Behind the Scenes of Pediatric Clinic Nursing- A Kind of Letter to Parents
To those who think being a clinic nurse is so easy...
Sometimes my job is pretty plush admittedly. There's usually time to chat and
laugh with my coworkers, time to check out the latest deal on Amazon and time
to get to know the doctors who I work with, a few who I now consider friends
and have hung out with outside work. I have a HUGE sit/stand desk that I've decorated with pictures of my family and our travels. Other days though, aren't so easy, and
that's why our office has nurses...
I am a pediatric triage|care coordinator nurse. Most days, I spend a good portion of
my day on the telephone. I am the voice you get when you have a question about
a rash, a cut that just doesn't look right, or a cough that won't go away. But
I am also the voice who directs you to call poison control and calmly calls
back to check on you. I am the voice who listens and advises you when your
child is suicidal, when their heart is racing, or when they're having chest
pain. I am the one you call when you're concerned about a concussion, a gluten
intolerance, or perhaps something even more serious. It is my job to calm you,
encourage you, and advise you on what I think is best for your child. Don't
worry, there are protocols in place and manuals to refer to. There is a shared tribal knowledge of sorts that increases with every case. Sometimes the answer is an appointment with the doctor because I can also
get you that and be the careful keeper of the same day appointments that I
control. Often it is something I can talk you through at home, though it may
take a while to get you to understand what to do or there may be many, detailed
instructions. Sometimes your questions at first sound silly but we respect
you for calling. Being a parent is hard and we are there to hold your hand and
help you through it. Many times a day a question will stump me and I walk into
my doctor's office and confirm with him or her. Also, we are human and don't know everything-so sometimes we will try to work things out with you, and call you back when we have researched some more.
I also know way more than I would like to about your
insurance and the process of doing referrals to specialists for your child. I
know how to rush things through and how to get approval when it is absolutely
needed in a timely manner. I will speak directly to the specialty doctor myself. I know which prescription medications tend to be
covered and which do not. And many of them I can refill without even asking the
doctor because, again, there are protocols for that. Because of the pediatric
nurses you get your medication in a much more timely manner than if the doctor
had to look at and filter every request. It may surprise you to know that the
doctors don’t see everything that the nurses take care of because they are entrusting
us to be their right hand.
I do a fair amount of hands-on skills too. It is myself and the
other nurses of course, who spend time in the medication room carefully calculating (and always double checking), mixing and drawing up a potent dose of antibiotics based on your
child's weight and infection. Sometimes it is a breathing treatment that I will
help administer, or medication such as steroids to help a child breathe
better and easier. Often I am called upon to do urinary catheters. This is
sometimes traumatic for both the patient and parents and we try to do the skill
as quickly, calmly, and compassionately as possible. I might be giving strong
medication to help boost growth, delay puberty, or birth control. On a few rare occasions I have placed and monitored IVs, helped temporarily cast a broken limb, or cared for a wound.
Pediatrics is an interesting environment. It is both primary
care and specialty all in one at the same time. A temperature range for an
adult may not worry me as much as a smaller temperature range on an infant
for example. There are things that we just need to know about our particular
population of patients. In Pediatrics, when I go to room the patient it is not
uncommon for them to grab my hand and walk with me or to ask what stickers I
like best. I know that a smile and friendliness goes a long way to calm a scared child. A pediatric worker must have a heart for both communicating with
parents and children alike.
When we lose a patient, hopefully never in office, our entire
staff is aware. The pediatricians attend the funeral. Our doctors work long and
hard to make sure that each and every one of their patients is getting the care
needed. This may mean phone calls in the evening from home, calling specialty
offices to get the patients in sooner, and basically whatever we can do. We
will baby our parents and hold their hands as much as and for as long as
possible because again, your children are precious to us.
Your children are amazing, the reason we have fun murals on
the walls, they are resilient and tough, and we love watching them grow. Our
doctors truly do love their jobs. I have never met a set of happier doctors who
often say things like, “how amazing we get to work with these young people
every day."
In pediatrics, I am shown so much respect as a nurse. I know
it is already an esteemed position to hold, but when I walk down that hallway
and hear our amazing front desk staff say to parents "let me get the nurse
she will know", "the nurse will help you", "the nurse will be out to talk with you
in just a moment", I know that my opinion and my education are valued and that you know I will advocate for you and help you as best I can with your child. Even though we sometimes get easy calls, keep in mind that all our nurses are emergency trained in pediatric life support and can help a choking child, perform CPR, give meds to stop a seizure, put in an advanced airway and even start an IO (intraosseous <into the bone> IV) if the need arose. We hope it doesn't, but we are trained just in case.
It is all a matter of perspective. It really is. Sometimes I
have been very bored with my job as it is not quite as hands-on as I would
like. I will say that I daily use clinical decision making and judgment, so my brain is never "off." Some of my restlessness has been helped by putting some of us nurses on the floor with patients
a few half days a week. That has been great to not be triaging
100% of the time. We also do triage in person should the need arise by the way.
Often once a day or so-when people walk in with their child scared of what is
going on. I know that I am blessed to have the position I do,
to work with an entire staff of people who care deeply about what they are
doing. I have inadvertently fallen in love with Pediatrics and will be here
likely until my next journey begins or hopefully completes. Should psychiatric
nurse practitioner, a position in which I would want to work primarily with
children and teens not work out for me, I have given serious thought to
becoming a pediatric nurse practitioner. Off to work I go!
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