Pediatric Nursing: Interview with Emma Sandhu, RN, BSN
Forming a special bond with young patients and their families
Emma Sandhu, RN, BSN
Pediatric ICU Charge Nurse
Children’s Hospital of Orange County (CHOC) Mission Hospital
What do you enjoy most about working in pediatrics?
Working with the entire family as a unit. We may physically care for children, but our jobs touch the lives of the entire family. Moms, dads, siblings, even grandparents and extended family.
What do you like least?
When a child has been abused or neglected.
What advice would you give to nurses considering this specialty?
You cannot be afraid to talk to, play with, hug and interact with your patient and their family. A pediatric nurse needs to be creative in his or her approach to each patient as an individual, and be aware of the impact that your actions can have on their perception of hospitals and illness.
Have you had any special patients or experiences you care to share with our readers that would illustrate what it's like to be a pediatric nurse?
I could talk for hours about the amazing families that I have met along my way as a PICU nurse! I absolutely love to take care of children of all ages but many of the patients that stand out to me have been teenagers. It is such a fragile age for children, especially when struggling for independence and acceptance at such a vulnerable time.
When I was first out of nursing school, I took care of a teenage boy that I will never forget. He was suffering from an illness that destroyed his lungs and he needed to be on a ventilator. He was scared and isolated from his friends due to being in the ICU and being so sick.
I remember working nights and not only providing him with the nursing care that he needed, but finding the college basketball playoffs on TV and watching it with him one night before he went to sleep. He had the biggest smile on his face from watching that game with his "Nurse Emma.”
He died on Easter Sunday, right after "March Madness.” I think of him and his family every single Easter. He was a remarkable young man.
Recently, I took care of a young man who had suffered a severe traumatic brain injury. He was a normal teenage boy who had an accident and was now fighting for his life in the ICU. Even though he could not say a word or even move his finger, you could just feel his strength and determination. His family was very dedicated to him and his recovery.
As the weeks went by and he started to wake up, we were amazed at his strength and acceptance of his injury. He worked so hard and never once complained. He had a job to do — to get better — and he did it! To see that young man beat all of the odds and walk out of our ICU was a day that I will never forget.
Zulema Vega, RN
Childrens Hospital of Los Angeles
How long have you worked at Childrens, and what did you do prior to your current position?
I’ve been there for nearly six years. I worked with the American Red Cross for a few months after graduation, but I wanted the acute care experience so I was hired directly into “6 North,” a 30-bed blending unit with both med/surg and rehab patients.
How did you manage to get hired as a pediatric nurse right out of nursing school?
I did a pediatric nurse residency at Childrens, and that’s something I’m really proud of having done. I had five months of working one-on-one with an experienced nurse, as well as classroom instruction and time on the unit. Little kids can be so intimidating — they seem so fragile. The residency gave me the skills I needed to be a good nurse and a safe nurse.
Is it difficult to get into a residency program?
Every year is different, but it has become very competitive.
What brought you into pediatrics?
During nursing school my pedi rotation was short, but it was one of the most enjoyable ones that I had. I was leaning towards pediatrics and I
wasn’t sure I could really do it until I found the residency program.
What fuels your passion for your work?
Pediatrics is truly rewarding in that we have kids on the unit who often have chronic debilitating conditions — from cancer to autoimmune diseases — or traumatic injuries, and they always find a way to smile and play no matter how tough it gets. Kids are so resilient.
Sometimes patients will come into our unit on a gurney, and they’re weak with multiple cognitive and functional deficits and at their worst. They’re often with us for months. To see our patients progress and show measurable improvement is extremely rewarding. The bonds we form not only with our patients but with the families are very special.
What are some of the challenges of your work?
It’s difficult to just be a nurse and not get attached and take things to heart because I’m still human. Sometimes I have to take a breather, step aside and get my feelings together because we see things that are hard to witness. We’re with people in the toughest times of their lives, and as a mom myself, it’s hard to not feel for the parents.
Any final thoughts to share?
Nursing is continual learning and pediatrics is fulfilling and special. You never stop learning and growing. I enjoy my job. Some days are tougher than others, but I couldn’t picture myself doing anything else!
Cindy Lewis, RN, MS, CNS
Clinical Nurse Specialist
Medical Rose Unit, Rady Children’s Hospital, San Diego County
What is your career history as a nurse?
I have been a nurse since 1977. After receiving my BSN from the University of Delaware I went to work at Children’s Hospital of Pittsburgh. I was commissioned as a Navy nurse in 1978 and worked in the pediatrics unit of Balboa Naval Hospital in San Diego. I was also assigned to an adult ICU at Balboa. I came to work for Rady’s in 1984 and have been there ever since. Rady’s has given me the opportunity to continue working with the patient population I love for the last 26 years.
What attracts you to pediatrics and keeps you focused on that specialty?
What has really kept me in pediatrics are the children and their families. We practice family-centered care at Rady’s. If parents are going to go home and manage their children, they need to know how to do it well. I love the educational aspect as much as the clinical practice and I love involving the families in what I do. We truly employ a multidisciplinary approach.
Can you say more about the children and families you work with?
We see a lot of stressed families who have been affected by divorce, the economy, and their children’s illness. We have great social work support, a Ronald McDonald House, therapeutic play programs, and special programs for siblings on the Hematology floor. We have programs available every day that allow the patients to get better, both physically and mentally, before we send them on their way.
Sometimes families and patients want something different than what I or their medical team might want. Sometimes their life is limited, and we can’t change that, but we can help them achieve their goals, if they are realistic. Diabetic children get sick when they do not manage their disease effectively. We get them back on track medically and allow them to return to their normal life. They can go to school, be with their friends and family, and perform their normal activities. If we can keep them out of ICU through good education and support, then that is a success!
Are there certain patients’ stories that have been particularly moving for you?
Awhile back, we had a patient with cystic fibrosis whose wish was to live through the Christmas holiday season. We were able to arrange a private room for this young child and we brought in decorations and a tree. She was able to have Christmas in her room with her family. Her survival through the holiday season was possible because that was her goal, and we were glad we could help her achieve it.
Recently we had a patient with a seizure disorder come onto our unit. This child had a service dog, and we were able to draft new regulations allowing service animals to be accommodated. The presence of the service dog increased the child’s comfort level while receiving care here on the medical unit. A comfortable patient heals faster. This is an example of how we deliver family- centered care.
Another child wants to live long enough to go home and celebrate her Quinceañera (a Latin American “sweet fifteen” celebration). We’ll try to make that happen because it is important to this patient and her family.
The staff gets very attached to these patients and we are very pleased that our efforts make such a difference, but it is heartbreaking to see the courage and determination these young patients use to face life’s greatest challenges.
What advice do you have for nurses desiring to enter into the field of pediatrics?
Follow your passion. If you love pediatrics, then pursue it and do not give up! It can be hard to get your foot in the door of this specialty as a brand new nurse. While in school, seek out a pediatrics preceptor opportunity, or become a nursing assistant in a pediatric facility in the summer or during a semester. This not only proves to yourself that pediatrics truly is your passion, but it helps the facility to observe you at work. Our hospital wants to see that you did something above and beyond your school of nursing.
Our facility has a residency program for new nurses, but this past year there were 15 positions and 550 applications. The
competition is tough but there are positions for nurses who are passionate about the practice of pediatric medicine.
Are there any special certifications that you recommend?
The most important thing is to build up your clinical skills. One of the ways to do this is to become a Certified Pediatric Nurse. There are other special certifications as well that can enhance your clinical abilities.
Also I would definitely recommend looking into obtaining an advanced degree in nursing. The nursing profession is changing fast and a master’s degree can give you the skills to help deal with the changes. I am particularly passionate about being a Clinical Nurse Specialist!
PEDIATRIC NURSING OVERVIEW
Nurses who choose to specialize in pediatrics can be employed in a wide variety of settings, including physician offices, Pediatric Intensive Care Units (PICU), and pediatric specialty hospitals and facilities.
Due to the special physiological and psychological issues faced by children and teenagers, pediatric nurses must be conversant with the various stages of child development, as well as the issues pertaining to acute and chronic illness. Many pediatric nurses find their work highly rewarding, often citing the close relationships with both patients and their families as the reason.
After practicing for a period of time, many nurses working in pediatrics choose to pursue a special exam to earn the title of Certified Pediatric Nurse (CPN). Other specialty certifications are available, including Pediatric Advanced Life Support (PALS).
According to recent data, the median annual salary for a pediatric staff nurse is $62,527, with nurse practitioners earning approximately $20,000 more per year than RNs.
The demand for pediatric nurses is expected to continue to grow for the foreseeable future. This particular specialty is seen by some as significantly difficult for new grads to enter directly from nursing school. Internships and special integration programs can increase a new graduate’s chances of breaking into the field.
Pediatric Nursing Certification Board: www.pncb.org
Journal of Pediatric Nursing: www.pediatricnursing.org
Society of Pediatric Nurses: www.pedsnurses.org
National Association of Pediatric Nurse Practitioners: www.napnap.org
American Pediatric Surgical Nurses Association: www.apsna.org
Academy of Neonatal Nursing: www.academyonline.org
Association of Pediatric Gastroenterology and Nutrition Nurses: www.apgnn.org
To earn the title of Certified Pediatric Nurse (CPN), visit the website of the Pediatric Nursing Certification Board (www.pncb.org)
Pediatric Advanced Life Support (PALS) certification can be obtained through a variety of organizations, including the
American Heart Association (www.americanheart.org), the American Medical Resource Institute (www.aclsonline.us), among many others.
Emergency Nurse Pediatric Course (ENPC) can be obtained through the Emergency Nurse
Keith Carlson, RN, BSN, is a registered nurse, writer and blogger. He writes for a variety of nursing and health websites, and has been included in several nonfiction nursing books by Kaplan Publishing. He is editorial contributor to BlackDoctor.org. His own blog can be found at digitaldoorway.blogspot.com.
This article is from workingnurse.com.