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Head to head: Emergency Department Nurse vs. Paediatric Intensive Care Nurse

Expectation: Cute babies.

Reality: A months-old baby receive CPR or tracheostomy (a procedure which cuts open his windpipe.

Two nurses told their story.

FN: What does a typical day look like for each of you?

Emergency Department Nurse: “I don’t make a plan for the day because I could get ten – at a minimum – very different patients at any time in my allocated area. It’s quite hectic. I have a ‘Get them in and get them out’ strategy.”

Paediatric Intensive Care Unit Nurse: “but it’s a bit different for me I’ll have my set one or two patients that I know will be with me all day.”

FN: What did you find surprising when you first started out as a paediatric nurse?

Paediatric Intensive Care Unit Nurse: I found dealing with parents difficult as I’m relatively young. Trying to gain their trust when you don’t have kids of your own is hard. You might tell them to do something and they might not take you seriously as they assume you’re inexperienced.

FN: How are the patients different in Paediatrics?

Paediatric Intensive Care Unit Nurse: There was a little boy in the PICU who came in with a virus and ended up getting an infection of the heart which later migrated to other parts of his body. He needed CPR, a tracheostomy; the whole nine yards. He very nearly died before he was placed on a machine that did the work for his heart and lungs. He didn’t have a good prognosis and they almost gave up on him a few times as he was only a few months old.

The cardiac team noticed he had bad cardiac function – it was something ridiculous like 10 per cent – so even if he did make it through, he’d need a heart transplant which could involve further complications. One day he started getting better. It was a miracle. He eventually reached full cardiac function and no one knows how it was even possible.

His parents took him home a couple months ago and our whole unit love him. He’s our miracle baby. But it can be hard when they’re that little.

“Trying to gain their trust when you don’t have kids of your own is hard.”

Emergency Department Nurse: I looked after a baby with infant Acute Lymphoblastic Leukaemia (ALL) when she was three-months old. The family had two other children and lived four hours away. The baby was in hospital for about 11 months and did not leave once. It was really tough on them but they were the most amazing family.

I got to be there for the whole journey of treatment and support. The baby ended up being fine and her mum sent her photos of her going to school and updated us on her life. It was really nice to know I’d made an impact on that family and got to see this baby, who had such a rough start, lead a normal and healthy life.

 FN: Are night shifts compulsory? How do you manage these?

Emergency Department Nurse: Pretty much. Ninety-nine per cent of nursing jobs are shift work and therefore have night shifts. I don’t really like night shifts. It’s hard as you have to think as you would at 10am on a normal weekday. But at 4’oclock in the morning, you’re bound to have less cognitive function, so it’s rough.

 FN: How did you decide on your career?

Emergency Department Nurse: I decided in high school that I wanted to work in a hospital. I liked working in teams and with people and wasn’t really phased by blood or anything so I thought, “Why not be a nurse?”.

Paediatric Intensive Care Unit Nurse: I wasn’t as sure. I’m kind of lucky I enjoyed it when I came out of Uni! As for paediatrics, I did a practical lesson as a student on a paediatric ward and that was the first time I felt like everything made sense to me. You’ve got to trust your gut.

FN: What career hurdle/s have you had to jump?

Emergency Department Nurse: I was pretty lucky. I knew it was hard to get into Westmead Children’s Hospital so I enrolled in a third-year undergraduate program (I applied directly to Westmead. It had no affiliation with uni and the only prerequisite was that you just had to be in third and final year) where I could do most things apart from give medication – just shy of a registered nurse – and I worked at Westmead doing that. It gave me a better chance to get a job, especially in the Paediatric ICU, as Westmead only took two recent graduates.

Paediatric Intensive Care Unit Nurse: It’s difficult to get into paediatrics because there aren’t a lot of paediatric hospitals in Australia. It’s quite selective so you need to do reasonably well in Uni then interview very well. Another hurdle for me was that I didn’t have any nephews or nieces so I found the simpler skills hard i.e. bathing, feeding and burping babies. Those things are difficult when you have no experience. You pick them up as you go though.

FN: What kind of person is suited to a career as a paediatric nurse?

Paediatric Intensive Care Unit Nurse: You have to be able to be comfortable around kids and be patient with them. And the parents.

Emergency Department Nurse: Yeah. And be creative I think. You can’t be set in your ways. If one strategy works with one kid, it might not work with another. You also need to learn different ways to make them comfortable about being in hospital. That’s true with the parents too.

You also need a Bachelor of Nursing after completing the Year 12 exams of course!

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