Johnson & Johnson Notes on NursingGetting Real: Today’s Nurse

A Conversation with a New Pediatric Nurse

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"I believe that nursing is a field that doesn’t completely click until you practice it — no matter how much studying and reading you do. In school you learn the textbook, but in practice, no patient is 'textbook.' You realize that your patients are human, and they have an entirely different range of needs and personalities that should be considered in your care." —Kimberly Appelbaum, RN

Jumping head first into pediatric nursing can be both exciting and scary. In order to help those looking to go into this popular career path feel more at ease, we sat down with Kimberly Appelbaum, RN, a pediatric nurse at Children's Healthcare of Atlanta in Atlanta, Ga. to tell us about how she has found her way during her first four months as a new nurse.

NN
What are the three most important things that you’ve learned in your four months as a nurse?
Kimberly

One of the most important things I have learned is that it’s okay, and normal even, to feel overwhelmed when transitioning as a new graduate nurse. It’s important to remember that you have the knowledge and the skills, it just takes time to adapt them to your new environment. That being said, I have also learned to become comfortable asking for help and that it is okay to do so. As a new grad, you are not expected to know everything or to be a perfect nurse. Take advantage of the wealth of knowledge your colleagues have to offer. Above all, the most important thing I have learned is that every patient is unique. In school you learn what interventions to apply to specific diagnoses. In practice you learn how to tailor your care to the patient’s needs.

NN
What is the biggest difference between being a pediatric nurse and learning about pediatrics in nursing school?
Kimberly

I believe that nursing is a field that doesn’t completely click until you practice it - no matter how much studying and reading you do. In school you learn the textbook, but in practice, no patient is “textbook." You realize that your patients are human, and they have an entirely different range of needs and personalities that should be considered in your care.

NN
Why did you pursue a pediatric nursing career?
Kimberly

I have always had an interest in working with children, but it didn’t fully click until I began volunteering on a pediatric hematology/oncology floor. Children can be amazingly resilient, even in what we may think are the worst of circumstances. When kids are sick, they want to get better, and they want to play and lead normal lives. Blowing bubbles with a patient and seeing them smile is so incredibly rewarding.

NN
Did you feel prepared to begin to care for patients?
Kimberly

I have been told many times that it can take a year for new nurses to feel comfortable in their practice. After completing my orientation, I did feel prepared caring for patients on my own, but I also knew that there are days when I wouldn’t feel prepared. Some days I look at my assignment and see a diagnosis I have never seen before. Being prepared doesn’t mean knowing everything, but instead it can mean using your resources effectively. Look up your patient and your meds, read the progress notes, look up policies, ask your colleagues for help. You can’t be 100 percent prepared for everything. Even experienced nurses have to look things up. Being prepared in nursing means knowing how to use your resources effectively.

NN
What do you think students need to know about pediatric nursing?
Kimberly

The most important thing to know about pediatric nursing is that kids are not tiny adults, and should not be treated as such. Their symptoms manifest differently, and they respond to treatments differently than adults. They can even vary across different age ranges. Pediatric nursing care is very specialized, and varies from one patient to the next.

NN
Who is your nurse mentor and why is it so important to identify a mentor to help guide you in your first stages as a nurse?
Kimberly

Firstly, I recommend that new grads seek out positions that offer nurse residency programs. Often these combine classes with an orientation period where you are paired with an experienced nurse. My preceptor was an invaluable resource when I first started. She helped me adjust to the flow of the unit and served as a resource for any questions I had. A mentor can help you adjust both at work and outside of work, with things such as work/life balance, how to give a specific medication, or how to prepare for a night shift. Trust me, it is so valuable to have at least one person you feel comfortable asking questions to in your first couple of months.

NN
What was the most valuable class you took in college?
Kimberly

Despite what I said earlier about children and adults being completely different patients, the most valuable class I took was medical surgical nursing. Med/surg, as we call it, permeates all fields of nursing, and provides a base knowledge for most patients you may come across. Once you have the basics down, you can tweak your care to fit the patient’s needs.

NN
How do you “keep learning” as a nurse, now that you are no longer a student? Why is it important for nurses to stay in the “student” mindset of learning about new innovations, trends or technology?
Kimberly

In your first year it is nearly impossible to stop learning. In fact, it can be exhausting having new policies and procedures thrown at you all the time. Choosing nursing means choosing a commitment to lifelong learning, for your benefit, but also for the safety of the patient. The medical field changes rapidly and new products come out all the time, so it is important to stay knowledgeable about new advancements in your field. In my opinion, this is an important question to ask during your interview. Ask, “What opportunities will you provide to advance my knowledge and practice as a new nurse?” Read your emails and use your nurse educators as a resource. Stay up to date with your practice.

NN
What are the three most important things you think student nurses and new nurses need to know?
Kimberly

As I mentioned before, it’s important to recognize that you won’t be a perfect nurse when you start, and no one expects that from you. Always ask for help and know your limitations. If you aren’t comfortable with something, it’s always better to ask for help than to put the patient at risk. Lastly, take time for yourself outside of work. Transitioning to a nursing career takes a lot out of you physically, mentally, and emotionally. Find ways to relax on your off days and take time for things you like to do (and probably didn’t have time for in nursing school).

NN
Nursing can be emotionally demanding. How do you maintain your energy and a positive perspective?
Kimberly

Positive energy is so important in pediatrics. Children read faces really well, so they know if you are having a bad day. It is important to gain the trust of your patients, especially in pediatrics, where kids are placed in strange and scary new environments. Every day when I drive into work I pass a sign that says “Today you will make a difference in the life of a child." That is the outlook I bring to work with me every day.

To learn more about pediatric nursing, visit www.DiscoverNursing.com

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