Working on a small Peds unit in Community Hospital?

KelRN215, BSN, RN · Jan 1, 2013

While in college, I worked as an aide on a combined med-surg/pedi floor in the community hospital in my town. As a nurse, I then spent 5 years in the large academic pediatric hospital in my state's largest city. My experience is that children in the small community hospital were overwhelmingly more stable with more run-of-the mill pediatric illnesses. Which makes sense... these hospitals are simply not equipped to deal with major pediatric illnesses. I once had a patient who was intubated, sedated and lifeflighted from the hospital in my town due to a seizure. Once she got to us she was immediately extubated, admitted to the floor overnight and discharged home the next day. If she lived closer to us and had come to us directly from home, she never would have been intubated and probably wouldn't have even warranted an admission. This was common with patients that we received from community hospitals... they didn't have the resources or the experience to deal with these patients so anything that seemed remotely serious was sent out.

When I worked in the community hospital, pediatric patients we had typically were admitted for things like asthma exacerbations, neonatal fever work-ups, appendicitis, viral meningitis and I recall a teenager who had taken an overdose of tylenol and was awaiting psych placement. Any of the other things that Children's Hospitals see frequently- congenital heart disease, cancer, cystic fibrosis, epilepsy- got sent out as soon as the kids got to the ER.

That said, I think it would likely be fine experience for you... it just depends on what you are looking for.

Genista, BSN, RN · Jan 2, 2013

Thanks KelRN215. I was thinking along the same lines. I would prefer comprehensive training & orientation, and not sure if I will get that in the small hospital. But I figure any serious/unstable patients would be sent out. I don't particularly want to take care of critically ill children all the time, so the smaller setting might be a fine match. I guess there are pros/cons to either. Thanks for your reply.

hiddencatRN, BSN, RN · Jan 9, 2013

The PEDs unit at the community hospital I work at routinely take adult patients when their census is low and the hospital's is high. I've also found the care of kids here to be....dated. This is frustrating coming from a major children's hospital.

elkpark · Jan 9, 2013

The PEDs unit at the community hospital I work at routinely take adult patients when their census is low and the hospital's is high.

I was going to comment on this, also. My (limited) experience with a peds unit in a small-city community hospital was that there sometimes weren't any kids, and the beds were filled with adults, or there was a mix of kids and adults. I was teaching peds clinical in an ADN program at that hospital, and it was often a challenge on many clinical days to have at least enough kids on the peds unit for my students to have one child client each, and the remainder of their assignment adults (not a good situation for peds clinical). The situation seemed to be that most kids in the community were either healthy (and at home :)) or sick enough that they needed to be sent somewhere else.

I agree that you can expect to not see much in the way of complex/exotic cases, and there is a good chance you will spend a fair amount of your time caring for adults.