THE PROFESSIONAL NURSE

As nursing care changed from the category-specific care of the infant or child to family-
centered care, pediatric nursing entered a new era of autonomy and independence.
Nurses today must be able to communicate with and teach children of many ages and
levels of development and education. They must be able to think critically and use the
nursing process to develop a plan of care that meets the unique needs of child and
family. They are expected to use current research to solve problems and collaborate with
other health care providers.

The role of the nurse

The professional nurse has a responsibility to provide the highest quality care to every
child and family. Nurses must maintain competence and a current knowledge base in
their areas of practice. Standards of practice describe the level of performance expected
of a professional nurse as determined by an authority in the practice.

Nurses who care for children in all clinical settings can use the ANA/Society of
Pediatric Nurses (SPN) Standards of Care and Standards of Professional Performance
for Pediatric Nurses and the SPN/ANA Guide to Family Centered Care as guides for
practice. Other standards of practice for specific clinical areas, such as pediatric
oncology nursing or emergency nursing, are available from nursing specialty groups.

As health care continues to move to family-centered and community-based health

services, all nurses should expect to care for children, adolescents, and their families.
Pediatric nurses function in a variety of roles, including those of care provider, teacher,
collaborator, researcher, advocate and manager.

Care provider

The nurse provides direct nursing care to infants, children, and their families in the times
of illness, injury, recovery and wellness. Nursing of children is especially based on an
understanding of the child’s developmental stage and is aimed at meeting the child’s
physical and emotional needs at that level. Developing a therapeutic relationship with
and providing support to children and their families are essential components of nursing

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care. Pediatric nurses practice family-centered care, embracing diversity in family
structures and cultural backgrounds. These nurses strivea to empower families,
encouraging them to participate in their care and the care for their child.

Teacher

Education is an essential role of today’s nurse. Nurses who care for children prepare
them for procedures, hospitalization, or surgery, using knowledge of growth and
development to teach children at various levels of understanding. Families need
information as well as emotional support so they can cope with the anxiety and
uncertainty of child’s illness. Nurses teach family members how to provide care, watch
for important signs, and increase child’s comfort. They also work with new parents are
prepared to assume responsibility for care at home after the child has been discharged
from the hospital.

Education is essential for the promotion of health. The nurse applies principles of
teaching and learning to change the behavior of family members. Nurses motivate
children and families to take charge of and make responsible decisions about their own
health. For teaching to be effective, it must incorporate the family’s values and health
beliefs.

Nurses caring for children and families play an important role in the prevention of
illness and injury through education and anticipatory guidance. Teaching about
immunizations, safety, dental care, socialization, and discipline is a necessary
component of care. Nurses offer guidance to parents regarding child-rearing practices
and prevention of potential problems. They also answer questions about growth and
development and assist families in understanding their children. Teaching often involves
providing emotional support and counseling to children and families.

Collaborator

Nurses collaborate with other members of the health care team, often coordinating and
managing the child’s care. Managing the transition from a hospital or any other acute
care setting to the child’s home or another facility involves discharge planning and

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collaboration with other health care professionals. The frequent use of home care makes
collaboration increasingly important. The nurse must be knowledgeable about
community resources, appropriate home care agencies for the type of child or problem,
and financial resources. Cooperation and communication are essential as clients,
including parents of children, are encouraged to participate in their care.

Researcher

Nurses contribute to their profession’s knowledge base by systematically investigating

theoretical or practice issues in nursing. Nurses should keep their knowledge current by
networking and sharing research findings at conferences, by publishing and by
evaluating research journal articles.

Advocate

An advocate is a person who speaks on behalf of another. As the heath care environment
becomes increasingly complex, care can become impersonal. The wishes and needs of
children and families are sometimes discounted or ignore in the effort to treat and cure.
As the health professional who is closest to the child, the nurse is in an ideal position to
humanize care and intercede on the child’s behalf. As an advocate, the nurse considers
the family’s wishes in planning and implementing care. The nurse informs families of
treatments and procedures, ensuring that the families are involved directly in decisions
and activities related to their child’s care. The nurse must be sensitive to the values,
beliefs, and customs of families.

Nurses must be advocates for health promotion for vulnerable groups, such as children.
Nurses can promote the rights of the children and families by participating in groups
dedicated to the welfare of the children and families, such as professional nursing
societies, parent support groups, religious organizations, and volunteer organizations.

Nurse practitioners

Pediatric nurse practitioners use advanced skills to asses and treat well and ill children
according to established protocols. The health care services they provide range from
physical examinations and anticipatory guidance to the treatment of common illness and

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injuries. Newborn nurseries and some children’s hospital specialty units may be staffed
by pediatric or neonatal nurse practitioners.

Family nurse practitioners are prepared to provide care for all family members,
including children. They diagnose and treat clients holistically, with a strong emphasis
on prevention.

School nurse practitioners receive education and training that is similar to that of
pediatric nurse practitioners. However, because of the setting in which they practice, the
school nurse practitioner receives advanced education in managing chronic illness,
disability, and mental health problems in a school setting, as well as developing skills
required to communicate effectively with students, teachers, school administrators, and
community health care providers. School nurse practitioners expand the traditional role
of the school nurse by providing on-site treatment of acute care problems and providing
extensive well-child examinations and services.

Clinical nurse specialists

Clinical specialists are registered nurses who, through study and supervised
practice at the graduate level (master’s or doctorate), have become expert in the care of
children and families. Four major roles have been indentified for clinical nurse
specialists: expert practitioner, educator, researcher, and consultant. These professionals
often function as clinical leaders, role models, client advocates, and change agents.
Unlike nurse practitioners, clinical nurse specialists are not prepared to provide primary
care.