Friday, September 15, 2006

Pediatricity

NewFNP feels that she is not alone in declaring that, for FNP students, pediatrics can be daunting. Kids have high fevers, they have weird rashes that may be viral or may be frigging measles. Who knows? What new NP has ever seen measles? What parent feels confident in the diagnosis of 'viral exanthem'?

Nonetheless, pediatric visits have turned into the highlights of newFNP's day. Why, just this week, newFNP had a five year old boy laugh and scream, "You're touching my penis!" during a regular old testical exam during a well-child check. You just don't get that kind of enthusiasm during the adult exam. A four year old boy this week told newFNP several times, "You're funny." And, damn it all, that kid is right. NewFNP was having a grand old time chatting up this four year old about school, his cousin, crying, Batman - a little sample of all things important.

For all the students, newFNP thought she would share some secrets to help overcome the fear of pediatrics for you and your patient.

1) This lesson is courtesy of Sunshine, a co-ed with whom newFNP studied. New FNP uses it without fail. Kids hate the ear exam, but looking for Dora or SpongeBob in a kid's ear will greatly facilitate the process. Sometimes newFNP tells the kid that she saw Dora running to the other ear and they graciously turn and offer the ear for examination. This tool is not limited to the ears, no sir. It works on the mouth too!

2) Making an amazed face upon cardiac auscultation is a wonderful tool to get kids interested in what's up. Of course, older kids can listen to their own hearts, but the young kids like to see that you think their body is working well.

3) Knowing when you don't have to do a full exam is important. Not every well child check needs to be a head-to-toe. If kids are scared and crying, newFNP lays off, especially if they are a regular patient. NewFNP explains her lame exam to the parent, letting them know that being scared is normal and that newFNP will provide a more thorough exam when the child is not screaming and kiding under the chair.

4) Tell parents to bring the kid back the next day if you're concerned. In newFNP's experience, parents don't appear too put out when it comes to their kids' health. You can also try obvious things like oral rehydration and fever management in the office. Duh.

"You're touching my penis!" Ah, good times.

2 comments:

Anonymous said...

First a confession: I am in love with NewFNP. Yep, in love. Albeit in an extremely long distance, never to be requited kind of way. The combination of obvious (though sometimes grudging) compassion and NO FUCKING BULLSHIT is completely irresistible. With that qualifier, and knowing nothing about the substance of your advice (not being in the health care field, myself) I bet it is of great use to your target audience, the graduates following you into the profession. I'm a big fan of the practical: do what works. I'm sure your trials and tribulations will make the path smoother for other newbies. And they're damn entertaining for the rest of us.

Nurse Practitioners Save Lives said...

At least the kid knew the correct term for his anatomy! HA HA! Great tips for the rest of us that will be joining your ranks!