Pediatric patients are not simply small adults. They possess unique physiological, developmental and social elements or nuances that impact their healthcare. The key to successful pediatric care is to engage caregivers and ensure that patients and their caregivers understand their role in the child’s healthcare journey.
Pediatric acute care nurse practitioners (PNP-AC) have a unique position to provide family-centered, culturally sensitive care for pediatric patients with acute and chronic illnesses in various settings. To be successful in this role, nurses need to understand some of the nuances of pediatric care. Professionals can gain this critical knowledge and skills base through a Master of Science in Nursing (MSN) – Pediatric Acute Care Nurse Practitioner online program.
There are anatomical and growth differences between children and adults. Understanding how anatomical differences can change how children present, react or respond to an illness or accident is critical for optimal patient care. For example, children are more susceptible to pulmonary illnesses due to their smaller airways, higher respiratory rates and breathing patterns. Any disease in the chest can quickly become an emergency due to the narrowing of the airways or blood vessels.
In addition, most pediatric nurses know that small veins can also be more challenging to place an IV and gain vascular access for treatment. Since children’s anatomy changes far more rapidly than adults, PNP-ACs require a breadth of knowledge as patient anatomy varies with age.
Pediatric nurses are experts at dosage calculations due to weight-based dosing. In addition to having dosing differences, children respond to pharmacological interventions differently than adults. For example, absorption is much more erratic in children than in adults. Variability in gastric pH, bile secretion, intestinal permeability and gastric emptying plays a role in medication absorption. These differences in absorption and metabolism may result in higher or lower drug plasma levels in children than adults.
Beyond these physiological changes that create pharmacological differences, many drug trials include limited pediatric patients.
Nurses practitioners should learn Erik Erikson’s eight stages of psychosocial development from infancy to late adulthood. PNP-ACs become experts in developing a comprehensive, holistic, personalized plans of care based on each stage of a patient’s development. For example, an adolescent with a new acute illness disrupts the natural developmental process of moving toward independence and individual identity. Suddenly, the adolescent must step back into a parent or caregiver-child relationship instead of the healthy function of individuation and separation from caregivers. Knowing how an acute illness can trigger this stressor by naming and normalizing it can help.
In addition, PNP-ACs need to be aware that developmental changes can lead to significant feelings of depression, anxiety and guilt and mobilize care team resources in response.
Excellent pediatric care includes understanding family dynamics, roles and socioeconomic needs. Each child/caregiver unit has different priorities and concerns. Often, navigating pediatric healthcare is a challenge. Therefore, PNP-ACs must be able to assess patient needs to understand, identify and address barriers to care — called health disparities. Caregivers may feel overwhelmed, as caring for a sick child is extremely stressful.
Consequently, pediatric patients undergoing acute or chronic care often have a disruption in their education, after-school activities and social relationships. Understanding each unique situation includes an assessment of the family dynamics and how they handle the demands of a sick child and screen for distress. With a better understanding of their concerns and situation, PNP-ACs can tailor their care and communication for more personalized care.
Caring for pediatric patients requires expert developmental-based communication skills. For example, the selection of a pain assessment tool (faces, numbers or colors) varies depending on the child’s development and communication ability. Since young children cannot communicate their discomfort, their caregivers must advocate for them based on their symptoms and behavior change. Effective communication at the right health literacy level using proven techniques (e.g., teach-back method, simple language) is fundamental to maintaining an effective, trusting therapeutic relationship. In addition, nurses must work to identify language bias in themselves, colleagues or their institution to combat care inequity.
The University of Texas at Arlington’s MSN – Pediatric Acute Care Nurse Practitioner (NP) online program prepares graduates to address the unique nuances of the pediatric population and incorporate evidence-based interventions to facilitate optimum health and growth. Graduates learn the essential elements of advanced nursing practice for pediatric acute and chronic healthcare in a wide range of environments including critical care, emergency rooms and specialty office practices or clinics, as well as intensive rehabilitation and early intervention programs.
The Pediatric Assessment Lab course advances understanding of pediatric anatomy and developmental milestones, while the Advanced Pharmacology course explains how clinical pharmacological therapeutics impact children. In addition, the Pediatric Acute Care and Pediatric Primary Care courses sharpen care planning and communication skills.