“I’m a nurse in the Pediatric ICU”. A statement that often gets responses like “Aw you work with kids all day!” or questions like “Do you just hold and play with babies all shift?”. The most common question I get is “how can you work with children?? That’s so sad to see them sick!”. Since nobody knows what it is really like as a Pediatric ICU nurse, here is a little insight into what we do.
I work the night shift which means that I get home from work around 8 in the morning and will sleep from around 9 to 4pm most days. I often have to take melatonin just to be able to get a restful day of sleep to prepare me for the next shift. I get woken up by my family coming home, the neighbors construction or the gardeners next door. It is hard not to get mad because as a night shift nurse, you cannot expect everyone else to work around your crazy schedule. By the time I wake up and get ready for work, I have about an hour to talk to my friends, boyfriend and family before I have to leave.
I drink my iced tea or coffee in the car while trying to guess how work will be. If it is my first shift on in a few days, I am a little more anxious not knowing how many patients we have or how sick they are. I try to mentally prepare myself for the worst case scenario. I clock in and walk into the unit so I can get a glimpse of the patient board and which ones I have. Afterwards I put my stuff down, go to the bathroom one last time and gather my supplies as I take my last deep breath.
Finding a job in Pediatrics, let alone in the ICU, is hard if not impossible unless you already have experience in the area. Being a new grad is hard enough but being a new grad AND working with children’s lives can be a little overwhelming at times. However, I am ever so grateful that I got my first nursing job in my dream field. Pediatrics is a small world and a lot of the nurses on my unit know or have worked in other children’s hospitals in Orange County so everyone knows everyone. The turnover with pediatric nurses can be higher than other areas due to the stress we have to deal with. Most people think that I either hold babies all night, which some nights I may, or that all we have on our unit is dying children, which is hardly the case. My job is a lot more complicated than that.
As a pediatric nurse, I have to take on many different roles throughout the night. I admit patients, transfer them out, start IVs, weigh diapers, administer medications, and assess patients every 2 hours. I have to chart everything I do every 2 hours, I constantly watch the monitors to make sure my patient’s vitals are good and talk to doctors if I feel something is needed or not right. On top of doing my basic duties as a nurse, I have to try and calm the parents by informing them of everything that is going on. Sometimes just telling them that their child’s heart rate is good or that their lung sounds are clearer than before can instantly make them feel better. It is stressful having your child of any age in the hospital because children are supposed to be healthy. The parents can be rude and snap at me but I try to put myself in their shoes by thinking how stressed out I would be if I had a sick child here. A lot of the time, the parents come off as angry but I know that they are scared and that they feel they have no control, which is not easy for anybody to handle. Sometimes I have to care more for the parents than the child.
My pediatric ICU admits newborns to 21 years of age (yes, I know that seems weird). How I approach my patient depends on the age. Babies just want to be held, swaddled, fed and changed so you cannot really have a problem caring for them if you do those things. Most toddlers on the other hand, are afraid of EVERYTHING. They start crying from the second you walk in the room because you are not their parents and seem scary. Giving them toys or playing with them can sometimes make them warm up to you. School-age children can be shy but once they open up, they love to talk, play and watch movies. Adolescents/teenagers can be tricky because they are trying to gain their independence and learn about themselves. When they have to follow our rules that they don’t like, they can get angry. They also are self-conscious of their growing bodies so we have to know to give them privacy. Knowing how a majority of children act at certain ages, can help you care for them and gain their trust.
Now, with all that being said, I am finally going to answer the common question “how do you work with children? That is so sad!”. A majority of the time, the children are not that sick. They come in for allergic reactions and need to be watched overnight. Or they come in for an asthma flare up and need some breathing treatments and oxygen for a few days before going home. Occasionally we do very sick kids who had some crazy medical problem or came in for a smaller problem and ended up becoming septic (whole body becomes taken over by the sickness). Majority of the problems that children have are respiratory related. Children can become very sick very quick but they are very resilient and can dramatically improve overnight. There has been many times that I have a kid who isn’t themselves, per their parents, and are very weak and look sick but when I come back in 12 hours, they are sitting up smiling at you and playing with their toys. Those are the cases that make you smile because getting to see that turn around in them is so rewarding.
I have always loved children and wanted to work with them. I often wondered throughout nursing school if I would be able to work with them because I have never seen them really sick. Once I started working on my unit, I realized how much I love it. Now do I love seeing kids sick and on ventilators? Absolutely not, but I use my love for them to drive me to do all I can to help them get better ASAP. Some times I randomly will tear up while watching a child and parent cry while getting an IV or blood drawn but I try not to let myself get too attached to my patients. That does not mean that I don’t wonder about them when they leave and wonder months later how they are doing. I know that not seeing them means that they are doing good and that I did my part in helping them go home healthier.
My job can be so physically and mentally demanding some days that I almost fall asleep on the drive home. Some nights seem like there will be no end and that there is no possible way you can get all of your stuff done before 0700. And some nights you forget that you haven’t eaten since 6pm the night before or that you haven’t peed since you clocked in but all of that is forgotten the parents thank me for caring or when a child gives me a card with their hand print on it, saying thank you.
To all the past and future pediatric patients and their families, us pediatric nurses care about you. Whether or not you or your parents believe it, all of you make an impact on us and teach us something new every shift. Our job, just like all other areas of nursing, is not easy but seeing our patients smiling as they walk out our doors makes all the tough nights worth it. And that’s what being a Pediatric ICU nurse is really like.