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Pediatric ER Nursing

Pint-Sized Patients Pile On The Rewards…and Stress.
Forget what you’ve seen on TV. That high-intensity, fast paced scene, where everyone is running around yelling “STAT!” or “Bag ’Em!” is an entirely different world than the one described by Pediatric ER nurse, Elizabeth Amplo.

Elizabeth started her career as a Pediatric ER nurse two years ago at a hospital in Trenton, NJ. Facing burnout after working eight years as NICU nurse, Elizabeth explains, “I wanted a position where my high acuity for treating young patients would still be warranted, but I didn’t want to deal with the serious emotional attachment that came with working in the neonatal unit. I had heard of pediatric ERs and thought it would be a perfect direction to take my career. I was right.”

Listen to Your Heart. Follow Your Gut.
As for how Elizabeth found her current position, she says it was part luck, part who you know. In essence, it just kind of fell into her lap. “I happened to have a friend who went to a hospital where they were starting up a pediatric ER. When it was fully operational she gave me a call, told me to come over and I went running,” Elizabeth says.

Elizabeth’s intuition served her well. She says the ped ER is an intense place to work but it doesn’t cross the personal line. “You stabilize a child and you send them on their way to received specialized care. In the NICU you treat the same patient often for long periods of time. I found it practically impossible not to grow close with them and their families and that was very draining. Now I still feel the joy of taking care of patients who, for the most part, can’t take care of themselves,” Elizabeth explains.

Small Patients Carry Big Issues.
Although serious patients usually move on to specialized units, a majority of the patients in the ped ER are treated then sent home and many are repeat visitors. Elizabeth says unfortunately too many parents treat the ER as a clinic rather than a place to receive emergency care.

“I’ll see the same patients over and over. Often it’s because of chronic conditions such as Asthma or Diabetes. “The toughest challenge I face is educating parents on what’s going to make their child healthy,” states Elizabeth. “I seriously think that if I beat it into their heads…they still wouldn’t get it. If a child with asthma is in a house with a smoker he or she is not going to get better. If a child has diabetes, he or she has to follow a strict diet to keep their blood sugar under control. I tell the same faces the same simple instructions time and time again. I’ll never give up though, because one day the light bulb will go on and they’ll get it!”

When it comes to handling children you are never treating just the patient. You’re treating everyone who is responsible for that child — parents, grandparents, aunts, uncles, even government and state agencies. “You always have some else making the decisions, and sometimes it’s the wrong decision but there’s nothing you can do about it,” Elizabeth shares. “You have to bite your tongue and respect their choice.”

Pediatric Nurses — Mind Readers?
Is it magic? A crystal ball? How do nurses know what’s wrong with a patient if he or she can’t tell them. Well Elizabeth says it’s not always easy. “You have to read the cues. It’s all eyes and ears…you have to really watch and listen to the patient. After a while, you start to recognize common signs.”

You have to stay focused, which is the reason why this job is both physically and mentally exhausting. You work long shifts and if you start to drift towards the end you might miss something. So you do whatever you have to do to keep your mind in the game — eat candy, drink coffee, get some fresh air.

If Not Me, Then Who?
Long shifts, working every other weekend and every other holiday, for patients who don’t know enough to thank you, can leave you wondering why you entered the field in the first place. Elizabeth says there are always times she second-guesses herself, but the feeling doesn’t last very long.

“My patients may not always verbally thank me, but when I see their smiling faces, I know I’ve done my job well. Any time I’m feeling defeated and ready to give up, I think about my patients.” Elizabeth reflects, “I say to myself, if I go, I’m leaving them high and dry. Who will take care of them if I don’t? Who will care about them as much as I do? That’s all I have to consider and that’s enough.”