The hospital where I work part time has a children's hospital incorporated into it. I occasionally work in the PICU and other units there.
The children's hospital has a standard practice of not doing painful or scary procedures in the kids room, and not having the child's nurse preform scary or painful procedures. Instead he kids are taken to a procedure room, accompanied by a child life specialists and an outside staff member is brought in to do the scary and painful procedures. That outside staff member is nearly ALWAYS me when I am working. I get a call from the nursing supervisor to please go to peds and start an IV, get and ABG, drop an NG, start a central or art line or some other procedure.
I get that they want to keep the child's nurse and room as a safe and caring place for the kids. I get that they do not want the kids to fear their primary nurse. I get that sick kids need procedures preformed on them. I get the whole thing.
I just HATE always being the one who has to play the bad guy. Despite taking as many precautions as possible to prevent pain in children during procedures, occasionally what they need done hurts them, and even when it doesn't it's usually scary for them. The child life specialists do a great job with the kids during procedures, but still crying kids is very common.
I am a father, I love children, I love caring for pediatric patients when I get the be the primary RN. I hate when cute little kids start crying just at the sight of me. Makes me feel like I must be a truly evil person.
Last night I worked transport on that hospital. When some of the other transport nurses and I went down to the cafeteria to grab some dinner there were a bunch of kids from the pediatric floor accompanied by a child life specialists there getting ice-cream sundaes. As soon as I walked in two or three of the little kids started crying as the sight of me.
I'm going to agree this is a bit excessive. I'm all for minimizing trauma. And if there's something bad to do and I can do it right before I leave so the kid hates me instead of the nurse that will have him for 12 hours after the procedure, I'll do it. And treatment room for some things is good. But in general, we tend to use treatment room more for the parents than the kids. You do it, they get mad, they move on.
I think the whole keeping the room a safe place is a nice theory, I used to buy it. And in the occasional kid may be called for. But in general, it's really unnecessary.
But I get the bad guy thing. Our phlebotomists are soooo cranky. But I try to be forgiving of it because I figure if my job consisted solely of walking into rooms and making kids cry, I'd be cranky too.
Ask for a break. I get that you feel responsible because you're the most qualified, but you got that way by doing it back before you were qualified. Others can get there too if given the chance.
First off, it takes a tremendous amount of skill to be able to successfully start an IV, put down an NG tube....many other procedures on a child. Most hospitals that don't have dedicated peds units--a couple people hold them down, and the most "skilled" at IV starts attempts. That you are all mindful of making this less traumatic for a child is really a wonderful thing.
As difficult as it is, don't internalize this. In hindsight, and not in the heat of the moment I know of exactly no parents who would say "that mean old nurse who hurt you" as opposed to the fact that you did what needed to happen to save a kids life, to make them healthy. And in the whole scheme of things, if a kid is ill, they are perhaps feeling really lousy to begin with.
I am so glad that you do what you do. I look at it as thank goodness there's a skilled nurse who can do this. After my own child was poked and prodded by 3 different nurses, (and I was about to just do it myself) along came the calvary--no fuss, no muss, and bingo, line in.
Please know that you are asked I am sure because they know you get it right the first time. And from parents everywhere, we thank you from the bottom of our hearts.
Specializes in Clinical Research, Outpt Women's Health.
Maybe it is time for them to increase the skill set of the other night nurses. It is unfair to make you always the bad guy even though the attempt to minimize trauma for the kiddos is very laudable.
I remember this when I worked Pedi. The only resolution I have is that I knew I was doing something to help the child, whether the child knew it or not. I even had a kid apologize once he was a teenager! He had sickle cell and we had been thru a lot together.
Specializes in Oncology; medical specialty website.
I agree with llg. I worked on a peds unit, and as primary nurses we routinely started IVs, NGs and other scary/painful experiences. Guess what? The kids coped just fine. The docs did spinal taps in the kids' rooms, and the kiddos were able to sleep and play in their cribs/beds with no problems.
The peds nurses need to learn how to suck it up and handle all parts of their job, not just the fun, cuddling parts. It sounds to me like you're being taken advantage of in this very lopsided situation.
I'm kinda surprised that the kids aren't sedated for some of these procedures. I've never heard of a CVL or an art line being done on a little kid without sedation. Peripheral IVs and NGs, yet, but 12 and under we're usually sedating for CVL's.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I'm kinda surprised that the kids aren't sedated for some of these procedures. I've never heard of a CVL or an art line being done on a little kid without sedation. Peripheral IVs and NGs, yet, but 12 and under we're usually sedating for CVL's.
I am curious as to what gave you the idea that no sedation was being used?
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I agree with llg. I worked on a peds unit, and as primary nurses we routinely started IVs, NGs and other scary/painful experiences. Guess what? The kids coped just fine. The docs did spinal taps in the kids' rooms, and the kiddos were able to sleep and play in their cribs/beds with no problems.
The peds nurses need to learn how to suck it up and handle all parts of their job, not just the fun, cuddling parts. It sounds to me like you're being taken advantage of in this very lopsided situation.
The same was true where I worked at a PICU nurse. However I am only part time in this hospital and strait nights, and half of those shifts I am tucked away over in the hangar and not in the hospital proper. Maybe they aren't doing it right. I am not in any position to make changes.
OH... my. I feel for you (as best as I am able to in my limited Peds experiences).When I worked ED, I had similar experiences. Jabbing sharp instruments into their little limbs did not make me a candidate for the "Favorite Nurse" award.Hugs to you.
I agree this policy is extremely excessive. ALL kids have to go to the treatment room for invasive procedures and have a "safe" person come do the procedure? What about a 12 yr old who's been on chemotherapy for 2 years and needs his port accessed? I GUARANTEE he'd roll his eyes at you if you said to him, "Ok, Johnny, we need to keep your room a safe place so we're going to bring you to the treatment room to put your tubies in." I mean, I have three year old patients who can sit still for that.
I'm a pedi nurse and when I worked inpatient, the treatment room was definitely utilized less often than just doing the procedure in the child's room. (Heck, sometimes we'd be so full that there would be a patient IN the treatment room as his room.) Most of the time, the parents didn't want to bring the kids into the treatment room and we left it up to them. The only thing we always did in the treatment room was LPs. I never once had an issue with a child not wanting to go to their room because it wasn't safe or an invasive procedure had been done there. And we definitely did not have the luxury of calling in someone else to do the procedures- we had an IV team but they always had a list a mile long and if you could do it, 9 times out of 10 you were better of just doing it yourself. Phlebotomy only came around once/day and wouldn't draw the same patient more than once so if you had a kid who needed frequent labs, you were it. They also left at 3P. I never once had another nurse drop an NG for me.
What about things like shots, finger sticks and straight cathing? Children are going to hate those just as much as they hate the procedures the OP mentions but there's certainly not going to be another nurse popping by to do q 3hr glucose checks or give insulin coverage before every meal/snack or cath a child q 4hr. I think most kids realize that the hospital is not really free of these things whether they're done in their room or in the treatment room. And, speaking of "safe places" for kids... we could all probably agree that most kids consider their home to be a safe place, right? Well, in my current job I do procedures that a child would view as invasive all the time in their homes (PICC line and CVL dressing changes, port accessing, shots), sometimes in their own room and they all seem to get along just fine. I've had a couple 2-3 yr olds who would cry/run away as soon as they saw me but they eventually got over it too. Kids have an incredible ability to adapt, that's one of the great things about them.
meanmaryjean, DNP, RN
7,899 Posts
Excellent plan!