A Pediatric Nurse Practitioner

Mrs. Carmen Highsmith
Childrens Hospital
Philadelphia, P.A.

How does one become a pediatric nurse?

Basically you apply to work at a site that serves pediatric patients and you receive your specialized training there. There are no specialized nursing programs specifically for pediatrics. The hospital where I work offers a 3 month intern program for a new nursing graduate. The program includes both classroom and clinical training specifically in pediatrics. Once you have graduated, you can also take an exam to become a Certified Pediatric Nurse. There are also special classes that address pediatrics. These include Pediatric Advanced Life Support and the Emergency Nurse Pediatric course which is offered through the American Heart Association.

How did you become a Nurse Practitioner?

After obtaining a BSN and working for 6 years as a nurse, I went back to school to obtain a Master's degree in Nursing and was trained as a Family Nurse Practitioner. I then took certifications exams in both family and in pediatrics. Currently I have a position as a Nurse Practitioner in a Pediatric Emergency Department- a new role in my hospital. This additional training took 16-18 months and as a NP, I can diagnose, treat, and prescribe medications.

What are your responsibilities?

I take a history from the child's caregiver and often from the child, depending on their age. I then examine the child and make a diagnosis based on my assesssment. Sometimes if I don't know immediately what is wrong I will order additional tests such as lab work or X-rays. Based on these results and my assessment I decide if the child can go home or needs to be admitted to the hospital. Usually the nurse performs an initial assessment of the child by taking vital signs etc.

How does your job affect your personal life?

For me, my job affects my personal life greatly because I love what I do and tend to be a workaholic. My current shift is evening (5pm to 2am). Because of this I rarely see my children during the school year. During the summer it is a great shift because I am home during the day and we can do a lot of things together. I have worked every shift including days, evenings and nights. I also work about 2 weekends a month. Basically you can choose your shift.

What part of your job do you like best and what part of it do you wish you didn't have to do?

I like making children feel better and reassuring parents that their child is going to be ok. Often, I have a patient come in who is desperately worried about their child, and by talking and listening to them I can relieve a lot of their fears. This can be very rewarding. The part of my job that I hate the most is when children are critically injured or die. We deal with this a lot. It is especially frustrating when the injury could have beens prevented. For example, the child was injured because of he/she was not wearing a seat belt. I hate to see children suffer and I hate to see a young life taken away.

What special skills are required when working with children?

In the emergency room we treat the child based on what is wrong with them when they come in. It is important to consider basic child development when treating children and to communicate with them on their developmental level. This requires an extensive knowledge base about basic cognitive levels and developmental milestones but you also have to know what equipment is appropriate to use for children of different ages and sizes.

What tools does a NP use on the job?

The basic tools are the use of the eyes, hands and ears. Other tools are a Stethoscope to listen to lungs, a Sphygmomanometer which is a blood pressure cuff and a thermometer to measure temperature. We also use a cardiopulmonary (CP) monitor which tracks the patient's heart and respiratory rate. A Snellen chart is used to test vision. There are many more tool but the common ones I have already mentioned.

What was your first job choice and why?

When I was younger I was going to be a Pediatric Neurosurgeon. Later when I started college at Temple University, I was going to be a Physical Therapist. I did not decide to be a nurse till my junior year. I'm not exactly sure what made me decide to become a nurse. Perhaps it was the rewards of the job, the flexibility and the pay.

Can you tell me about the education needed for this occupation?

All nurses must attend nursing school or college. Pediatric training is obtained at some hospitals.

What did you learn in school that helps you in your present job?

I learned the fundamentals of my profession. This includes basic disease processes, anatomy, physiology, pharmacology, assessment and research.

Is there anything else you would like to add?

Being a NP you are a patient advocate and you always have to maintain the patient's confidentiality. No matter how tired and upset you feel you must maintain your professionalism. Also, you must continue to learn by reading the trade journals to keep up with upcoming trends in the medical field.

Interviewed by Badia Ali for a College 101 assignment on 12/04.