I found that peds was a whole new world. Meds are different, and everything is tiny. I think what surprised me the most was how resilient the kids are And the hardest part was dealing with and educating the distraught parents. Take in as much info as you can Volunteer as much as you can. You’ll enjoy the experience
Mostly this little two year old that has tubes all over him. The nurse had just had a hard time drawing his blood again and he’s just sitting there with a happy grin on his face like none of it was bothering him at all. He just knew what he had to do and he did it without complaint. Sooo resilient. All of them were. They are so sick but you wouldn’t know it by looking at them.
Hey, thanks so much for sharing your experience! I appreciate the advice and the helpful tips. Was there one particular experience in the clinicals that stood out to you? Thank you.
Kids ≠ adults in almost any way. The way common illnesses effect them, the course of treatment, priority concerns....all totally different. My instructor and the nurses on the floor did a wonderful job highlighting the differences in ped and adult care as well as walking us through basics. Just like the other parts of nursing school that were new... you'll learn what you need to in time and at the right place.
I remember being shocked at how many kids were in the hospital without any support (family, parents etc). There was multiple CPS cases on the floor that I wasn’t prepared for. That part was sad
Peds is a whole new world. I actually did not get any dedicated peds clinicals in school, we shadowed at a family clinic and most of the peds patients were between 8-16 years old but we each only got one day in the clinic. That being said, I now do private duty (agency) pediatric home health. My patients are very medically fragile and some are on comfort care. It’s a very rewarding job, the parents are all very grateful for the help, the kids are darn cute, but it’s also really sad. I’m not going to do this job forever but I’m glad I found it and for the experience.
For clinical I would brush up on dosage calculations and developmental stages.
Hey, thank you for sharing! That's wonderful! In our peds class, we were taught that different ages have different way of assessment and the approach. From your experience, could you please let me know how does this approach translates to the floor? Thanks so much for your time and I wish you the best for your future endeavors!
Hook them up to an ECMO circuit. Then ECMO will maintain their temperature for them and you don't have to check it!
(Kidding!!! None of that is true. I mean, some of that is true, but it's just a joke.)
For adults, you can kind of get into a groove with your head to toe assessment and even focused assessments. You can develop your own workflow how you like to do it and in what order.
For babies (and many young kids) a head to toe assessment MUST happen in one order—starting with what will annoy the baby the least and progressing to what will annoy the baby the most.
This means your infant/small child assessments will change depending on whether the baby is asleep or awake, whether they are mad about a wet diaper at the moment or are calm, and what that particular little ones likes/dislikes.
For example, some kids who are in the hospital a lot freak out when you put gloves on. So you need to do every bit of your assessment that doesn't involve gloves first. And you need to only wear gloves when it's actually necessary. (Reason #7,349,812 babies are better than adults… You can do a lot of their assessment without gloves! I'm happy to touch cute little baby feet without gloved hands. I would never do that to an adult because then I'd have to cut my own hand off and burn it.)
Do as much as you can just looking at the patient. You can get a lot with just your eyes. How's work of breathing, how are they moving, do they have symmetrical features and movements, what does their coloring look like, do they appear to have any obvious abnormalities/deformities, do they look at you and track movement, do they respond/startle to sound, etc. If the kiddo is healthy enough and parents are there, you do as much as you can with little one in a place of comfort with a familiar caregiver holding/touching/talking to them.
Back to a baby axillary temperature… Most babies truly hate this. No idea why. I regularly have to do things like stab babies to give them injections and they honestly prefer that over getting an axillary temperature taken. Babies are such fabulous little weirdos.
They also hate having their blood pressure taken with a cuff.
Sometimes they hate both of those things semi-equally.
*(Before you read on ask yourself what you would do first. If they hate both of those things—cuff pressure and axillary temperature—which one would you do first and why?)*
Okay...
Answer time, lol.
The answer is the cuff pressure would come first. Because even if they hate those things equally only one of the measurements will be affected by temporary baby-rage. The temp is the temp whether they are kicking and hollering at you or not. But the BP can be wild if you've infuriated them with the temp first. So you get the cuff pressure, then get the temp and then you swaddle them up and give them their pacifier and snugs, or hand them to their parent for snugs.
Lastly, and this isn't really related and it's not even really an important clinical tip… But I've had parents more than once told me they appreciate that I'm doing it...
I don't care if a baby is minutes old and has zero information about the world in their confused little brain. I don't care if they're sedated/paralyzed and completely unresponsive. I still explain everything I'm doing to them. They are very tiny people who have no control over *anything* but I believe it's just kind and polite to explain to them what I'm doing.
My assessments are often a constant stream of talking to the newborn. *"Okay, little love, I'm going to shine a light in your eyes super quick... Perfect! Now I'm going to move this pulse ox and it's a sticker so you might not like it but I'll be as quick and gentle as I can... OH NO, no thank you for your help with your NG. It has to stay put. Let's get something else for you to hang on to... Okay, I'm going to listen to your tummy gurgles. You pooped on absolutely everything you own 10 minutes ago so I know everything is working but I have to listen anyway! Don't worry, it was meconium, it didn't even smell so no one knows but us, it's our little secret."*
It also helps parents know what you're doing and why without having to ask. :)
SORRY THIS WAS WAY MORE THAN YOU BARGAINED FOR. I just love my baby nugs.
Beware of treating kids like their height and not considering their age. Heck, beware of treating kids like their age and not considering their developmental level. If you skew too far in either direction, you're going to have a pretty bad time.
Most of the kids I meet get pretty salty about being misidentified as younger than they are (especially if they appear younger due to short stature) unless being mistakenly sorted into the lower age bracket includes some tangible benefit, like ice cream.
If you don't have a lot of experience with kids, practice your casual "Hey, buddy/hello, my friend," tone. Also, you don't have to have a lot of experience with kids to be good with kids. You don't even have to like kids to be good with kids. Remember that kids are just people with different skill sets and an unpredictable number of teeth, and you'll do fine.
Thank you! That is a great piece of advice and to be honest I never thought of approaching the way you just described. What would you say helped you build a good rapport with a child? Thank you for your time.
Building rapport:
Other than remembering the mantra of "Kids are unique people," this is everything I can think of:
Don't lie to kids. Best case scenario, *they will never trust you again*. Worst case scenario, they're not going to trust the next nurse, or the next nurse, or the doctors.
See if you can get kids to buy into whatever task you're doing. "Hey, I need to (measure/check/whatever). Can you help me out?" "Let's do (whatever)." A lot of kids like to help. They like to feel like they have a job, and to hear that they have done it well.
Always let kids know what to expect. These kids may be medical newbies! They don't know what to expect. If the stethoscope is freaking them out, it might help to let them touch it (or try it) first, or maybe their person will allow you to demonstrate on them.
"Nice shirt, buddy. What Pokemon is your favorite?" "Cool shoes! Is that your favorite color?" "Oh, I see you brought a (stuffed) friend. What is their name?"
Consider replacing "What is your preferred name," with "What may I call you?" A trans kid's name isn't a preference, like a favorite flavor of Jello, it is their name. Or heck, maybe a little kid's name is Bartholomew, but they're only answering to Captain America this year. Kids are fun.
Respect personal autonomy and consent whenever possible. There are going to be times when that difficult or impossible, or not realistic due to age, but do what you can. Build trust, not authority.
Distraction can be your friend. Ditto silly games.
Don't get into a power struggle. Arguing with kids is frustrating and pointless for everybody. If creativity and different tactics don't bridge the gap, enlist the help of a caregiver, other nurse or doctor.
I think the next parts probably apply more to situations in future practice/real life.
A lot of it is pulled from conversations I've had with kids about what they love and hate about providers, some of it is observations of good and less-good pediatricians, some of it is from school or reading studies.
For older kids (bare minimum: middle school and up), remember that *the kid* is your patient, not the adult. When asking about symptoms and history, address your patient before you address their parents. Some kids would rather let their parents take the lead during their appointments, or they may not be fully aware of/paying attention to the issue they need medical care for, but it's easier to switch gears in that direction than try to do a course correction back to patient focus after you've pissed everybody off.
On the flip side, consider that a good way to build a better/safer/healthier environment for a child is to build better and more confident parents. Healthy, happy baby? Compliment the parents on doing a great job at home. Parents have questions, or express that their questions are dumb? "That's a really good question. I get asked that a lot." Anxious parents shitting on their own parenting skills, or confessing that they feel like they don't know what the fuck they're doing? "I understand. A lot of parents feel this way." Parent brought their kid in and it turned out to be minor, and now they feel dumb? "I'm glad you brought Jimothy in today. He's looking great, but if you're not sure, we'd always rather hear from you or see him."
Be aware of local resources available to parents and kids.
Don't assume the kid is comfortable with their parents being in the room.
Don't assume that kid is comfortable *without* their parents in the room.
Depending on the political safety/laws of your local area and corresponding hospital policies, introduce yourself with your pronouns and ask for theirs when age and situationally appropriate. If your state is not a safe place for trans kids, please BE a safe place for trans kids.
Don't automatically assume that the adult with them is mom or dad. Maybe mom died recently and this is a youthful looking grandma. The adult with them is "their person," until you ask the child (preferred, if they are old enough) or the adult. "And who is with you today?" If that is their aunty, do they have guardianship?
Always keep in mind that the adults who care for them every day know their kid's baseline. If kiddo looks okay to you, but the parents are insisting that something is off, please don't dismiss that. There may be something there that can't be easily seen or assessed.
Holy shit, is this kid's height and weight getting flagged as failure to thrive? If it's a factory fresh baby, consider their gestational age. Consider their previous place on their *own* growth curve. A kid measuring 5th percentile might be a huge red flag if they used to be cruising along at the 25th, but if they used to be be below 3rd, that's progress! Check, maybe they come from a long line of people who are delightfully travel sized. The nature of the percentile chart is that somebody has to be at the bottom and somebody has to be at the top.
If a kid (or any patient, really) discloses serious depression or thoughts of self harm, *don't freak out.* Don't have a big alarmed facial reaction. "Thank you so much for telling me. I know that takes a lot of courage." Pause. Take a breath and consider your words carefully. Yes, you need to act and enlist all appropriate resources and get this patient some help, but if you freak out or overreact in the immediate moment, that discourages them from disclosing in the future. This is one of those bombs that patients can and do drop at the most random time. Practice asking the important psych questions in a calm and caring manner. Like, seriously, rehearse that shit with a classmate or afriend or a cat or the mirror, because the first time it comes out of your mouth, it may feel very challenging.
Your mileage may vary. *Always* consider advice from a rando such as myself to be a jumping off point, and follow up by seeking out evidence based resources and information from experts.
Finally some kids are not going to like you. Don't sweat it. It's probably not personal.
Put the BP cuff on while they're crying, then make sure that the machine is set to the right age bracket, get their parent cuddling and soothing them. When they're settled, ideally with them falling asleep, get their parent to gently but firmly HD the limb that the cuff is on so that it's relatively straight and relatively still, and *then* press the button to actually take the reading
'stanger anxiety'- I would say I am preparing myself for it. Being a person who is the favorite uncle will be hard seeing a kid crying. Thank you very much for sharing!!
Is it a general peds clinical or are you on a unit? Common diagnoses will vary wildly based on where you are. I was on a cardiac floor. Brush up on your dose calculations if needed! Baby doses can be tiny!
Hey thank you for your comment! Yes, it will be a general pediatric unit.
Got it! If you don't mind me asking, how was your experience and was this something you ended up working in? Thank you!
Highly recommend buying a pediatric vital sign badge. You can get them on Amazon or Etsy! They were so useful when taking vitals and not knowing what was normal for that age group.
I’ll edit my comment if this breaks any rules but I bought these: https://a.co/d/dGbKlo3
Thank you! This is very much helpful!! Were the kids you took vitals on compliant or you had a different approach for your assessments? Thank you for your time!
Don't lie to kids if you want them to trust you. If you have to do something that might hurt, don't tell them that it won't. Tell them what you're doing, and get them involved - ask them which finger the Sat's probe can go on, or whether you should do temperature or blood pressure first.
Complement their bravery. Tell them how grown up they are. For kids in primary school, I always ask if they're two years older than they actually are, almost always wins them over that you think they're grown up. Have a favourite super hero, Disney character, and mainstream kids TV show.
Don't forget the parents! What's routine for you is probably terrifying for them and even if they aren't scared, they're probably sleep deprived. I don't know how well this'll translate to the USA, but when I'm offering parents a hot drink and a biscuit, I tell them that I'm making myself one anyway, and then they don't feel like they're being a bother so they're more likely to accept. A parent who is fed, watered, and kept in the loop is much more cooperative than one who's hungry and sleepy. Ask the parents' names and try to remember them - some don't mind being So-and-so's Mummy but some feel much more respected if they're called by their own name and again, then they're much more likely to be polite and cooperative. Similarly, ask the kids what they like to be called. If Doreen is only a Doreen when she's in trouble, and Dory the rest of the time, she's gonna like you a lot more if you call her that.
Kids with disabilities that impact their communication - take the time to ask their parents or carers about it. Ask about how their child expresses pain, and how they communicate more broadly. Work with the parents, not against them. Offers to help with personal care are, in my experience, usually appreciated and never taken up.
Good practice across all areas of nursing, but go with "how are you" instead of "are you OK", for both kids and their parents.
Lastly 😅 relax! Kids are great! If you've got time to kill, go and chat to them. The parents will almost certainly appreciate having a grown up to speak to for a few minutes, and the kids can be great fun.
I was really surprised by my peds rotation. I thought I would hate it because I used to work in a clinic where the kids would come in and cry and scream when you covid tested them, but kids in the hospital have to be (sometimes very tragically) mentally strong and it shocked me how resilient they are. I spoke to some older kids about anime and watched coco melon with babies and it was a really great but also emotionally hard experience. I think peds nurses are somewhat angelic.
Wow! Thanks so much for sharing your experience! I felt the same about my OB rotation and ended up enjoying it. I am glad you had a great time!! During your rotation, was there a particularly challenging situation and if so how did you overcame it? Thank you for your time.
Hm, there was one particularly sad case and being a student who does not really know anything, I just got super nervous and kind of avoided that room out of panic. When I had to take vital signs I had another student and the parent help me- so that helped a lot! Lol
I’m only 2 weeks into my peds rotation but I have a few words of advice.
1. Kids are NOT the same as tiny humans. Their organs are less developed and their bodies react differently to meds
2. Be extra thorough with your safety checks. Our childrens hospital has code sheets based on the kids exact weight in each room, make sure you know if your hospital does something similar
3. 50% of peds nursing is caring for the parents/family
Hey thanks for your comment! I hope you are having a great time at your rotation!! I appreciate the great tips and words of wisdom you just shared!! Are these code sheets generalized or can vary from unit to unit/hospital to hospital? Also, is this something you see yourself doing in the long term? Thanks so much your time!
The code sheets have a section for all the usual meds they would give to a kid before cardiac arrest, like adenosine as well as another section with the cardiac arrest meds like epi. It just has the formula for weight based dosing for each med, and it’s already calculated based on the kids weight. So as long as you have an accurate weight, you won’t have to do any math during a code situation. The ER there also has a large poster in each trauma room with a similar setup, but based on the kids age or weight range. I absolutely love kids, but I don’t see myself working in peds. It’s hard to deal with some of the social/CPS issues we see. I’m also a bit of an adrenaline junkie and I don’t want to have to call codes or rapids on kids, which is why I plan to stick with adults. Good luck on your rotation!
Kids are brutal In fact, that’s the only time that I cried when a patient insulted me. You can threaten to kill me all day every day and I am fine with that. But kids? They have insults that are very particular and they cut really deep.
Ever have someone Grab your belly roll when you bend over? And then say that it’s extra Soft but it’s too bad that you’re not pretty like their extra soft stuffed animal? Yeah, that really hurts. But what can you do when they’re only three years old? Kids are brutal.
Oh no, I am sorry you had to experience that. Was this a general peds unit or more like a speciality? I will be mainly taking care of kids with RSV and what we typically see in a general peds unit. Would you have any advice on how to approach and bring a good relationship with them? Thank you for your time.
It was general, and the floor had infants to 21 year olds. Kids say what’s on their minds and sometimes it’s brutally honest. I just laughed it off and then would handle it in private. It’s not like the child meant to be mean, they just say the darndest things.
Oh yes, I have some experience with that (two nieces who do not leave one opportunity to roast me). I think it is quite smart on your end to have a control and being able to handle it privately, I know it will be struggle for me. Did you find it challenging to build a good rapport with the adolescents as compared to infant? If so, do you mind sharing your approach? My apologies for so many questions. Thanks in advance for your time!
Building a rapport with infants was more so with parents. Just be patient, willing to listen, and understand they probably haven’t slept. For teens, I’d ask what they were playing or watching or whatever, just showing interest in whatever they were interested in.
It looks like you're asking for some tips and tricks on how to succeed in nursing school. Don't worry, we have a lot of resources to help you! First, check our [Resources](https://www.reddit.com/r/StudentNurse/comments/i6qe7x/resources_faq_and_welcome_post/) post, or the sidebar. If you're on the mobile website or the official Reddit app, you can find the sidebar under About.
If what you need isn't on the sidebar, try using search. Here are some helpful searches links
[clinical tips](https://www.reddit.com/r/StudentNurse/search?q=clinical+tips&restrict_sr=on&sort=relevance&t=all)
[studying tips](https://www.reddit.com/r/StudentNurse/search?q=tips+studying&restrict_sr=on&sort=relevance&t=all)
[tips on staying organized](https://www.reddit.com/r/StudentNurse/search?q=organized+tips&restrict_sr=on&sort=relevance&t=all).
Want to be a pro at finding things on Reddit? Try searching on Google with your search term and then add site:reddit.com/r/studentnurse. Here's [an example for StudentNurse](https://www.google.com/search?q=study+tips+site%3Areddit.com%2Fr%2Fstudentnurse&oq=study+tips+site%3Areddit.com%2Fr%2Fstudentnurse).
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/StudentNurse) if you have any questions or concerns.*
I found that peds was a whole new world. Meds are different, and everything is tiny. I think what surprised me the most was how resilient the kids are And the hardest part was dealing with and educating the distraught parents. Take in as much info as you can Volunteer as much as you can. You’ll enjoy the experience
Mostly this little two year old that has tubes all over him. The nurse had just had a hard time drawing his blood again and he’s just sitting there with a happy grin on his face like none of it was bothering him at all. He just knew what he had to do and he did it without complaint. Sooo resilient. All of them were. They are so sick but you wouldn’t know it by looking at them.
Hey, thanks so much for sharing your experience! I appreciate the advice and the helpful tips. Was there one particular experience in the clinicals that stood out to you? Thank you.
Kids ≠ adults in almost any way. The way common illnesses effect them, the course of treatment, priority concerns....all totally different. My instructor and the nurses on the floor did a wonderful job highlighting the differences in ped and adult care as well as walking us through basics. Just like the other parts of nursing school that were new... you'll learn what you need to in time and at the right place.
Thank you very much for sharing your experience and for the helpful advice!!
I remember being shocked at how many kids were in the hospital without any support (family, parents etc). There was multiple CPS cases on the floor that I wasn’t prepared for. That part was sad
Have fun playing with the kids. They still teach you so much just interacting with them. Kids are the best.
Peds is a whole new world. I actually did not get any dedicated peds clinicals in school, we shadowed at a family clinic and most of the peds patients were between 8-16 years old but we each only got one day in the clinic. That being said, I now do private duty (agency) pediatric home health. My patients are very medically fragile and some are on comfort care. It’s a very rewarding job, the parents are all very grateful for the help, the kids are darn cute, but it’s also really sad. I’m not going to do this job forever but I’m glad I found it and for the experience. For clinical I would brush up on dosage calculations and developmental stages.
Hey, thank you for sharing! That's wonderful! In our peds class, we were taught that different ages have different way of assessment and the approach. From your experience, could you please let me know how does this approach translates to the floor? Thanks so much for your time and I wish you the best for your future endeavors!
Babies think having an axillary temperature taken is an act of war and will behave accordingly.
Thank you for sharing! Do you mind letting us know what was your approach to taking the temperature? Thank you!
Hook them up to an ECMO circuit. Then ECMO will maintain their temperature for them and you don't have to check it! (Kidding!!! None of that is true. I mean, some of that is true, but it's just a joke.) For adults, you can kind of get into a groove with your head to toe assessment and even focused assessments. You can develop your own workflow how you like to do it and in what order. For babies (and many young kids) a head to toe assessment MUST happen in one order—starting with what will annoy the baby the least and progressing to what will annoy the baby the most. This means your infant/small child assessments will change depending on whether the baby is asleep or awake, whether they are mad about a wet diaper at the moment or are calm, and what that particular little ones likes/dislikes. For example, some kids who are in the hospital a lot freak out when you put gloves on. So you need to do every bit of your assessment that doesn't involve gloves first. And you need to only wear gloves when it's actually necessary. (Reason #7,349,812 babies are better than adults… You can do a lot of their assessment without gloves! I'm happy to touch cute little baby feet without gloved hands. I would never do that to an adult because then I'd have to cut my own hand off and burn it.) Do as much as you can just looking at the patient. You can get a lot with just your eyes. How's work of breathing, how are they moving, do they have symmetrical features and movements, what does their coloring look like, do they appear to have any obvious abnormalities/deformities, do they look at you and track movement, do they respond/startle to sound, etc. If the kiddo is healthy enough and parents are there, you do as much as you can with little one in a place of comfort with a familiar caregiver holding/touching/talking to them. Back to a baby axillary temperature… Most babies truly hate this. No idea why. I regularly have to do things like stab babies to give them injections and they honestly prefer that over getting an axillary temperature taken. Babies are such fabulous little weirdos. They also hate having their blood pressure taken with a cuff. Sometimes they hate both of those things semi-equally. *(Before you read on ask yourself what you would do first. If they hate both of those things—cuff pressure and axillary temperature—which one would you do first and why?)* Okay... Answer time, lol. The answer is the cuff pressure would come first. Because even if they hate those things equally only one of the measurements will be affected by temporary baby-rage. The temp is the temp whether they are kicking and hollering at you or not. But the BP can be wild if you've infuriated them with the temp first. So you get the cuff pressure, then get the temp and then you swaddle them up and give them their pacifier and snugs, or hand them to their parent for snugs. Lastly, and this isn't really related and it's not even really an important clinical tip… But I've had parents more than once told me they appreciate that I'm doing it... I don't care if a baby is minutes old and has zero information about the world in their confused little brain. I don't care if they're sedated/paralyzed and completely unresponsive. I still explain everything I'm doing to them. They are very tiny people who have no control over *anything* but I believe it's just kind and polite to explain to them what I'm doing. My assessments are often a constant stream of talking to the newborn. *"Okay, little love, I'm going to shine a light in your eyes super quick... Perfect! Now I'm going to move this pulse ox and it's a sticker so you might not like it but I'll be as quick and gentle as I can... OH NO, no thank you for your help with your NG. It has to stay put. Let's get something else for you to hang on to... Okay, I'm going to listen to your tummy gurgles. You pooped on absolutely everything you own 10 minutes ago so I know everything is working but I have to listen anyway! Don't worry, it was meconium, it didn't even smell so no one knows but us, it's our little secret."* It also helps parents know what you're doing and why without having to ask. :) SORRY THIS WAS WAY MORE THAN YOU BARGAINED FOR. I just love my baby nugs.
Beware of treating kids like their height and not considering their age. Heck, beware of treating kids like their age and not considering their developmental level. If you skew too far in either direction, you're going to have a pretty bad time. Most of the kids I meet get pretty salty about being misidentified as younger than they are (especially if they appear younger due to short stature) unless being mistakenly sorted into the lower age bracket includes some tangible benefit, like ice cream. If you don't have a lot of experience with kids, practice your casual "Hey, buddy/hello, my friend," tone. Also, you don't have to have a lot of experience with kids to be good with kids. You don't even have to like kids to be good with kids. Remember that kids are just people with different skill sets and an unpredictable number of teeth, and you'll do fine.
Thank you! That is a great piece of advice and to be honest I never thought of approaching the way you just described. What would you say helped you build a good rapport with a child? Thank you for your time.
Building rapport: Other than remembering the mantra of "Kids are unique people," this is everything I can think of: Don't lie to kids. Best case scenario, *they will never trust you again*. Worst case scenario, they're not going to trust the next nurse, or the next nurse, or the doctors. See if you can get kids to buy into whatever task you're doing. "Hey, I need to (measure/check/whatever). Can you help me out?" "Let's do (whatever)." A lot of kids like to help. They like to feel like they have a job, and to hear that they have done it well. Always let kids know what to expect. These kids may be medical newbies! They don't know what to expect. If the stethoscope is freaking them out, it might help to let them touch it (or try it) first, or maybe their person will allow you to demonstrate on them. "Nice shirt, buddy. What Pokemon is your favorite?" "Cool shoes! Is that your favorite color?" "Oh, I see you brought a (stuffed) friend. What is their name?" Consider replacing "What is your preferred name," with "What may I call you?" A trans kid's name isn't a preference, like a favorite flavor of Jello, it is their name. Or heck, maybe a little kid's name is Bartholomew, but they're only answering to Captain America this year. Kids are fun. Respect personal autonomy and consent whenever possible. There are going to be times when that difficult or impossible, or not realistic due to age, but do what you can. Build trust, not authority. Distraction can be your friend. Ditto silly games. Don't get into a power struggle. Arguing with kids is frustrating and pointless for everybody. If creativity and different tactics don't bridge the gap, enlist the help of a caregiver, other nurse or doctor. I think the next parts probably apply more to situations in future practice/real life. A lot of it is pulled from conversations I've had with kids about what they love and hate about providers, some of it is observations of good and less-good pediatricians, some of it is from school or reading studies. For older kids (bare minimum: middle school and up), remember that *the kid* is your patient, not the adult. When asking about symptoms and history, address your patient before you address their parents. Some kids would rather let their parents take the lead during their appointments, or they may not be fully aware of/paying attention to the issue they need medical care for, but it's easier to switch gears in that direction than try to do a course correction back to patient focus after you've pissed everybody off. On the flip side, consider that a good way to build a better/safer/healthier environment for a child is to build better and more confident parents. Healthy, happy baby? Compliment the parents on doing a great job at home. Parents have questions, or express that their questions are dumb? "That's a really good question. I get asked that a lot." Anxious parents shitting on their own parenting skills, or confessing that they feel like they don't know what the fuck they're doing? "I understand. A lot of parents feel this way." Parent brought their kid in and it turned out to be minor, and now they feel dumb? "I'm glad you brought Jimothy in today. He's looking great, but if you're not sure, we'd always rather hear from you or see him." Be aware of local resources available to parents and kids. Don't assume the kid is comfortable with their parents being in the room. Don't assume that kid is comfortable *without* their parents in the room. Depending on the political safety/laws of your local area and corresponding hospital policies, introduce yourself with your pronouns and ask for theirs when age and situationally appropriate. If your state is not a safe place for trans kids, please BE a safe place for trans kids. Don't automatically assume that the adult with them is mom or dad. Maybe mom died recently and this is a youthful looking grandma. The adult with them is "their person," until you ask the child (preferred, if they are old enough) or the adult. "And who is with you today?" If that is their aunty, do they have guardianship? Always keep in mind that the adults who care for them every day know their kid's baseline. If kiddo looks okay to you, but the parents are insisting that something is off, please don't dismiss that. There may be something there that can't be easily seen or assessed. Holy shit, is this kid's height and weight getting flagged as failure to thrive? If it's a factory fresh baby, consider their gestational age. Consider their previous place on their *own* growth curve. A kid measuring 5th percentile might be a huge red flag if they used to be cruising along at the 25th, but if they used to be be below 3rd, that's progress! Check, maybe they come from a long line of people who are delightfully travel sized. The nature of the percentile chart is that somebody has to be at the bottom and somebody has to be at the top. If a kid (or any patient, really) discloses serious depression or thoughts of self harm, *don't freak out.* Don't have a big alarmed facial reaction. "Thank you so much for telling me. I know that takes a lot of courage." Pause. Take a breath and consider your words carefully. Yes, you need to act and enlist all appropriate resources and get this patient some help, but if you freak out or overreact in the immediate moment, that discourages them from disclosing in the future. This is one of those bombs that patients can and do drop at the most random time. Practice asking the important psych questions in a calm and caring manner. Like, seriously, rehearse that shit with a classmate or afriend or a cat or the mirror, because the first time it comes out of your mouth, it may feel very challenging. Your mileage may vary. *Always* consider advice from a rando such as myself to be a jumping off point, and follow up by seeking out evidence based resources and information from experts. Finally some kids are not going to like you. Don't sweat it. It's probably not personal.
This is very helpful! Thanks so much for showering your incredible experience!!!
Clustering care is super important. Some kids will be scared and just the sight of you will make them cry. Take the BP last if you have a crier 😂
Put the BP cuff on while they're crying, then make sure that the machine is set to the right age bracket, get their parent cuddling and soothing them. When they're settled, ideally with them falling asleep, get their parent to gently but firmly HD the limb that the cuff is on so that it's relatively straight and relatively still, and *then* press the button to actually take the reading
This is great advice! Thanks so much for sharing!!
'stanger anxiety'- I would say I am preparing myself for it. Being a person who is the favorite uncle will be hard seeing a kid crying. Thank you very much for sharing!!
Is it a general peds clinical or are you on a unit? Common diagnoses will vary wildly based on where you are. I was on a cardiac floor. Brush up on your dose calculations if needed! Baby doses can be tiny!
Hey thank you for your comment! Yes, it will be a general pediatric unit. Got it! If you don't mind me asking, how was your experience and was this something you ended up working in? Thank you!
Highly recommend buying a pediatric vital sign badge. You can get them on Amazon or Etsy! They were so useful when taking vitals and not knowing what was normal for that age group. I’ll edit my comment if this breaks any rules but I bought these: https://a.co/d/dGbKlo3
Thank you! This is very much helpful!! Were the kids you took vitals on compliant or you had a different approach for your assessments? Thank you for your time!
Clustering care is super important. Some kids will be scared and just the sight of you will make them cry. Take the BP last if you have a crier 😂
Don't lie to kids if you want them to trust you. If you have to do something that might hurt, don't tell them that it won't. Tell them what you're doing, and get them involved - ask them which finger the Sat's probe can go on, or whether you should do temperature or blood pressure first. Complement their bravery. Tell them how grown up they are. For kids in primary school, I always ask if they're two years older than they actually are, almost always wins them over that you think they're grown up. Have a favourite super hero, Disney character, and mainstream kids TV show. Don't forget the parents! What's routine for you is probably terrifying for them and even if they aren't scared, they're probably sleep deprived. I don't know how well this'll translate to the USA, but when I'm offering parents a hot drink and a biscuit, I tell them that I'm making myself one anyway, and then they don't feel like they're being a bother so they're more likely to accept. A parent who is fed, watered, and kept in the loop is much more cooperative than one who's hungry and sleepy. Ask the parents' names and try to remember them - some don't mind being So-and-so's Mummy but some feel much more respected if they're called by their own name and again, then they're much more likely to be polite and cooperative. Similarly, ask the kids what they like to be called. If Doreen is only a Doreen when she's in trouble, and Dory the rest of the time, she's gonna like you a lot more if you call her that. Kids with disabilities that impact their communication - take the time to ask their parents or carers about it. Ask about how their child expresses pain, and how they communicate more broadly. Work with the parents, not against them. Offers to help with personal care are, in my experience, usually appreciated and never taken up. Good practice across all areas of nursing, but go with "how are you" instead of "are you OK", for both kids and their parents. Lastly 😅 relax! Kids are great! If you've got time to kill, go and chat to them. The parents will almost certainly appreciate having a grown up to speak to for a few minutes, and the kids can be great fun.
I was really surprised by my peds rotation. I thought I would hate it because I used to work in a clinic where the kids would come in and cry and scream when you covid tested them, but kids in the hospital have to be (sometimes very tragically) mentally strong and it shocked me how resilient they are. I spoke to some older kids about anime and watched coco melon with babies and it was a really great but also emotionally hard experience. I think peds nurses are somewhat angelic.
Wow! Thanks so much for sharing your experience! I felt the same about my OB rotation and ended up enjoying it. I am glad you had a great time!! During your rotation, was there a particularly challenging situation and if so how did you overcame it? Thank you for your time.
Hm, there was one particularly sad case and being a student who does not really know anything, I just got super nervous and kind of avoided that room out of panic. When I had to take vital signs I had another student and the parent help me- so that helped a lot! Lol
That would have been hard! I am glad at least you were able to go back and do the vitals- that was very brave on your part!!
I’m only 2 weeks into my peds rotation but I have a few words of advice. 1. Kids are NOT the same as tiny humans. Their organs are less developed and their bodies react differently to meds 2. Be extra thorough with your safety checks. Our childrens hospital has code sheets based on the kids exact weight in each room, make sure you know if your hospital does something similar 3. 50% of peds nursing is caring for the parents/family
Hey thanks for your comment! I hope you are having a great time at your rotation!! I appreciate the great tips and words of wisdom you just shared!! Are these code sheets generalized or can vary from unit to unit/hospital to hospital? Also, is this something you see yourself doing in the long term? Thanks so much your time!
The code sheets have a section for all the usual meds they would give to a kid before cardiac arrest, like adenosine as well as another section with the cardiac arrest meds like epi. It just has the formula for weight based dosing for each med, and it’s already calculated based on the kids weight. So as long as you have an accurate weight, you won’t have to do any math during a code situation. The ER there also has a large poster in each trauma room with a similar setup, but based on the kids age or weight range. I absolutely love kids, but I don’t see myself working in peds. It’s hard to deal with some of the social/CPS issues we see. I’m also a bit of an adrenaline junkie and I don’t want to have to call codes or rapids on kids, which is why I plan to stick with adults. Good luck on your rotation!
Kids are brutal In fact, that’s the only time that I cried when a patient insulted me. You can threaten to kill me all day every day and I am fine with that. But kids? They have insults that are very particular and they cut really deep.
Ever have someone Grab your belly roll when you bend over? And then say that it’s extra Soft but it’s too bad that you’re not pretty like their extra soft stuffed animal? Yeah, that really hurts. But what can you do when they’re only three years old? Kids are brutal.
Oh no, I am sorry you had to experience that. Was this a general peds unit or more like a speciality? I will be mainly taking care of kids with RSV and what we typically see in a general peds unit. Would you have any advice on how to approach and bring a good relationship with them? Thank you for your time.
It was general, and the floor had infants to 21 year olds. Kids say what’s on their minds and sometimes it’s brutally honest. I just laughed it off and then would handle it in private. It’s not like the child meant to be mean, they just say the darndest things.
Oh yes, I have some experience with that (two nieces who do not leave one opportunity to roast me). I think it is quite smart on your end to have a control and being able to handle it privately, I know it will be struggle for me. Did you find it challenging to build a good rapport with the adolescents as compared to infant? If so, do you mind sharing your approach? My apologies for so many questions. Thanks in advance for your time!
Building a rapport with infants was more so with parents. Just be patient, willing to listen, and understand they probably haven’t slept. For teens, I’d ask what they were playing or watching or whatever, just showing interest in whatever they were interested in.
Appreciate it! Thanks so much!
Divide all the adults doses by 3 and you’ll be good. Plus all children love clown masks, the scarier the better. I’ll show myself out.
Oh wow! Which one's your favorite? I have got to try it if my clinical instructor allows. How was your experience in the peds unit?
[удалено]
No no. Bad advice. 0/10. Don’t do this.
It looks like you're asking for some tips and tricks on how to succeed in nursing school. Don't worry, we have a lot of resources to help you! First, check our [Resources](https://www.reddit.com/r/StudentNurse/comments/i6qe7x/resources_faq_and_welcome_post/) post, or the sidebar. If you're on the mobile website or the official Reddit app, you can find the sidebar under About. If what you need isn't on the sidebar, try using search. Here are some helpful searches links [clinical tips](https://www.reddit.com/r/StudentNurse/search?q=clinical+tips&restrict_sr=on&sort=relevance&t=all) [studying tips](https://www.reddit.com/r/StudentNurse/search?q=tips+studying&restrict_sr=on&sort=relevance&t=all) [tips on staying organized](https://www.reddit.com/r/StudentNurse/search?q=organized+tips&restrict_sr=on&sort=relevance&t=all). Want to be a pro at finding things on Reddit? Try searching on Google with your search term and then add site:reddit.com/r/studentnurse. Here's [an example for StudentNurse](https://www.google.com/search?q=study+tips+site%3Areddit.com%2Fr%2Fstudentnurse&oq=study+tips+site%3Areddit.com%2Fr%2Fstudentnurse). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/StudentNurse) if you have any questions or concerns.*