What can you say about the competency in pediatric nursing skills of nursing students

nanay · Aug 27, 2006

Hi NoMoreBlues

Im interested to know also how the nurses evaluate our competency during our clinical rotation.

After youre done with your project, I would appreciate if you can post a summary (just a short one) on how we are doing.

Good Day!

nomoreblues · Aug 28, 2006

im a 3rd year student too... what school are you from?

Pediatric Critical Care Columnist · Sep 1, 2006

In my experience, nursing students don't get enough exposure to clinical practice with kids to really "get" peds. Kids are not little adults and everything we do with and for them has to be tailored to their development, anatomy and physiology. There are as many "norms" in peds as there are stars in the sky it seems, and the amount of preparation nursing students get isn't enough to give them more than an overview. Time and experience are the only sure-fire methods of knowing that a heart rate of 150 in an infant is probably nothing to worry about, particularly if they're febrile. Or that falling BP in a child is a VERY ominous sign of impending collapse, because kids compensate for shock states by increasing their heart rates and maintain a "normal" BP until their compensation mechanisms are exhausted. It does help if the student has kids... they can bring their experience with parenting to nursing and know what little tricks might work to gain cooperation, for example. It's not enough to read about peds in a book, one actually has to observe it clinically. Think about the amount of time in a nursing program devoted to peds... it's about what -

You know how I see it... how do you?

nomoreblues · Sep 3, 2006

thanks a bunch! :) it did help me a lot... have a nice day!

Pedi-ER-RN, RN · Sep 8, 2006

My Peds clinical faculty was very competent. Did I get enough experience to think I wanted to be a Peds nurse at that time, NO. I didn't even get to attempt an IV or blood draw on a kiddo (truth be known, I was probably too scared to do anything but give meds and do assessments, dsgs, etc..). I am now confident in my skills after 3 yrs peds er experience (I do still doubt myself sometimes though).

PedsER-RN, BSN, RN · Sep 8, 2006

hello i'm just new in this community. i need some help for a school project. what can you say about the competency in pediatric nursing skills of nursing students and faculty instructors? please do reply. thank you.

from the schools that are around here (including the one i graduated from), the level of competency (of the students) is pretty low. then again, it's not really the students' fault, b/c (at least at my school), most students aren't allowed to do procedures on kids. our instructors allowed us to start iv's *if* and only if the pt was an adolescent with decent looking veins. we had lots of skills labs on dummies and such, but other than that, not a whole lot. i got most of my experience pre-graduation by working as a tech in the pedi er where i still work nearly 3 years later. we got a lot of book knowledge but like some of the others have said, there's such a wide range of norms for peds, even the book knowledge can only go so far.

SarasotaRN2b · Sep 22, 2007

Unfortunately, most schools will only spend a semester, if that on peds. I'm looking at a Children's Hospital when I am finished that offers a 22-week residency program that will hopefully provide a more indepth clinical experience.

vonxojn · Oct 7, 2007

When I was in school, we had very little contact with kids. We didn't do much with clinicals on the Pediatric floors. That's made me very reluntant to care for kids. It's different caring for your own verses someone elses.

marilynmom, LPN, NP · Oct 21, 2007

Good question.

I know when I had my 8 weeks of ped clinicals (at a teaching hospital no less) the RN's wouldn't let student do much with the kids except the basics (VS, diaper changes, I&O's, etc). I think the RN's were just overly protective and basically wouldn't let us be involved in patient care like we are with adult clinicals. My ped instructor was horrible because she only worked in the NICU and knew nothing of children not PICU age and didn't consider herself a pedi nurse.

Most of the focus in nursing school is adult.

I work as a tech in the PICU and I love it and plan to stay there after I graduate in May. But I've had to do a lot of OTJ learning because I certainly didn't get it in school. I know I'm not alone in that because I haven't met a nursing student or RN yet that had a good ped foundation out of nursing school.

So to answer your questions, I think for the most part, most nursing students are pretty incompetent when it comes to peds...but I don't think it's the students fault. Schools just focus on adult care far more than ped care.

Pediatric Critical Care Columnist · Oct 21, 2007

So to answer your questions, I think for the most part, most nursing students are pretty incompetent when it comes to peds...but I don't think it's the students fault. Schools just focus on adult care far more than ped care.

I think we need to place some heavy emphasis on the part about it not being the nursing student's fault that they don't have any clinical skills related to caring for children when they graduate. Yes, the population is aging. Yes, the baby boomer demands health care in excess of any other generation. Yes, people come into hospital sicker than ever before, stay longer and have more complications. But that doesn't mean that children deserve less. Children recover from even critical illness with far fewer sequelae than adults and go on to be productive, TAX-PAYING citizens... and the new wave of caregivers, too! I commend hospitals that are willing to provide a lengthy internship for nurses wishing to enter pediatrics. They obviously value excellent, skilled, appropriate care for children over other "goods". At the same time I condemn nursing schools and their partners for taking the view that the only valuable nurse today is the med-surg nurse. We can't all be cookie-cutter nurses. After all, when the decision was made to eliminate all levels of nursing education save the degree, wasn't it to promote critical thinking, advanced skill, technological savvy and that elusive quality, professionalism? (Spoken like a true diploma nurse with no critical thiking skills or professionalism... ) So why push everyone into the med-surg mold?

marilynmom, LPN, NP · Oct 22, 2007

I think we need to place some heavy emphasis on the part about it not being the nursing student's fault that they don't have any clinical skills related to caring for children when they graduate. Yes, the population is aging. Yes, the baby boomer demands health care in excess of any other generation.

That reminded me of something my Gero instructor said in class a couple of weeks ago. She made some snide comment about how "none of you want to work with the elderly, your more interested in the baby birthin and being baby/kids nurses" as if children's medical needs are somehow less important than adults or we are choose to work with ped population because it will be easier?! It REALLY pissed me off when she said that! Apparently she has never stepped foot in the PICU where I work. And I'm not even sure why she said that because there are only a handful of us even planning on working in peds!