Dawn Papandrea
Dawn Papandrea
March 27, 2015 - 4 min read

The Rewards and Trials of PICU Nursing

No one ever said that a nursing career was easy on the mind, body, or soul, but one specialization in particular – pediatric ICU (PICU) nursing – comes with a unique set of challenges. On the flipside, however, it’s hard to find a more rewarding career. Pediatric ICU nurses are often the saving grace in the midst of a family health crisis, helping young patients and their loved ones through physically and emotionally difficult times. With the right expertise and a caring nature to go along with it, PICU nurses can really impact a child’s hospital experience, and help aid in his or her recovery.

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Unfortunately, as with all aspects of nursing, illness, pain, and sometimes death is the outcome for some patients, and that can be especially tough to take when the patient is a child. If you’re considering becoming a PICU nurse, you should be aware of some of the emotional and physical tolls of the job, so you can determine if you have the right temperament to give it your all. Take a look at some of the workplace stressors that pediatric ICU nurses have to deal with on a daily basis to figure out if it’s a good career match for you.

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Sad Diagnoses

Children who wind up in the PICU usually have a serious condition, have experienced some sort of trauma, are facing a tough recovery after a complex surgery, or might be suffering from a chronic illness or disease. They might also be there because of social factors such as a drug overdose. What all of these possible conditions have in common is that they are frightening, even devastating, moments for not only the child, but for his or her parents and loved ones. And, you, as the health care professional have to do your best to keep your emotions in check, which can be difficult, especially if you are a parent yourself.

Ask yourself: Can I make health care decisions without letting emotions get in the way?

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Administering Patient Care to Kids

Not every adult is a good patient, for sure, but routine medical diagnostic exams or basic procedures like running an IV or changing bandages can be traumatic for small children; and sometimes these tests and treatments are painful. Still, you need the child to be still and calm in order to get through whatever it is you need to do. This is where your bedside manner skills come into play. Keeping your cool and using a kid-friendly approach can make all the difference.

Ask yourself: Are you able to administer patient care that might be painful or scary to the child without feeling guilty about it?

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Dealing with the Family

Labor and Delivery NurseAs a PICU nurse, you’ll spend a lot of time with your patients, sometimes only having one or two patients to care for during your entire shift. As such, it’s easy to become attached, and likely that you’ll get to know the family members who are visiting. This can work to your advantage, in which you can comfort the families and help educate them about the child’s condition. The more people working together to help the patient improve, the better. On the other hand, with stress levels running high, sometimes family members are difficult to deal with and may project their anger and sadness onto you and your staff. It’s important not to take any outbursts personally, but also know how to deal with them appropriately.

Ask yourself: Are you able to diffuse difficult situations and deal with a range of personalities?

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When Things Go Wrong

The nature of all nursing positions is that sometimes things go wrong. Sometimes a patient’s outcome is totally out of your control. And, sadly, some patients – even innocent children – may not make it. The death of a child can be particularly hard to deal with, as can delivering bad news to family members. If this is something that you deal with on a regular basis – especially if you’re in an oncology unit – you have to be able to leave the sadness of the day behind when you go home, or you will quickly burn out.

Ask yourself: Do I have strategies in place for coping with seeing suffering and death happen before my eyes?

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Beyond these aspects, there are some challenges that are common to all types nurses. For starters, it’s a physically demanding job in which you’re on your feet most of the time, and you have to stay mentally sharp through it all to ensure patients are cared for appropriately.

Of course, if you’re going into nursing, you are already aware of most of these challenges. For pediatric ICU nurses, however, workplace pressures can feel that much more intense. But then again, the feel-good moments that come from nursing a child back to good health, or telling a family that their child is going to be OK after a difficult experience can outweigh the negatives. There’s nothing more uplifting than knowing that a child is in good health because you did a great job. 

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