Pediatric Nurse Practice Definition - Assignment Example

? Pediatric Nurse Practice This scholarly paper will address issues concerning Pediatric Nurse Practice (PNP). The paper will start by defining the meaning of PNP and its historical background and explain its educational, practice and certification requirements. The paper will try to identify and explain professional challenges inherent in PNP. This paper will then address the legal, ethical and cultural competence challenges affecting PNP. It also strives to bring into focus how PNP integrates the concepts of philosophy of nursing, caring and the improvement of healthcare delivery. Key word: Pediatric Nurse Practitioner (PNP), Pediatric Nurse Practitioners (PNPs) Nurse Practitioner (NP). Historical Background and Certification Requirements Pediatric Nurse Practice (PNP) refers, the practice of nursing concerned with infants, children and adolescents together with their families providing health promotion, illness management and health restoration across the entire healthcare spectrum (Tylor as cited in eHow, 2011). It requires knowledge of both child development and the physiological difference between children and adults. PNP is also family centered requiring the realization of the essential role that the family plays in children lives, growth and development which should be reflected in the children’s care whenever they are ill. It involves collaborative partnership between families and health care professionals built on respect and embedded in the families’ strengths, choices and values (Tylor, 2006). Pediatric nurses also attempts to provide attramautic care in order to eliminate or minimize the physiologic and physical distress experienced by children and their families in the health care system. Pediatric nurses may function in many roles that include direct caregiver, educator, counselor, consultant, advocate, care coordinator, or health systems manager (Tylor, 2006). They also work as researchers or pediatric clinical nurse specialists. Pediatric nurses may practice in many locations such as homes, clinics, hospitals, long term care facilities and schools (Schachtel, 2008). The opening of The Children’s Hospital of Philadelphia (the first children’s hospital in the U.S) in Pennsylvania in 1855 formed the cornerstone upon which the specialty of pediatric nursing developed (Tylor, 2006). In colonial America, most children were delivered by the help of midwives and treated with folk medicine. The Children’s Hospital of Philadelphia goal was to provide excellent healthcare and reduce child mortality. Other children hospitals were later established in different regions but, none would admit children with communicable diseases because of high mortality. In 1895, The Children’s Hospital of Philadelphia began to admit children. It also started its own nursing school in the same year (Tylor, 2006). The approach enabled the hospital to amass knowledgeable staff that provided the level of care, education, observation and assessment that the children and their families needed. Some private duty nurses of the hospital specialized in care of children. With services for nurses increasingly needed, what followed was an awakening in the nursing practice. The directive on the 1917 standard curriculum for nursing schools to increase some detailed topics in regard to pediatrics and the Rockefeller Foundation publication in 1923 (Nursing and Nursing education in USA), generally impacted positively on the pediatric nursing specialty and the nursing profession as a whole (Tylor,2006). Later, in the century pediatric nursing moved to advanced degrees and advanced practice. It is not unusual that, the first nurse practitioners were pediatric nurse practitioners. Those who aspire to become Pediatric Nurse Practitioners in the U.S have various options. In order to work as Pediatric nurses, students must first become Registered Nurses (RN)…An RN may be achieved through hospitals or educational institutions (PNERCI, 2011). The coursework may differ but graduates from these programs qualify to sit for the National Council Licensing Examination for Registered Nurses (NCLEX-RN) (SEH College, 2011), to become a registered nurse (PNERCI, 2011). Hospitals offer nursing diploma programs that can take 2-3 years. Aspiring pediatric nurses may also undertake an Associate Degree in Nursing (ADN) for two years or Bachelor of Science in Nursing (BSN) for four years. The Completion of either these course enables one to sit for the NCLEX-RN exam in order to be registered as a nurse. To become a Pediatric Nurse Practitioner, one must have a Master of Science degree in nursing degree (MSN). Enrollment into the masters program requires a BSN. Students with a diploma in nursing/associate degree in nursing, can enroll in a bridge program like LPN-BSN, LVN-RN, RN-MSN or AND- MSN. MSN program takes 2-3 years allowing the student to specialize in the area of interest (PNERCI, 2011). In this case, one needs to specialize in pediatrics. Pediatrics as a discipline is wide and students may specialize in pediatric sub disciplines. Once one acquires the MSN, they need to get certification to practice in pediatrics from either the Pediatric Nursing certification board or the American Nurses Credentialing Center. Professional Challenges Currently, PNP faces several challenges. PNP continuously face the challenge of decreased staffing and resources which prevents them from accomplishing to the fullest the adoption of family centered and attramautic care (Tylor,2006). Experts argue that nursing schools should train students to work in outpatient settings in addition to their tradition inpatient roles. Pediatric nursing seems to be adopting evidence based Nursing Practice whose implementation seems to be under serious discussion at the moment (Tylor, 2006). On the other hand, PNP like other NP nurses have their traditional roles extended. Their nursing background seems to be contrasted by the medical training orientation of physician extenders. The distinction between nursing and medical origin creates tensions and confusions amongst healthcare practitioners beyond their differences and nuances of the names themselves (Schachtel, 1978). The American Academy of Pediatrics believes that optimal pediatric health depends on a team based approach with coordination from a pediatrician consultant. The pediatrician uniquely, coordinates the entire spectrum of the pediatric care (diagnosis, treatment and practice setting) (AAP PubPediatric, 2003).The academy however appreciates the role played by non physician clinicians including Pediatric Nurse Practitioners in providing pediatric care. The academy believes Pediatric Nurse Practitioners who provide services in undeserved need the support of consulting pediatricians, and/or physicians through the use of telemedicine technologies (AAP PubPediatric, 2003). Philosophy of Nursing Masters (2009), describes philosophy as a discipline concerned with how one should live, the sort of things that exist together with their essential natures; accountability of genuine knowledge and the meaning of correct principles of reasoning (Holland School, 2011). On the other hand, the American Heritage Dictionary of the English Language (2000), defines philosophy as love and search of wisdom by intellectual means and moral self discipline; investigation of nature, causes, principle of trueness, knowledge, values basing on logical reasoning and not empirical methods (as cited in Socrates Cafe, 2011). Masters (2009), argues that since nursing seems to be inextricably linked to the society, stakeholders in this field should consider how society defines values and beliefs in nursing. Masters (2009, argues that it might not be possible to please everyone all the time. However, practitioners do consider the fact that their values and beliefs are interdependent with of society. Masters (2009), continues to state that philosophy helps us to see that asking questions about humans, environment, health and nursing will continue to prevail and leads to a better understanding of truth in this profession. Care givers values and philosophies should be clearly clarified in order to authentically respond to the healthcare needs. This enables practitioners to question the values of this profession, society and themselves aiming to better the health of their patients and families (Henry, 2008). Caring Role Caring and Nursing have always been thought of synonymously (Browning, 2005). A majority of practitioners enroll into the profession of nursing because of their desire to take care of individuals. Two theories of caring exist; Leininger’s Theory of cultural care and Jean Watson’s theory of human caring. Watson argues that caring refers to the science that includes human caring processes, events and experiences of life (Watson Institute, 2011). Transpersonal caring appreciates the unity of life and the apparent connections circles of caring encompassing individuals, others, society and the universe as a whole (Watson Institute, 2011). Nurses are known to have caring behaviors like attentive listening, comforting, honesty, patience, responsibility, respect, touch, sensitivity and the provision of information to patients. Leininger subscribed to the idea that suggests that care appears to be the dominant focus of nursing. Pediatric Nursing Practice deals with sensitive matters concerning children. The specialty involves the practitioner working closely with families of patients in order to provide in depth care. Pediatric Nurse Practice advances the concept of care through the provision of direct care to children. Secondly, it offers consultancy, counseling services, and education to the relevant parties and finally through coordination of health care systems for the general wellbeing of children and their families. PNP also in cooperates the concept of caring through campaigns and awareness needed to protect the needs of pediatrics. Ethical Issues Ethical challenges occur in many professions. First, Pediatric Nurses are struggling to balance their ethical obligations to patients, families and other professionals, institutions where they practice and the society (Kenny, 2006). The practice calls for a collaborative approach between families and healthcare providers. Pediatric Nurse Practitioners may work in environments in which the roles of registered nurses may have been replaced by Unlicensed Assistive Personnel (UNP). Ethical concerns normally arise when Pediatric Nurse Practitioners find themselves in situations that call for assignment of nursing roles to UNPs. They are left to ponder on the dilemma of the patient’s well being while under the care of UNPs. This challenge also puts their Licenses at risk. Secondly, these Nurse Practitioners also encounter intense conflicts between their personal values and values in the organizations where they practice. Some individual practitioners encounter less supportive and adversarial working environments. Administrators may offer ultimatums forcing Nurse Practitioners to practice under suboptimal conditions (Rushton, 2001 as cited in find articles). When faced with the threat of unemployment, some Nurse Practitioners retreat in order to preserve their own well being at the expense of patients care. Thirdly, Pediatric Nurses encounter the challenge about the efficacy of providing some expensive or innovative therapies to neonatal and pediatric patients with uncertain futures. Concurrently, pediatric nurses face the challenges caused by political climate that threatens the healthcare services for children and families in vulnerable environments, that reduces vital services for children with exceptional healthcare needs (Rushton, 2001 as cited in find articles). Legal Issues Pediatric Nurse Practitioners need certification from the Pediatric Nursing Certification Board in order to Practice (APA, 2005). Legal cases may arise when a Practitioner Practices without certification. Nurse Practitioners should therefore store compilations of documentation containing the NP’s education, training and experience. Some states require NPs to submit to the Board of Nursing a written agreement indicating the precise services to be performed. Another legal challenge may involve the scope of practice. Some states require a physician’s supervision in the Nurse Practitioners service production. Different states may have different laws regarding the extent to which Nurse Practitioners should practice. Legal issues may a rise involving cases in which Nurse Practitioners over exercise with possible clinical shortcomings. Cultural Competence Culturally competent nurses should be able to observe their own world views and those of the patient while avoiding stereotyping and misinterpretation of scientific knowledge. To become culturally competent, one needs to obtain specific cultural information and then apply the knowledge (Commonwealth Fund, 2011). In this case, Pediatric Nurse Practitioner should be in a position to collect any cultural information that might be influential in assisting the patient’s health. In order to adapt to cultural beliefs and practices of others, one should be flexibility and respect other people’s opinion. The provision of culturally appropriate care calls for the need to understand culturally influenced behaviors. The U.S community generally provides a culturally diverse environment and nurses will not travel to distant part for them to encounter cultural competence challenges. The perception of illness, disease and their causes varies by culture, thus it is bound to affect Pediatric Nurse Practitioners. Culture also influences how people seek healthcare and how they behave toward healthcare providers. How healthcare providers respond to this challenge, also depends on their culture. Therefore Pediatric Nurse Practitioners should posses the necessary technical skills needed to understand health behaviors that culture influences. Achieving cultural competence depends on how people value the diverse nature of culture, having the capacity to do cultural self assessment, remaining keen on the complexities that occurs when cultures interact and having institutionalized cultural knowledge (Commonwealth Fund, 2011). This also calls for the need to develop adaptations of service delivery and an understanding of cultural diversity. Improvement of Healthcare delivery Pediatric Practitioners handle very delicate clinical situations in children. Clinicians normally rely on clinical history of patients to make tentative diagnoses. Clinical history of patients is crucial during emergencies because it gives the clinician the chance to decide on the immediate control medication (Techno log, 2011). Handling pediatrics however, becomes challenging in situations when the Practitioner does not get detailed clinical history from the person who brought the ill child to the hospital. Such cases arise in scenarios when the guardians are illiterate and insensitive to the child’s health. In this case, the Practitioner needs to have vast experience to unravel the mystery at hand. Pediatric Nurse Specialty allows these Practitioners to gain an in-depth understanding of the special needs of children (Hockenberry & Wilson, 2005). This advancement in pediatrics equips the Practitioner with the necessary tools and skills to handle medical complications affecting children. On the other hand, an advanced course in pediatrics equips practitioners with counseling skills. Children normally encounter complex childhood disorders some which might be of genetic origin and untreatable. This normally leaves the family members of such patients’ devastated. Practitioners, with an advancement in pediatrics offer professional education and counseling services to such families. Such practitioners become very resourceful to such families and the community at large. In addition, Practitioners in the field of Pediatrics have an added role of protecting children rights. At times, in different societies, children rights might be undermined or neglected including the right to proper healthcare. Pediatrics Practitioners work towards the improvement children’s healthcare. In this regard, practitioners in this field create awareness for the need to address children’s healthcare plights. They work with other stakeholders in the mitigation of children’s rights and protection thus improving the wellbeing of pediatrics (Browning, 2005). Personal and Professional Goals The field of pediatrics fascinates me because of its child centered care. On the other hand, children form an interesting part of the family and the society at large. The BSN course has equipped me with the necessary skills required in the field of nursing. It will assist me to achieve my goal of working in the profession that champions the welfare of children. A nursing background offers me an opportunity to move to the next level and pursue an advanced course in pediatrics that will allow me to exercise what fascinates me the most, nursing and caring for children. Conclusion Pediatric Nurse Practitioners work for the welfare of children and their families because the health, growth and development of children depend greatly on the child’s family (Techno log, 2011). It requires vast knowledge on the development of children and the need to differentiate the physiological difference between children and adults. Pediatric Nurse Profession has a unique history since the first Nurse Practitioner in the U.S studied Pediatrics. Students who aspire to become Pediatric Nurse Practitioners need to study BSN degree at the undergraduate level and then pursue a MSN degree specializing in Pediatrics. However, other alternatives exist for aspirants without a BSN degree. Pediatric Nurse Practitioners need to be certified as registered nurses and as also receive certification from the Pediatrics Nursing Certification Board. References American Pediatricians Academy (APA ), 2005. Scope of Practice Issues in the Delivery of PediatricHealthcare, http://aappolicy.aappublications.org/cgi/content/full/pediatrics;111/2/426 Browning, D.M and Solomon, M.Z. (2005). The Initiative for Pediatric Palliative Care: An Interdisciplinary Educational Approach for Healthcare Professionals. Journal of Pediatric Nursing, 2, 5: 326-334. Henry, B. (2008). Globalization, Nursing Philosophy and Nursing Science. Image; Journal of Nursing, 30, 202: 224-233. Hockenberry, M. and Wilson, David, (2005). Essentials of Pediatric Nursing. Amsterdam: Elsevier. Kenny, G. (2006). The Importance of Nursing Values in Inter professional collaboration. British Journal of Nursing, 11(1): 65-68. Masters, K. (2009). The Development in Professional Nursing Practice. Massachusetts : Jones and Barlett. Pediatrics Nurse Educational Requirements and Career Information (PNERCI), Retrieved on Dec. 5th. 2011 from.hppp:// http://education-portal.com/pediatric_nurse.html Pediatric Nurse, (2011). How to Information/eHow.com. Retrieved Dec.5th, 2011 from. http/:www.eHow.com/pediatrics-nurse/ Rushton, C. H. (2011), Ethical and Legal Challenges for Pediatric Nurses .Retrieved on Dec. 5th, 2001 from. http://findarticles.com/p/articles/mi m0FSZ/is_n4_v22/ai_n18607139/ SEHCollegeofNursing-programs.retrevedonDec.5th,2011 from.http://www.southeastmissourihospitalcollege.edu/Programs.aspx Schachtel, B.P. (2008).The Pediatrician Nurse Practice Origin and Challenges. Medical care Journal, 16, 12: 1978 Scope of Practice Issues in the Delivery of Pediatric Health (2003).Retrieved Dec.5th, 2011 from http://aappolicy.aappublications.org/cgi/content/full/pediatrics;111/2/426- Socrates Cafe’. (n.d).Retrieved on Dec. 4th 2011, from http://socratescafemn.org/ Technolog-Japan’searthquake.Howtohelp.RetrievedonDec.4th,2011from http:/technolog.msnbc.msn.com/news/2011/03/11/6246445-japans-earthquakes-how-to The American Heritage English Dictionary (2000). Philosophy. Boston: Boston Publishers Tylor, M.K. (2006). Matching the Literature of Pediatric Nursing. Journal of medical Library Association, 92, 2: E128-E13L WatsoncaringScienceInstitute:Theory.RetrievedonDec.3rd,2011from. http://www.tsoncaringscience.org/index.cfm/category/80/theory.cfm Read More