NSNA/IMPRINT 39

as crucial to the child’s recovery. Advo-cacy is an important aspect of thenurse’s role. For example, if a child mustundergo numerous diagnostic tests, thenurses should always consider how tocoordinate the tests in the best interestsof the child, causing as little physical oremotional distress as possible.

Pediatric nurses seek the least inva-sive and least painful methods of med-ication administration. Ideal candidatesfor pediatric nursing should love chil-dren, be flexible, empathic, and enjoydaily challenges. Compassion and up-to-date clinical knowledge are musts.The challenges I face each day keepme going. Pediatric nurses must under-

stand how illness affects children physi-cally, emotionally, and psychologically.

If you enjoy creative problem solv-ing, pediatrics is ideal. For example, Ionce had a four-year-old patient whorefused to take her oral prednisone forher leukemia because she hated thetaste. I tasted it for her, and agreed ittasted awful! Her parents and I triedeverything short of placing an NG tubeto administer the medication. Then Iremembered that four-year-olds want tobe independent, so we came up with aplan. Taking the prednisone was notnegotiable; however, she could choosehow to take it as creatively as shewished. She mixed the medication withvanilla ice cream, chased it with grape

juice, and immediately chewed a pieceof gum to get rid of the taste. Theintervention provided a creative solu-tion that worked.

The following considerations areuseful when considering a career inpediatrics:

1. Children look up to nurses ascaregivers, teachers, and comforters. Be sure you are comfortable in these roles.

2. Try caring for kids and see if youenjoy it. Volunteer on a pediatric unitat a local hospital, at a daycare center,at a summer camp for sick or chronical-ly ill children, or in0 an extern programat a children’s hospital.

3. Take a child development courseto help broaden your understanding ofthe issues.

4. Network with pediatricians, nursepractitioners, and child life therapists,and get a sense of their daily lives.

5. Expect the unexpected, andexpect to be fulfilled.

We touch the future when we reachout to the tiny hands of children, andthis makes pediatric nursing a phenom-enal specialty. This year, I will graduatefrom a masters program in the acuteand chronic care of children, and I willbecome a pediatric nurse practitioner.This is a testimony of my lifelong com-mitment to working with children. Ihope that many of you will make thesame commitment, and discover thewonderful specialty that awaits you.

The author is a clinical nurse on the oncologyand bone marrow transplant unit at the Children’s Hospital of Philadelphia, Philadelphia, PA. A graduate of VillanovaUniversity, she is a student in the PediatricNurse Practitioner Program at the University of Pennsylvania. She was the 1988-1989NSNA president.

SUGGESTED READINGAshwill, Jean Weiler and Droske,

Susan Colvert. Nursing Care of Children.Principles and Practice, Philadelphia, W. B.Saunders Company, 1997.

Dearmun, Annette K. Nursing Standard 13(27):59. 1999 March.

Kuntz, KR. Pediatric nursingresources in cyberspace. Journal of theSociety of Pediatric Nurses. 3(4):155-160,October-December 1998.

Nethercott, Sally. Child support.13(17):58, January 1999.

PUBLICATIONSJournal of Pediatric NursingJournal of the Society of Pediatric NursesPediatric Nursing-AJJ, Inc.The Pediatric Nurse Practitioner Newsletter

RESOURCES

Society of Pediatric Nurses (SPN)2170 S. Parker Road #350Denver, CO 80231800-723-2902 www.pednurse.org

National Association of PediatricNurse Associates and Practitioners,Inc. (NAPNAP)1101 Kings’ Highway N. Suite 206Cherry Hill, NJ 08034-1912856-667-1773www.napnap.org

Association of Pediatric OncologyNurses (APON)www.apon.org

Association of Pediatric Gastroenterology and NutritionNurses (APGNN)www.naspgn.org

Association of Camp Nurseswww.campnurse.org

38 JANUARY 2000 http://www.nsna.org

It was the first morning of my stu-dent clinical rotation at the Chil-dren’s Hospital of Philadelphia. Ihad chosen pediatrics for my

advanced clinical in the fall of mysenior year as an undergraduatebecause I was sure my future was inadult medical/surgical nursing. Whynot get the pediatric clinical over withand focus on adults? That was wherethe real excitement would be, right?Little did I know, my future plans wereabout to change.

The hospital lobby was full ofexcitement that day: kids in wheel-chairs racing toward the cafeteria ...bald children with huge smiles ... a lit-tle girl with a nasogastric tube coloringin the waiting room of a nearby clinic... babies being rocked to sleep in thequiet corner of a family lounge. Thatwas it for me! I looked around andknew the excitement was here. In pedi-atrics, the nurse not only touches thechild’s life, but the family, the commu-nity, and all those involved in helpingchildren reach their maximum healthand potential. I chose pediatrics for thechallenges, the unpredictability, andthe chance to work with families inmaking a difference in children’s lives.The following issues are helpful to keepin mind when considering a career inpediatric nursing.

Growth and development are the foundation on which nurses provide guidance and care at each developmental stage. They influence every nurse-child interaction.Family centered care is the hall-mark of pediatrics. The nurse cares for the child within diverse family structures and addresses the needs of siblings. Nurses are responsible for child advocacy in areas such as abuse,

neglect, and access to health care, so they must possess a keen awareness of legal and ethical issues.See life through the eyes of the children while providing their care and helping their family members learn to cope.

Remember that kids will be kids, andsick kids will still be kids. I am alwaysstruck by how unaffected most childrenare by their illness. For example, kidseat, even with tubes in the way. Kidsrun, even with crutches. Kids smile,even after a painful or scary procedure.Kids play amidst the IV poles and themonitors. I often find it is the parentswho are devastated by the impact of anillness, while the child lives one day ata time.

Pediatric nursing is a specialtyencompassing the care of children, ado-lescents and their families in a varietyof settings. The age range in pediatricsis from newborns to age eighteen.Common childhood diagnoses includeboth acute and chronic illnesses, fromear, nose and throat infections, to asth-ma, to growth and development issues.Chronic illness is also a major subspe-cialty in pediatrics.

My niche is pediatric oncology, andI find that the challenges of dealingwith chronically ill children and theirfamilies are very rewarding. There isnothing more moving than effectivelymanaging a child’s pain, or morerewarding than teaching the familyhow to care for a sick child at home.

Reintegration back into the schoolenvironment is also a hurdle many fam-ilies face. I have been able to speak tothe classmates of some of my clients onthis topic, serving as a positive rolemodel for nursing to future generations.

Pediatric nursing presents uniquechallenges in that children have suchrapidly growing and changing bodies.The pediatric nurse assesses the child asa unique individual who may requirespecialized equipment, special monitor-ing, and specific medication dosages.In pediatric care, whether in hospitals,clinics, long-term care facilities, orcommunity or health care agencies,teamwork is critical, and nurses managethe team and coordinate the child’scare. Nowhere is the concept ofpatient/family centered care so vital.Most importantly, the nurse works collaboratively at all times with thefamily and recognizes family members

BY CYNTHIA RICH SCHMUS, BSN, RN

PEDIATRIC NURSING

If you enjoy creative

problem solving, pediatrics is ideal.

1.

2.

3.

4.