Journal Entry #2

Jadiam Lopez

MSN, Walden University


Dr. Mariah Morris


Nursing in general is a career of challenging an obstacle while still performing with a high level of professionalism. This scenario is undoubtedly the case as I entered my first clinical rotation in adolescent primary care. My strengths were IM injections, assessments, and speaking to parents. Many pediatric patients’ families get nervous when they first come in for their appointment. I try to make them feel comfortable and give them the chance to warm up to me and the environment around them. My weaknesses include communication with pediatric patients, gaining trust from pediatric patients as I tend to be for a lost of words or it may just be my nerves.

Childhood Leukemia

In this clinical rotation, we had a patient arrive with his mother who was 6-years-oldwith leukemia. If I remember correctly, he was very energetic and had the greatest smile, I thought he must be here for something simple like diarrhea or flu symptoms since that is what I have seen most as of late. I looked at his chart and my smile turned upside down, he had leukemia with an unknown prognosis.


So, most of the things that I found challenging were related to me maintaining my professionalism, gaining the trust of pediatric patients, and not letting my emotions get the best of me. I understood that once I let my emotions get the best of me and focus on only the child. Talking to the parents was very taxing because their health education was extremely limited. I did my best to explain to them the purpose of the medications, and the assessments we were doing and emphasized that we are doing our utmost to care for their child.


My preceptor is used to seeing sick children, so he was able to treat this just like any other visit while not getting emotionally attached. My preceptor spoke to the parents, and he also spoke to the child about happy topics which has the child smiling and laughing. Nevertheless, if I was to encounter another case like this one, I would do things a bit differently because simple actions like making the child feel comfortable can go a long way when caring for a terminally ill patient (Zisk et al.,2015).

Cultural difference

During my rotation, I had a bit of trouble making the parents of the child understand the nature of the disease and why the child might have acquired it. They had a firm belief and at times those beliefs became a barrier for the healthcare team to provide effective care and treatment.

The parents stated they gave up accepting that it is the will of God. Putting faith in God is ok but the parents gave up on the little time the child had, time that could be used to show their love for the child, make him amazingly comfortable and make meaningful memories, which could give meaning to the child’s life before death (Rempel et al.,2004).

The belief that someone put a curse on the child: This is quite common in Filipino culture, especially in rural areas where the health education of the people is extremely limited. I remember talking to the parents and they told me that when the child began showing symptoms, they bought him to see a "witch doctor" in hopes of curing him. In the back of my mind, I thought that what if back then they brought him immediately to the hospital. That could have been detected earlier and his life might have been different from today. At the end, I spoke to my preceptor about how to handle parents and very ill children and he advised it’s a fine line you have to feel the parents out as each case is different.


Rempel, G. R. (2004). Technological advances in pediatrics: Challenges for parents and nurses. Journal of Pediatric Nursing, 19(1), 13-24.

Zisk-Rony, R. Y., Lev, J., & Haviv, H. (2015). Nurses' report of in-hospital pediatric pain assessment: Examining challenges and perspectives. Pain Management Nursing, 16(2), 112-120.

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