By Michael Burke
As nursing students in the pediatric clinical setting, the character and values we display are crucial to not only our own growth, but also to the well-being of our patients. We all understand that the “student” label is often correlated with inexperience, and can lead to feelings of uncertainty and apprehension from patients. In the pediatric setting, hearing “student nurse” can add an extra level of anxiety for parents whose vulnerable, sick children are at risk. While parents may be wary of having students as caregivers for their children, there are several ways to help put them at ease and give confidence to both parties. In the pediatric setting parents are often exponentially more nervous than the patients themselves, but through positive practice values and confidence, the student nurse has the ability to truly make a difference when it comes to providing the best family and patient centered care possible.
According to Ruhl, Golub, Santa-Donato, Cockey, and Bingham (2016), nurses who give care integrate six core values into their practice including compassion, engagement, integrity, courage, humility, and wisdom. During our time as students in the pediatric clinical, I found that of these six core values, integrity served me the best and helped me grow the most when it came to family centered care. Integrity is something that is valued in all facets of life, but is expected in the nursing field. It is something that nurses pride themselves on not only because of the types of people who pursue nursing, but also because it can have a very positive influence on patients and families. Integrity is shown through honesty, respect, and judgment-free care and the nurse with integrity will stand up for the patient and family even while risking criticism and/or distain (Ruhl et al., 2016).
On the final clinical day of our pediatric rotation, I was assigned to a 42-day-old male patient who had presented one day earlier in respiratory distress, which was later determined to be a symptom of positive metapneumovirus. When I first entered the room with my clinical instructor, the introductions revealed that the patient’s mother was also a nurse, but had no experience with pediatrics and was understandably very concerned about her son. As a student in this situation, I could tell that the mother was instantly uncomfortable with my presence, but the clinical instructor did a great job of integrating me into the conversation and into the patient’s care. Weighing only 3.18kg with a respiratory infection, the patient was rather unstable throughout the shift, often fluctuating from low 90’s O2 Sat down to the low 80’s at some points even with supplemental 0.2L/min O2 by nasal cannula. The patient was prescribed PRN nebulizers, corticosteroids, and suctioning for these situations and with busy nurses and a busy clinical instructor; it was my responsibility to be on top of the patient’s status. Over the course of the shift it was often me alone with the patient and the mother, and from her perspective, I can imagine her hesitant feelings about this, especially considering her profession. However, through use of the core values, most notably integrity, I was able to gain her trust over the course of the shift. If there was something that she was more comfortable having the primary nurse do instead of me, I showed understanding and alerted the nurse. If she had a question and I did not know the answer, I would find the primary nurse or my instructor in order to find out. If I did know the answer I would simply and confidently respond. I could tell that her comfort level increased over time and by the end of the shift, she trusted my judgment enough to leave her son in my care while she took a dinner break. As a student, the important thing was not to know everything; the important thing was that I had the judgment and honesty to know my limits and ask for help when needed.
Ruhl C., Gulab Z., Santa-Donato A., Cockey D. C., Bingham D. (April/May, 2016). Providing nursing care women and babies deserve. Nursing for Women’s Health Journal, 20(2), 129-133
Michael Burke was born in Boston and raised in Carlisle, MA by his parents Kate and Jim. He attended Concord-Carlisle High School and went on to earn a BA in Anthropology and a minor in Journalism from The George Washington University in Washington DC, where he also served as captain of the division 1 men’s soccer team. Currently a student nurse in his final semester at MGH Institute of Health Professions, Mike hopes to continue to progress as a student and future nurse by providing the best care possible to his patients.