Children are not tiny adults, and pediatric nursing is not merely adult practice made smaller. The field is as special as the children it caters to and, consequently, requires particular clinical and interpersonal know-how.
How does the distinctiveness of pediatric nursing play out in day-to-day practice? Consider these everyday realities of nursing’s pediatric pros.
From an infant in need of an immunization to a 17-year-old with a probable concussion, the stream of patients seen by a pediatric nurse varies significantly in shape, size and development. As a result, equipment, treatments, and even symptoms vary depending on the patient.
For example, symptoms of ADHD in elementary school-age children include speaking out in class and trouble waiting their turn in games, according to ADHD & You. During the teen years, hyperactivity sometimes becomes less visible while other symptoms, such as inner restlessness and disorganized schoolwork, emerge.
Pediatric professionals know this, as well as the most appropriate thermometer to use, for example, or the correct hand placement for chest compressions when administering CPR to a specific child. Appropriate customization is all in a day’s work.
Especially toward the younger end, children are not the most skilled at telling nurses what is bothering them or how their pain rates on a scale—even if that scale has corresponding happy, sad and tear-streaming faces. Still, children are adept at picking up on an adult’s emotional state. Nurses who are impatient, annoyed or stressed over something that happened earlier that day are not going to get very far with their intuitive younger patients needing their full attention and reassurance.
“Positive energy is so important in pediatrics,” said Kimberly Appelbaum, RN, a pediatric nurse at Children’s Healthcare of Atlanta on The Campaign for Nursing’s Future website. “Children read faces really well, so they know if you are having a bad day. It is important to gain the trust of your patients, especially in pediatrics, where kids are placed in strange and scary new environments.”
Family members can provide the words many younger patients cannot. They can also provide additional history, context and clues that verbal children may forget or neglect to communicate.
Pediatric nurses know how to collaborate with parents for the best interest of their patient.
“Parents in general, and especially new parents, often lack awareness about their child’s ailments and crave information,” explained the Rasmussen College School of Nursing in a blog post about pediatric nursing. “The more detail you can glean from them and also provide about your diagnosis, the better off you will be at treating the child.”
Relating to children is invaluable for pediatric professionals. So while their friends are catching the late afternoon news, pediatric nurses might instead make it a point to take in the latest episode of Daniel Tiger, the Beauty and the Beast trailer, or the first ballgame of the season to make small talk with patients flow a little easier. And when it comes to exam time, they are well aware that distractions—such as a toy pulled from a pocket or trick up a sleeve—can dissolve tension like magic.
Pediatric nursing veteran Joan Rich, DNP, Rasmussen College’s VP of nursing, recalled an encounter with a 3-year-old who had an earache of rather mysterious origins.
“I told the little boy that I was going to see if I could guess what he had for breakfast by looking in his ears,” she recalled. “To my surprise, I found a bright green-and-yellow foreign object placed securely in the canal, staring back at me!”
She removed the colorful piece while playfully questioning the young patient on his breakfast choices and whether or not they included—to his gleeful delight—Oreos.
With its innocent population, pediatrics can be blissfully happy and full of giggles. At times, though, it can also be hugely heartbreaking and full of tears. When the latter happens, pediatric nurses collect themselves, cope and continue on.
But that does not mean they deny their humanity.
“I have learned over the years, that it is indeed OK to cry with families,” reflected pediatric nurse Stefanie Bull, RN, reflected on MightyNurse.com. “It’s OK to cry while you hold, cuddle, and comfort your patients who may be only a few days, weeks, months or years old.
“I’ve also learned that you look at how you made a difference in the life of that child and their family, what you may have done to make just one aspect of their hospital stay or life better.”
To those in pediatric nursing, the importance of the role is clear and motivating.
As Appelbaum recalled, “Every day when I drive into work, I pass a sign that says, ‘Today you will make a difference in the life of a child.’ That is the outlook I bring to work with me every day.”
Nurses, what did we miss? Tell us your tell-tale signs that you just might be a pediatric nurse!
Pediatric clinicians and managers, did you miss our 2/2 joint webinar with SPN (Society of Pediatric Nurses) on ‘Using Clinical Informatics to Drive Evidence-Based Practice,’ presented by SPN’s Vice President, Jennifer Lombardi? Not to worry, the webinar recording is now available! Visit http://lippincottsolutions.com/spnwebinar to check it out.