Pediatric nursing

Pediatric nursing is the medical care of neonates and children up to adolescence, usually in an in-patient hospital or day-clinic. Pediatrics comes from the Greek words 'paedia' which means child, 'iatrike' which means physician.[1] 'Paediatrics' is the British/Australian spelling and 'pediatrics' is the United States spelling.

Overview

Direct nursing care

The main role of pediatric nurses is to administer directly procedures and medicines to children according to prescribed nursing care plans. Nurses also continually assess the patient by observing vital signs, and developing communication skills with children and family members and with medical teams. Being a support to children and their families is one component of direct nursing care. Awareness of the concerns of children and parents, being present physically at times of stress and implementing strategies to help children and family members cope are all part of the work.[2]

Neonatal Nursing

Neonatal nurses are registered nurses who specialise in working with these young, vulnerable patients. Neonatal nursing is a branch of health-care that mainly focuses on providing care and support for newborn babies who were born prematurely, or suffering from health problems such as birth defects, infections, or heart deformities. Many neonatal nurses work in Neonatal Intensive Care Unit (NICU), providing highly specialised medical care to at risk newborns.[3]

A dysmature newborn "is one whose developmental level is poor at birth."[4] These newborns require a special type of care, due to the health issues that arise, such as:

Inadequate respiratory function
Poor control of body temperature
Increased tendency to bleed
Poor resistance to infection
Poor nutrition
Immature kidneys and skin
Jaundice.[5]

Neonatal nurses employ a plethora of medical techniques to improve the condition of premature infants, including the use of incubators. Essentially, the incubator "provide[s] proper heat, humidity, oxygen, and mist... and protection from infection."[6] The Isolette is a popular example of an incubator used by hospitals and, furthermore, improvements upon the successful continue to be made.The medical apparatus provides essential medical care for at-risk newborns and, to this day, remains a staple of neonatal care.[7][8]

Pediatric emergency nursing

Pediatric nurses are expected to have a fast mobility and quick response on stressful situations to contain the life-threatening situations. Key features of pediatric emergency nursing include:

Handling multifaceted trauma, injury or illness cases with equal levels of calmness without letting the patients feel the urgency of the situation
Stabilizing patients with focused and wholesome care
Quickly diagnosing conditions and providing on-spot solutions
Administering the right medications to minimize pain
Keeping up with the fast-paced work environment by constantly upgrading skills and knowledge
Being patient and caring for the families who accompany the little patients and working on easing their mental trauma
Most importantly, not giving in to heartbreak and despair when some cases do not see improvement or success. Learning to control emotions and moving on is the key to helping more and more patients in this work environment.[9]

Nursing goals

Normalise the life of the child during hospitalisation in preparation for the family home, school and community.
Minimise the impact of the child's unique condition.
Foster maximal growth and development.
Develop realistic, functional and coordinated home care plans for the children and families.
Respect the roles of the families in the care of their children.
Prevention of disease and promotion of health of the child.

Training in the United States and Australia

United States Training

The CPN (certified pediatric nurse) exam validates knowledge and expertise of pediatric nurses beyond basic RN licensure. Eligible RNs may have a diploma, associate's degree, BSN, MSN, or higher nursing degree and must have a minimum of 1800 hours of pediatric nursing experience. Over 20,000 nurses actively hold CPN certification.[10] All pediatric nurses begin their career by becoming registered nurses (RN). Additional training specific to the care of children is then required. Training involves a mix of formal education and clinical experiences. Pediatric nurses can become certified in the field and may choose to further specialize. Students can enroll in an associate or bachelor's degree program in nursing. Some diploma programs offered exclusively through hospitals may also prepare students for the RN exam. Possible undergraduate paths could be to receive:

Australian Training

To become a pediatric nurse you need to first become a Registered nurse. A Registered nurse is a Bachelor of Science (Nursing) at University which is 3–4 years full-time. Once completed you then need to work in a clinical setting for at least 12–18 months. To then become a pediatric nurse you complete a graduate certificate in pediatric nursing.

The paediatric nursing workforce globally

Southern and eastern Africa Strengthening the paediatric nursing workforce has been recommended as a primary strategy to reduce under-five mortality in African nations.[11] Children make up close to half the population in many African countries, but research suggests that children's nurses often make up less than 1% of the nursing workforce: a workforce survey published by researchers at the University of Cape Town in 2019 found approximately 4 000 qualified children's nurses in South Africa, Uganda, Zambia, Malawi and Kenya. The majority (8/10) were in South Africa.[12]

Career overview

Examining a newborn baby [13]

Pediatric nurses and pediatric nurse practitioners work in a wide range of settings from doctor's offices and community-based settings to hospitals and critical care facilities. Pediatric Nurses may also assist paediatricians or work alongside them whilst providing care to the children. They provide care to children and adolescents in all aspects of their growth and well being. Pediatric nurses give primary care services such as diagnosing and treating most common childhood illnesses and developmental screenings. Acute care and specialty services are also available for the chronically ill children. Some pediatric nurses and nurse practitioners focus on a specialty area, such as cardiology, dermatology, gastroenterology or oncology.

Pediatric nurse practitioners

Pediatric nurse practitioners (PNP) play a large role in the lives of young people in both sick and also healthy children. To become a pediatric nurse practitioner you will need to go to school for at least two years after earning a bachelor's degree, and you'll need to apply to your state board of nursing to be recognized as an advanced practice nurse.[14] There is also a separate examination that must be sat and passed in order for a pediatric nurse to practice as a PNP.

Patient education

Patient education helps to enhance treatment results. Nurses must be inclined to work with children at various levels of understanding because in this field of nursing, patient is especially challenging. Children needs someone to help them adapt to the hospital setting and prepare them for medical treatments and procedures, and as a patient educator, pediatric nurses are responsible for this care. Nurses also coach parents to observe and wait for important signs and responses to therapies, to build and increase the child's comfort, and even to provide advanced care.

Another form of patient education is counseling. Injury-prevention strategies and anticipatory guidance is provided in counseling to boost development. Helping the child or family solve a problem is often the focus in counseling with the responsibility of the advanced practice nurses or other experienced nurses.[2][15]

Patient advocacy

The expected effective advocate nurse[16] must be aware of the following: child's and the family's needs, the family's resources, and the health care services available in the hospital and the community. The policies and resources of health care agencies must meet the psychosocial needs of children and families, where an advocate nurse must be sure of. The nurses can then reinforce the family and the child to make knowledgeable choices about these services and to achieve to act in the child's best interests.[2]

References

Datta, Parul (2007). Paediatric Nursing. Jaypee Brothers, Medical Publishers. p. 506. ISBN 9788180619700. Retrieved 27 March 2015.
Ball, J.W.; Bindler, R.C. (2003). Pediatric Nursing: caring for children. Upper Saddle River, New Jersey: Julie Levin Alexander. pp. 4. ISBN 0-13-099405-7.
"Is a Career in Neonatal Nursing Right for You?".
Thompson, Eleanor (1976). Pediatrics for practical nurses (3d ed.). Pennsylvania: Saunders. p. 71. ISBN 0-7216-8842-X.
Thompson, Eleanor (1976). Pediatrics for practical nurses (3d ed.). Pennsylvania: Saunders. p. 73-74. ISBN 0-7216-8842-X.
Thompson, Eleanor (1976). Pediatrics for practical nurses (3d ed.). Pennsylvania: Saunders. p. 74. ISBN 0-7216-8842-X.
Thompson, Eleanor (1976). Pediatrics for practical nurses (3d ed.). Pennsylvania: Saunders. p. 75. ISBN 0-7216-8842-X.
Healthwise Staff. "Isolette (Incubator)". Healthwise.
Majudmar, A.D. (2010). "Role of pediatric emergency nursing". Multibriefs.
"Pediatric Nursing Certificate Board". Retrieved 27 March 2015.
GHWA task force on scaling up education and training for health workers. Country case study: Malawi’s emergency human resources programme (Report). Geneva: WHO. nd. Available from http://www.who.int/workforcealliance/knowledge/case_studies/CS_Malawi_web_En.pdf.
North, N., Shung-King, M., & Coetzee, M. (2019). The children’s nursing workforce in Kenya, Malawi, Uganda, South Africa and Zambia: generating an initial indication of the extent of the workforce and training activity. Human resources for health, 17(1), 30. https://rdcu.be/bAYdR
Navy, Official Navy Page from United States of America MC2 John O'Neill Herrera/U S. (2012-04-13), SAN DIEGO (April 13, 2012) Lt. j.g. Linda Duque, a Neonatal Intensive Care Unit nurse at Naval Medical Center San Diego, checks a newborn. More than 1,000 active duty and civilian nurses provide patient care throughout the medical center. (U.S. Navy photo by Mass Communication Specialist 2nd Class John O'Neill Herrera/Released) 120413-N-LD533-011 Join the conversation www.facebook.com/USNavy www.twitter.com/USNavy navylive.dodlive.mil, retrieved 2016-10-25
"Pediatric Nursing Careers". www.pncb.org. Retrieved 2016-10-25.
Fraser, J. (2014). Paediatric Nursing in Australia. Cambridge. ISBN 978-1-107-68500-0.
Sterling, Yvonne M. (2013-05-01). "Pediatric Nurses as Advocates". Journal of Pediatric Nursing. 28 (3): 309–310. doi:10.1016/j.pedn.2013.02.022. ISSN 0882-5963. PMID 23473712.