Mathematical and assessment skills need to be mastered during this clinical rotation. By this time, you should have been to at least 2-3 other clinical settings and should be comfortable enough to perform a descent physical assessment. Two students may be assigned to one patient, depending on how large you clinical group is. Your group will also be on a specific floor or unit. For example, one particular children’s hospital has several units such as respiratory, neurological, orthopedic, and cardiology and the neonatal intensive care unit.
The emergency room specialty area will be very interesting and conducive to a great learning experience. The day probably won’t be as long as one of your regular clinical days that you spend on the floor but plan on being there at least 5 hours. It is fast paced and exciting. Most patients come in and they either get admitted to a unit in the hospital or stay in the emergency room until they are okay to get discharged home. Since the emergency room is fast paced, you may not get a chance to perform many procedures. You will be assigned to a nurse just like on the medical floors. Stay with nurse like your life depended on it. Things happen fast in the emergency room and you don’t want to miss a thing. You may even get a chance to start an IV on a pediatric patient. Some nurses may not let you touch any of the patients due to the risks of them being pediatrics patients. Observation may be the farthest a student will get in some of the pediatric specialty areas. Your clinical instructor will tell you what you are allowed to do in each facility.
The orthopedic surgery specialty area will most likely be observation only. You will see patients that will have surgeries for all aspects of the pediatric musculoskeletal system including fractures from injuries and deformities from birth. After seeing about 4-5 surgeries, they all start looking the same and boredom starts to set in, so hang in there. This are will also be very cold so wearing a long sleeve shirt underneath your school uniform may be a good idea.
The respiratory and cardiology floors will be about the same as far as the type of care you give. The respiratory unit will have children with pneumonia, H1N1, cystic fibrosis, asthma, and acute respiratory distress. A lot of the patients may be on contact and droplet precautions due to Respiratory Syncytial Virus (RSV). The cardiac floor will have pediatric patients with heart failure, congenital heart disease, and some diabetic patients. This unit will teach students a lot about electrocardiograms (EKG) rhythms and how the heart works with the rest of the organs.
The neonatal Intensive care unit (NICU) is the most sensitive area. Most students are instructed to stand in a particular area and observe. A lot of NICU nurses treat the babies like their own and guard them with their lives. The baby’s in this area are very sick and some may not live longer than a few months or days. The most common diagnosis students will see in the NICU are apnea, sepsis, HIV exposed infants, pulmonary hypertension, herpes simplex, and neonatal platelet disorders. You may not spend a lot of time in this area but it is very interesting. Some students are given a choice in which specialty area to attend. This is one of them that should not be missed.