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Getting Alternative Pediatric Experiences

Published December 3, 2012 10:45 AM by Frank Visco

I've been logging 12-hour shifts for my pediatrics rotation, and it's been a nice experience thus far. As with many clinicals, there has been a lot of downtime for us students, and so there's been a lot of playing games with kids and counseling parents. However, I recently got the opportunity to get some alternate experiences off the floor, spending half a shift shadowing a nurse in the emergency room (ER) and half doing the same in the critical care unit (CCU).

During clinical, I've gotten used to getting assigned one or two patients and then learning as much as I can about their situation so that I can manage their care. The ER is a totally different beast. I was there for five hours, and in that time, roughly two-dozen patients came through the six-room annex we were covering. It was a lot less about case management, and a lot more about getting in, doing a particular task (admitting assessment, medication administration, placing an IV, nasal suctioning, discharging patients, etc.), and moving on to the next job. Although one of my favorite aspects of nursing has been the interpersonal, therapeutic management of patients, I can't deny that I found the increased pace of the ER to be exciting and alluring.

CCU was at the opposite end of the spectrum, as it featured advanced care management. In the CCU, each nurse is responsible for only one or two patients, because the patients require so much constant, hands-on attention. During my time in the CCU, I got to help care for children recovering from surgeries related to coarctation of the aorta and tetralogy of fallot, and even got my first experience with high-frequency oscillatory ventilation (HFOV), an advanced type of mechanical ventilation that helps
prevent lung injury that can be associated with more conventional modalities. HFOV maintains high respiratory rates that result in 210 to 900 breaths per minute (bpm), depending on the hertz setting. My patient was experiencing 540 bpm, which resulted in a noticeable physical wiggle and made auscultation of the bowel, lung and heart sounds impossible. It was pretty surreal, as I hadn't realized so many bpm were even possible, little lone medically beneficial.

Overall, I've greatly enjoyed my pediatric rotation, but I especially enjoyed these alternative experiences. I'm just a few weeks away from finishing up the semester, and when I do, I'll have just three semesters left in nursing school. At this time next year, I'll be finishing my program, studying for NCLEX, and searching for nursing jobs. That time will come even quicker than I can imagine, and when it is, I know I'll be extra grateful for experiences like the ones I had in the ER and CCU.


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