Like I said in my mental health post, I am not going to go into my personal grievances related to this course in this post (you can read here if you’re interested in that). I will briefly go over how this course is laid out/general expectations/what we’re learning:
Schedule: 3 hour lecture each week with 10 hour clinical day on Saturday at a local children’s hospital
Tests: on the computer, 50 questions over 90 minutes. First test killed everyone and now we’re all considering how to change our study habits.
Instructors: Peds instructors/nurses are kind of snooty. They take themselves very seriously and I find that annoying. Even another nursing instructor pointed that out to our class so you can rest assured I don’t feel that way just because I’m a disgruntled, ignorant student.
Much of peds for nursing revolves around G&D (growth and development). Almost every test question incorporates that topic somehow. So not only are we learning about disease processes in children but we also have to consider the G&D implications when answering a question. For example:
A 15 year old patient admitted with cystic fibrosis states she is not going to take her medications, no matter “what they threaten me with!.” What is the most appropriate response for the nurse to say at this time?
- “I understand. We will find another way to control your symptoms.”
- “I would appreciate if you did not use that tone of voice with me. I am here to help.”
- “I understand this must be frustrating for you. What about your medications makes you not want to take them?”
- “You parents will not allow that.”
Number 3 is the best answer. Based on Erikson’s stages of development, an adolescent is searching for independence and is self-absorbed most of the time. They are very worried about appearance and social acceptance within their peer group. The nurse must consider the possibility that this patient isn’t compliant with her meds because she is embarrassed by her disease. The nurse knows the patient must take her meds (you know this because you understand the patho of CF), but simply stating that fact to a teen isn’t going to help. Offering a non-threatening response that allows the teen to express why she’s feeling the way she does is most helpful if the nurse hopes to intervene successfully.