Day in the Life of a Peds (Pediatric) Nurse

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Outline

Overview

The start of your shift- getting report from the off-going nurse
1. Get ALL the details
  1. Who are the caregivers with the child (parents, grandparents, foster parents)?
  2. What is the child’s general mood/anxiety level?
  3. Timeline of full hospital admission- not just the past 12 hours.
2. Do a bedside check with the off-going nurse.
  1. Things to check
    1. That the child is stable
    2. That the room and bed are safe for the child
    3. That the monitors are set to the correct parameters.
    4. That the IV is patent.
    5. That the fluids and medications infusing are correct.
    6. Are appropriate signs posted (infection control, special notices above the bed).
3. Get organized- plan your day
  1. Look at medications times, procedures, doctors orders
  2. Check medication room to make sure meds are available
  3. Talk to caregivers ASAP.
    1. Introduce yourself
    2. Let them know what the expect during your shift.
Assess your patients get a set of vital signs
1. Don’t delay with this even if the child is sleeping.
2. Be sensitive to tired families but always prioritize getting your eyes on your patients ASAP.
Medication administration
1. Med schedules are less predictable on pediatric units
  1. Fewer long-term prescriptions and home medications
  2. Stick to caregivers home routine
Patient care/ADLS
1. Parents usually provide this care to their child.
2. Nurses provide support and assistance
  1. Offer linens
  2. Help with baths/showers as needed.
Meal time
1. It’s always meal time on a peds unit!
2. Snacks always available
3. Formula and bottles are provided
4. Breastfeeding moms have access to breast pump and special refrigerator for milk
Procedures
1. Common
  1. Blood draw (usually done AM and as needed)
  2. IV’s (placed as needed, keep a close eye on these and reinforce dressings often!)
  3. NG tubes
  4. Catheterization
  5. Urine dip
2. Involve Child Life Specialist with all procedures
The end of your shift- handover to oncoming shift.
1. Prior to handover, one last final check on the patient and chat with caregivers
  1. Let them know you are going off shift. Also, tell them if you’ll be back the next day!
  2. Double check room, equipment.
  3. Check med room for meds for next shift
2. During handover
  1. Summary of day and patient status
  2. Highlight the care plan and any changes/updates to orders.
  3. Don’t forget to include the small details as well.
    1. Who is with the child
    2. What particular things seem to upset the child/family

Nursing Points

General

A typical day

0645 – arrive and find patient assignments for the day
1. Patient assignments
  1. Maria
    1. 3 yo female
    2. Admitted for Tonsillectomy & Adenoidectomy, post op day 1
  2. Jacob
    1. 9 yo male with cerebral palsy
    2. Admitted due to chronic constipation and fecal impaction, needs GI cleanout
  3. Vincent
    1. 2-week old male
    2. Admitted due to fever, undergoing septic work up to rule out meningitis and UTI
  4. Alex
    1. 16-year-old female with Cystic Fibrosis
    2. Admitted for antibiotics and “tune-up”
0700-0800
1. Get report from off-going nurse
2. Do bedside check
3. Check charts, get organized (if patients were stable at bedside check)
  1. Note medication times, lab results, procedures, order
4. Start assessments, get vital signs on all patients
5. Administer PRN acetaminophen to Maria
0800-0900
1. Administer scheduled IV antibiotics to Vincent
2. Talk with Alex about plan for the day
  1. Arrange for her to get a hospital pass to spend time with friends later
  2. Administer pancreatic enzymes
  3. Check PICC line dressing, flush PICC line
  4. Administer scheduled IV antibiotics
3. Document all assessments and vital signs.
4. Help Jacob’s mom with linen change and bed bath
0900-1000
1. Administer second scheduled IV antibiotic to Vincent
2. Chat with Vincent mom who is feeling anxious about breastfeeding
  1. Contact Lactation Consultant for support.
3. Total I’s & O’s for patients and prepare for morning rounds.
4. Call pharmacy requestion IV antibiotics for Alex and meds for GI clean out for Jacob.
5. Prepare for rounds with the providers.
6. Flush Vincent IV when antibiotics are complete.
1000-1100
1. Attend rounds with provider.
  1. Maria- discharge orders in place if she eats lunch
  2. Jacob- continue with GI clean out protocol
  3. Vincent- culture results will be back tomorrow at 2100 continue with antibiotics until then.
  4. Alex- has 7 more days left for Tune-Up. Provider aggrees to allow hospital pass for the afternoon.
2. Jacob pulled NG tube out. Speak to Child Life Specialist about plans to reinsert it.
3. Chat with RT while they administer Alex chest physiotherapy.
4. Flush Alex PICC line when antibiotics are complete.
1100-1200
1. Chat with Lactate Consultant about your conversation with Vincent’s mom this morning.
2. Spend time documenting.
3. Administer pancreatic enzymes to Alex.
4. Help give out lunches. Ring dietary to request high calorie diet for Alex.
5. Talk with Maria’s mom and dad, confirming that she can be discharged if she tolerates lunch.
6. Re-insert NG tube for Jacob with Child Life Specliast and another nurse. Confirm placement. Begin GI Clean out. Talk with mom about plan and importance of strict I’s & O’s. Bring extra linens, towels and supplies.
1200-1300
1. Start working on discharge paper work for Maria.
2. Check 1200 vital signs.
3. Notify provider that Vincent’s temp is elevated.
4. Administer acetaminophen to Vincent.
5. Check email and schedule some annual training.
6. Get handover from other nurse so they can go to lunch.
  1. Check on their patients
1300-1400
1. Discharge Maria
  1. Discontinue IV
  2. Provide discharge teaching
  3. Complete paperwork
  4. Escourt them out of hospital
2. Check on Vincent and Jacob.
  1. Help Jacob’s mom with linen change and diaper change.
3. Re-check Vincent temperature.
4. Give handover to other nurse and go to lunch.
1400-1500
1. Work on documentation
2. Administer scheduled IV antibiotics to Vincent.
3. Get report from ER nurse for new admission
  1. Tyler- 9 year old boy admitted with appendicitis. Going to surgery this evening.
4. Administer scheduled meds to Alex and discuss hospital pass.
1500-1600
1. Admit new patient (assessment, vitals, new admission paperwork, documentation)
2. Start pre-op check list.
3. Administer pain medicine to Tyler.
4. Administer scheduled IV antibiotics to Vincent.
5. Alex currently on hospital pass.
1600-1700
1. Check 1600 vital signs.
2. Call the OR nurse to give handover on Tyler.
3. Work on documentation
4. Administer scheduled medications to Jacob
1700-1800
1. Give handover to nurse, run to the lobby for a coffee.
2. Complete relevant items on pre-op checklist.
3. Give bedside handover to OR team collecting Tyler.
4. Help other nurse with IV placement in a 3 year old.
1800-1900
1. Alex completes chest physiotherapy and is ready to eat.
  1. Administer pancreatic enzymes.
2. Check medication room for meds for night shift.
3. Talk with Vincent’s mom about how she’s feeling. How is breastfeeding going?
4. Help Jacob’s mom with linen change.
5. Calculate I’s &O’s for patients.
6. Complete documentation for the shift.
1900-1920
1. Handover with oncoming nurse
2. Bedside checks.

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Transcript

Today we’re going talk about what a typical day as a looks like for a pediatric nurse!

So you come on shift and you get your patient assignment. Your patients are Maria, Jacob, Vincent, and Alex. Maria is a 3-year-old female who had her tonsils and adenoids removed yesterday. Jacob is a 9-year-old male how has cerebral palsy. He has chronic constipation and has had to come in for a GI cleanout. Vincent is a 2-week old male who has come in with a fever and is receiving antibiotics and waiting on culture results. Alex is a 16-year-old female with cystic fibrosis who has been admitted for a “tune-up”.

So you start your shift at 7am and you get handover and do your bedside checks. Then you get your assessment and vitals done.

8 am You quickly document and give Vincent his IV antibiotics. Alex is awake and talking about her hospital pass. You give her meds and check her PICC line. Then you answer a call bell and give Maria some pain medicine.

9 am Your patients are up and eating breakfast. You help with ADL’s and give Vincent his second round of antibiotics. Then it’s time to make some phone calls. You call pharmacy looking for meds, you call the lactation consultant for Vincent’s mom, then you call dietary to get high calorie meals for Alex.

10 am You get ready for rounds with the doctor and join in. You answer a call bell, Jacob pulled his NG tube out. You chat with the child life specialist about reinserting it.

11am You reinsert the NG tube. Calculate Jacob’s I’s & O’s and bring mom extra linens and supplies.

12pm You help with lunches and give meds. You start working Maria’s discharge paperwork and answer some emails. You get report from another nurse so they can go to lunch.

1pm You discharge Maria and discontinue her IV. Vincent has a fever. You give some prn medication and notify the provider.

2pm You give handover to another nurse so you can go to lunch. When you come back, you get report from an ER nurse about your new admission- Tyler, a 9 year old boy with appendicitis.

3pm Alex goes on hospital pass with friends. Tyler arrives from ER. You admit him and give him some pain meds.

4pm You ring the OR and give the nurse report on Tyler. And give scheduled medications to Jacob and chat with his mom for a bit.

5pm You give bedside handover to the transport team arrived to take Tyler to the OR, then help another nurse with a difficult IV in a very unhappy 3 year old.

6pm Alex returns in time for Chest PT before dinner. You calculate your patient’s I’s & O’s and finish up most of your documentation and give the last meds for the day.

Day in the Life of a Peds (Pediatric) Nurse

You're watching a preview. 300,000+ students are watching the full lesson.

Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Overview

Nursing Points

General

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Used by 300,000+ nursing students. 99.25% NCLEX pass rate.

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