My Specialty: Pediatric Nursing
Where little ones with big hearts meet life's ups and downs
What do you imagine pediatric nursing to be? Broken bones, colicky babies and preschoolers battling for their lives? Yes, it’s all of these. Yet it is so much more. You can be a pediatric nurse in an office, in a school, in an emergency room, even at a summer camp. There is tremendous variety, because children come in many distinct age groups and, to be sure, they are all over the place.
Fostering Support for New Parents
Connie O’Neill, RN, has a job most people don’t even know exists. She is a pediatric nurse who supervises the care of babies placed in foster care while they await adoption. After placement she helps the new family adjust to caring for the baby until the adoption is final — often six months to a year. During that time, she may be called on for all sorts of help, including moral support or feeding instructions. She keeps track of the baby’s progress, making sure development is on target.
Her agency, Holy Family Services, handles some special needs children; it is her job to be sure that the foster or adoptive parents understand the nature of the condition and how best to care for the child. Staff understanding is important, too, and she provides information to social workers who are supervising placement. When a child needs the attention of a specialist, she accompanies the baby to the appointment.
Much of O’Neill’s work is helping new parents adjust to their role, assuring them that while there may not be the instant bonding they anticipated, in time they will form the family they dreamed of for so long. “Walking along with them,” is the way she sees the process. Don’t forget, adoptive parents have a few days to get used to the idea of a particular baby — not the customary nine months. Initially, “Some say they feel like babysitters rather than mothers and fathers,” O’Neill says. And that is where her specialty certificates come in handy.
One technique she uses is infant massage, a method of therapeutic touching known to help relieve stress in both the baby and the parent. It also helps establish the emotional ties needed to form a successful adoption.
In many cases, new parents prefer to talk to her rather than discuss uncertainties with the pediatrician. She is on call for these parents to help work through any rough patches. Like all nurses, pediatric or otherwise, she does a good amount of teaching, including infant management and car seat safety. While a new graduate would be able to handle the technical aspects of this job, most insecure new parents appreciate the breadth of experience O’Neill brings to the job.
Giving Kids With Cancer a Chance
Dorothy Rider, RN, CPON, does a completely different kind of pediatric nursing. She works in oncology at Children’s Hospital of Orange County; and before you think it is all about dying kids, think again. As Rider is quick to point out, “That is not at the heart of what we do, not what drives us.” Instead, it’s about helping every child get better. Her own son Reed is a cancer survivor; it was his illness that propelled her into child oncology nursing. “Every kid has a chance,” she says, and she works hard every day to meet her goal: that every child feels as though he or she is the only patient of the day.
Rider acknowledges that some end-of-life care comes into her work. Still, she says, most children live every moment to the fullest and, currently, most survive. Her area of pediatric nursing is a fast-paced specialty, and you need to keep up both physically and mentally. In pediatric oncology, just as in adult, medical advances are constant, and it takes a keen interest in medicine to stay current.
Families are part of the patient unit, so the ability to help them is critical. For this Rider draws on her years as a traveling nurse, with new assignments every three months all over the country. Most important, she says, are good basic nursing skills, which do not change from location to location or age group to age group.
At Los Robles Hospital and Medical Center in Thousand Oaks, Kelly Schneider, RN, does yet another type of pediatric nursing — still hospital-based, but in a community setting with a small nine-bed pediatric unit. Her patients fall victim to the more ordinary hurdles of childhood. Some youngsters with chronic conditions like asthma do come in repeatedly, but most of the children are in overall good health. Their admissions arise from one-time incidents like broken bones or dehydration from a particularly bad flu. Usually they have no underlying disease to complicate the recovery, and an overnight stay or one that lasts a few days makes them good to go.
Seasons greatly affect what comes Schneider’s way. October through April sees an increase in respiratory viruses or pneumonia, although vaccines have decreased these numbers; and summer brings in children who need elective surgery. It can be traumatic for them and their families, but most do not face the stress of serious illness. Plus, Los Robles Hospital has a “rooming in” policy that keeps families involved and helps children feel supported.
A significant amount of teaching goes on during family visits to educate parents on what long-term management will require in, say, the case of a child who is asthmatic or diabetic.
Schneider, like Rider, finds children to be wonderful patients, resilient and tough. Yes, they cry and fuss, but they also bounce right back. Children, she says, “see illness as a part of life, and they don’t carry all the baggage adults do.” Symptoms and treatments are just interruptions in the day.
It wasn’t always clear that Schneider would become a pediatric nurse. True, she always wanted to be a nurse, but due to family opposition she initially studied business. After a career as an internal auditor for an electronics manufacturer — a job that involved much travel — she took the plunge and went back to school.
In the way that it does, meeting the requirements took much longer than the frequently mentioned two years for an associate degree, even with all the prerequisites she had covered for a bachelor’s degree. Think how disappointed she must have been when, after her first year of clinical, she began to wonder if nursing was really for her. It just didn’t seem a good fit. Then, in her second year, she did her pediatric rotation and found her niche. The risk had been worth it.
Pediatrics is a nursing specialty you can start in as a new graduate. It also has a clear path to advance practice, with the choice of clinical nurse specialist and practitioner offered in many graduate schools. Certification is through the various specialty organizations, either by area of concentration or pediatrics in general.
Take Kelly Schneider’s advice: Try it. You will know soon enough whether it is for you or not. Of one thing, you can be sure. You won’t be able to fake it; the kids will figure you out right away.
Statistics From the Agency of Health Research and Quality (2006)
• Injuries are the leading cause of death in ages 1-24 in the U.S.
• The gender of the parent, child and physician affect a child’s participation during visits to the doctor.
• Children and adolescents account for 212 million ambulatory health care visits, including 49 million visits to hospital outpatient and emergency departments.
• Handlebars can cause major abdominal injuries in what appear to be minor bicycle falls.
• Skin infections in the 15-to-17-year-old age group accounted for 10,500 hospital admissions
• Stays for children are significantly shorter — an average of 3.7 days — and less expensive when compared with all hospitalizations.
• Circumcision is the most common procedure received by children in U.S. hospitals.
Elizabeth Hanink RN, BSN, PHN, is a freelance writer with extensive hospital and community-based nursing experience.