rewarding than working with adults (as I've told students for years when talking about child psych vs. adult psych, "the highs are higher, and the lows are lower"). Those of us that love it, really love it. If you were looking for a challenge, you have come to the right place! I hope that your new position will be a satisfying one for you. Best wishes --

I had the exact same thoughts as you. I felt that you gave good advice. Not to be hateful... but I think that this new job will probably be a reality check for the OP.

BeachNurse · Apr 18, 2005

I also agree with elkpark. I have worked several sides of Peds and only did a peds psych rotation in nursing school. It actually made me feel crazy and I got a stress headache every single shift. I found it depressing, draining, and unrewarding. It was the only area of nursing I have encountered where I felt helpless to make a difference to my patient.

To each their own, and I hope the OP enjoys peds psych.

mydesygn · Apr 19, 2005

Hello everyone!
I'm new to the group and will be starting a new job in a couple of weeks in peds psych. I'm brushing up my skills and knowledge with my psych textbook from school and a book from the library on psych meds for child and adolescent so I'll have a little info going in, but wanted to know more about the fun side of working in peds. I'll be in an inpatient area for 4-12 year olds and I know some play time and enjoyment is to be had there. I actually bought some fun pens that light up and with animals on them, then I already have some kid oriented scrubs. What other ideas do you all have? From the simple to the extravagant, I want to hear how you interact and break through barriers with kids. I know the place is decorated with a sea theme, so that is fun, maybe I can think of something else with that in mind, they even have a giant sandbox outside. Anyway, thanks for the ideas, have a great Monday everyone!

I've been in peds for a while not in psych but every other area. When I have time, I have found the most interesting things thru talking with the kiddos. I try to sit on the bed with them and color or play or watch a movie. I usually ask about their family, favorite school subjects, etc.. bearing in mind that the child views me as a stranger so I maintain a comfortable distance. I have brought video tapes and other items based on info they have given me. You could plan movie night with popcorn. We usually have tons of toys so I never invested much in those. With the older kids, we would bring them to nurses station and play cards or UNO with them. Making sundaes and various craft projects are good. Actually, the craft projects usually are what is in short supply. the kids need something to use up energy and hours. The older kids might want to do a scrapbook of their hospital stay, if you can provide scrapbooking materials and a polaroid camera. The disposables are ok but you have to get them developed -- instant pics are always nice. However, the obvious considerations of what cannot be used (i.e. knitting needles) are to be considered but I am not sure of the restrictions in psych. Try visiting a craft store and see what is safe and appropiate. The youger kids I would sit with and color. Light up toys and pens, I have found work better with toddlers and infants. I use them primarily for distraction since the kiddos will lose interest in them quickly. What would work better is something that is more active for the child like a musical piano or guitar toy. Personally, the best playtime I have had has always been unplanned. I found if I think something is interesting usually that specific child does not. What you might do is call the child life department at one of the dedicated pediatric hospitals. There may be someone open to talking with you. I'm not sure if your child psych is part of a hospital facility or is not affilated with a medical hospital. However, I beleive with the limitations and boundaries with psych, so much of what you can do and when you can do it is really limited. I have a feeling you may be stuck with the same "stale" offerings cause you can't go to far out of bounds.

Secondly, don't get offended by others ideas regardless of whether they misunderstood you or not. I appreciate every comment regardless of whether I feel it is misdirected or not. It's a courtesy to say thank you, not belittle those who took the time to answer your post because you don't like the answers. Actually, after reading the posts, I thought it was good advice if it didn't seem to be what you were looking for.

RainDreamer, BSN, RN · Apr 19, 2005

When I read the Honu's original post I didn't see where they said they thought "child psych nursing is the fun side of peds". They just said they wanted to know more about the fun side of peds, not necessarily that child psych IS the fun part of peds.