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Pediatrics in the Emergency Room - International Nurses Association

All personal stories are recounted by Susan, a retired nurse.

For many nurses, working in the emergency room is a job they love, except when it comes to children.Pediatrics can often be very difficult, and not just on the child and family, but for the nurses too.  

Grumpy Nurse

Hildy was the grumpiest nurse I’ve ever known. I had the pleasure of working with her my second year of nursing. Don’t get me wrong, she was kind enough to the patients, and an excellent head nurse. She knew exactly what to do and how to do it, I’ll give her that, but she was a gruff woman that was not very pleasant to those working under her. Hildy had no friends, she once told me she did not like people, only reptiles, to which I said ok and never asked again. One night the emergency room was short staffed and there was a 7-car accident on the highway. Hildy and I went to help out, and I saw a totally different head nurse that night. A 3-year-old little boy was admitted; his parents both in critical condition, and this little guy had a broken leg and several cuts that required sutures. I walked up to his room to assist Hildy, and without looking inside, I turned and walked away, knowing I had the wrong room. I head a woman in the room talking to a child, but I knew that could not be Hildy.  Well it was after all, but it was certainly not the gruff Hildy I knew, it was a kind gentle woman comforting a child.  When I did go in to help I was amazed, she had this screaming hysterical child comforted and even smiling. He was holding her hand, and when she tried to walk away he asked her not to leave him. After the child’s aunt arrived to be with him, and Hildy and I head back to our floor, as we were on the elevator I was just looking at her when she very sternly told me, “What happens in the ER stays in the ER, got it”. I did get it, but I also learned that even the medical professionals without the best bedside manner can be wonderful with pediatric patients, you never know.  

Related:  Reasons Why You Should be Proud to be a Nurse

Working with A Child in the Emergency Room

Most children that arrive in the emergency room are there with parents, and most don’t have serious medical issues. Colds, flu, and stomach virus’ are the most common reasons children visit the emergency department. When a child is accompanied by their parent, they are more at ease. The parent knows what to do to keep the child calm, and how-to sooth them after an injection or other procedure. There are occasions however that a parent may not be with the child.  An auto accident, or similar might mean the parent is receiving care themselves. In such a case, the child may be alone, and very frightened. The approach to working with a child in these situations is dependent on age.

Infant – 1 year of age:  at this age most babies can be calmed with someone holding them.  They are not as frightened of strangers, and will usually be receptive of attention from whomever offers it.  Talk calmly and be gentle, entertaining them as you treat them. Make sure diapers are changed, and that a bottle is available.

18 months – 3 years:  at this age the child knows you are a stranger, which only adds to the trauma of the situation.  Offer a drink, depending on the child’s condition, and when they are calm enough to listen, explain mommy or daddy is seeing their doctor, and they can see them soon. The child may grasp what you are saying and calm down, if not just continue reassuring them they will see mom and dad in a few minutes.  Remember not to jump into a procedure, even though they are young, explain what you are going to do, and ask them if you can listen to their heart, etc., and involve them, allowing them to listen as well.  

4 years – over:  at this age most children can comprehend what is going on, although they may still be very frightened and need to be consoled.

Related:  To Wear or Not to Wear: Scrubs in Public

Working with children in the emergency department can be difficult at times, but patience and sympathy for what the young patient is going through can make a big difference and ensure the little one’s experience in the hospital is not a terrible one.  

Related:  Skilled Registered Nurse, Certified Hospice Nurse and Certified Legal Nurse Consultant Lucinda Perkins, RN, will be Spotlighted in the Worldwide Leaders in Healthcare

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