GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion
GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion
My name is xxand I have been a nurse since 1989. The first half of my career was in critical care nursing, and the last half has been as a corporate wellness nurse. In between those two ends of the spectrum, I brought a non-profit called Girls on the Run to Maryland. The mission statement is to prepare girls for a lifetime of self-respect and healthy living. GOTR is a program for third through fifth graders and a sister program was started for middle school girls.
Roles and Responsibilities / Strengths and Challenges.
Pediatric FNPs have two patients in family-centered care. Both the family and the patient. Part of the appreciation of family-centered care is a direct result of my own experience. At 34 weeks gestation, I had an abruption while working in the ICU, and consequently, my son was in the NICU for one month. The overlay of guilt, fear, lack of knowledge, or a support system was crushing. Nurses are pivotal in decreasing parental anxiety (Louis & White, 2023). As suggested by a NICU nurse, I would drive daily and provide kangaroo care. As a pediatric FNP, I believe one of my strengths will be the ability to bring sensitivity and knowledge sharing to my family patients. Developing trust with both the patient and family will also improve patient outcomes and decrease anxiety and I believe I will be able to generate trust (Sheehan & Fealey, 2020). (I am happy to report my son is a healthy, thriving pilot who shows no hint of the challenging start that he had.)
Anticipatory guidance is a role of pediatric FNP that I will enjoy and is one of my strengths. In GOTR we discussed, through age-appropriate activities, topics of bullying, eating healthily, communication, feelings, exercise, inclusion, and empathy. The program was research-based and demonstrated less high-risk behaviors in those girls who participated (Weiss et al., 2023). This platform of intervention has given me some foundations for anticipatory guidance especially for the school aged child.
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Understanding normal growth and development is an essential role and responsibility for pediatric FNPs. While I have a small working knowledge of the benchmarks, this is an area that will need refreshment and improvement. This will enable me to recognize abnormalities and provide the correct anticipatory guidance to promote optimal health outcomes and early interventions if needed.
Another challenging area is pediatric pharmacology. Pediatric dosing is an area of higher errors (Westbrook et al., 2022). Electronic medication management will assist in decreasing the likelihood of errors (Westbrook et al., 2022). Additionally, being methodical and understanding the process will assist with this competency.
Career Goals and Objectives
My career goals are to integrate the proactive health focus of corporate wellness with the critical thinking skills of the ICU. One of my career goals is to provide primary care in the home. Nurse practitioner providers of home care are increasing (Chun-An Sun et al., 2022). Having an FNP who makes home visits, assesses, provides plan of care, education, and care coordination decreases emergency room visits and hospitalizations (Chun-An Sun et al., 2022). Pediatric home care is often palliative care ( Neunhoeffer et al.,2022). Home care of vent-dependent pediatric patients has no increase in serious adverse events as compared to skilled nursing care (Neunhoeffer et al., 2022). However, there were increased infections of tracheostomies with children under the age of one and who had feeding tube challenges (Neunhoeffer et al.,2022). Family-centered care is found in home care too. Research about other children in the home of pediatric palliative home care patients found that they have decreased perceived quality of life, decreased physical, and psychological well-being (Dinkelbach et al., 2023). Home visits for pediatrics can also include assessments of growth and development which can lead to early interventions (Wrightman et al., 2022). In summary, for providing home care for the pediatric patient and family, an intimate knowledge of growth and development, a knowledge of abnormal findings and resources available, and an awareness of the “family” patient, and shared decision –making will lead to improved outcomes.
References
Chun-An Sun, Parslow, C., Gray, J., Koyfman, I., deCardi Hladek, M., & Hae-Ra Han. (2022). Home-based primary care visits by nurse practitioners. Journal of the American Association of Nurse Practitioners, 34(6), 802–812. https://doi.org/10.1097/JXX.0000000000000706
Dinkelbach, L., Köhler, M., Galushko, M., Pieper, L., Kuhlen, M., Danneberg, M., Dechert, O., Trocan, L., & Janßen, G. (2023). Psychosocial Well-Being of Siblings of Pediatric Patients in Palliative Home Care. Journal of Pain and Symptom Management, 66(6), 630–637. https://doi.org/10.1016/j.jpainsymman.2023.08.022Links to an external site.
Louis, K., & White, A. (2023). Impact of Kangaroo Care on Caregivers in the NICU: An Integrative Review. Pediatric Nursing, 49(4), 185–194.
Neunhoeffer, F., Miarka-Mauthe, C., Harnischmacher, C., Engel, J., Renk, H., Michel, J., Hofbeck, M., Hanser, A., & Kumpf, M. (2022). Severe adverse events in children with tracheostomy and home mechanical ventilation – Comparison of pediatric home care and a specialized pediatric nursing care facility. Respiratory Medicine, 191.https://doi.org/10.1016/j.rmed.2021.106392Links to an external site.
Sheehan, R., & Fealy, G. (2020). Trust in the nurse: Findings from a survey of hospitalised children. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 29(21/22), 4289–4299. https://doi.org/10.1111/jocn.15466Links to an external site.
Weiss, M.R., Kipp, L.E. & Riley, A. (2023). Inspiring IDEA: Girls on the Run’s developmental approach to and assessment of inclusion, diversity, equity, and access programming. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1128680
Westbrook, J.I., Li, L., Raban, M.Z., Mumford, V ., Badgery-Parker, T., Gates, P., Fitzpatrick, E., Merchant A., Woods, A., Baysari, M., McCullagh, C., Day, R., Gazarian, M., Dickenson, M., seaman, K., Dalla-Pozza, L., Ambler, G., Barclay, P., Gardo, A., O’Brien, T., Barbaric, D., and White, L. Short- and long-term effects of an electronic medication management system on paediatric prescribing errors. NPJ. Digit. Med. 5, 179 (2022). https://doi.org/10.1038/s41746-022-00739-xLinks to an external site. GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion
Wightman, L., Hutton, A., & Grant, J. (2022). Child and family health nurses’ roles in the care of infants and children: A scoping review. Journal of Child Health Care, 26(3), 448–460. https://doi.org/10.1177/13674935211026123Links to an external site.
GETTING STARTED WITH PEDIATRICS
Primary care of children from newborns to those on the cusp of adulthood requires considerable knowledge, as well as the finesse to manage parents and families of all types, and the changing needs, attitudes, and independence of young people as they grow and mature. Considering that this week—in fact, this entire first module—is focused on growth and development, it is fitting for you to reflect on your current and anticipated growth and development in advanced nursing, and specifically, in pediatric care. When you made your decision to pursue training as a Family Nurse Practitioner, how did pediatrics factor in your thinking? Is the opportunity to work with children and adolescents a strong motivator, or does it rank for you as more of a concern?
As you get started with this course, take time to reflect on your present capacity as you prepare to immerse yourself in the requirements of pediatric care as a nurse practitioner. How can you benefit most from this course, and how can it further you along the professional path you have chosen or in achieving your career goals?
This Discussion can be a catalyst for self-assessment and offer valuable insights from your colleagues. It is also an opportunity to get to know them and to introduce yourself, in anticipation of further interaction as you engage in the course i-Human Assignments.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To prepare:
- Review this week’s Learning Resources, and particularly Chapters 5, 6, 8, and 14 of the Burns’ Pediatric Primary Care text.
- Consider the roles and responsibilities of a nurse practitioner providing pediatric primary care. Work to define the strengths you bring to the position of Family Nurse Practitioner and the challenges you face.
- Reflect on this course and what you expect to learn and do, such as by reviewing the course description, outcomes, and course introduction. Consider how the next 11 weeks can help build your strengths and address your challenges.
- Also consider your career goals and objectives and how this course can support and/or further them. Be detailed in your thinking.
BY DAY 3 OF WEEK 1
Post a brief introduction of yourself that includes an explanation of your strengths and challenges as they apply to pediatrics and the role of a Family Nurse Practitioner. Also explain your career goals and objectives, and how your work in this course can help to accomplish those goals and objectives as a Family Nurse Practitioner. Use your research to support your explanations by providing credible and scholarly sources.
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues’ posts on two different days by offering suggestions or resources to help your colleagues in addressing their professional strengths, challenges, or career goals and objectives. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources.
GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion sample 2
GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion sample 3
Getting Started with Pediatrics
My Strengths and Challenges
After reviewing my self-evaluation of clinical skills and reading the assigned materials for this week, I have realized that I face more challenges than strengths when it comes to caring for children and adolescents. Although I have a background as a home health pediatric nurse for two years and a pediatric operating room nurse for six years, I now recognize that my experience was limited to a specific age range and a small number of patients. Despite being aware of the challenges in pediatrics, I am not opposed to considering specialization in this field. I feel comfortable working with children, which is an advantage developed from my previous training. According to Armstrong et al. (2023), there are concerns about the reduced number of advanced practice practitioners specializing in pediatrics. Their study found that the primary factor that influences a candidate’s decision to specialize in pediatrics is their prior exposure to pediatric care. After a few years in adult health, I hope to diversify my skill set and consider working in pediatrics.
In my role as a home health nurse, I primarily worked with the same 2-4 children each week, which allowed me to establish a rapport with them but also meant that most of my assessments were similar unless a child had a cold or seizures. Similarly, in the operating room, the Nurse Practitioner completed the initial head to toe assessments during the patient’s preoperative visit, leaving little time for me to speak with the patient and parents on the day of surgery as my focus was on setting up the equipment and sterile supplies.
Strategies for Improvement
As a healthcare professional, I acknowledge the need for me to improve my knowledge and experience in conducting health assessments for pediatric patients of all ages. It is essential to develop my assessment skills to ensure quality care is provided to this patient population. According to Musselman et al. (2023), interacting with pediatric patients in a developmentally appropriate manner can alleviate their anxieties about medical treatments. Horner (2020) suggests that soliciting feedback from the child can be a simple yet effective way to ensure appropriate care is being provided.
This week, I have been working on developing a strategy to assess the appropriate growth and development stages of children. It is a significant challenge, but it is an integral part of providing quality care to this patient population. With the guidance of our professor, I have initiated a developmental map that incorporates the CDC vaccination schedule.
In this course, we will learn how to treat acute and chronic conditions in children and adolescents. When dealing with children suffering from chronic conditions, it is important to remember that they may regress to a previous developmental stage to cope with stress (Musselman et al., 2023).
Like the rest of the nation, Hawaii faces a shortage of primary care providers. Shockingly, new graduates leave their jobs within the first year, with the need for NPs continuing to rise (Horner, 2020). Horner’s study found that new NPs reported higher satisfaction in their first year working with positive mentors. Applying this to my situation, I can develop positive relationships with professors, preceptors, and pediatric office personnel to help me succeed.
Career Goals
My current career plan is to begin adult care with the practice I currently work with. The two internal medicine physicians I work with are great mentors and sources of information. I look forward to diversifying myself professionally and providing care from pediatrics to adults, giving back to my home and people in Hawaii, and truly caring for others. Though it may seem daunting, with practice and application of my studies, I know it is attainable.
References
Armstrong, A. B., Bowman, A., Goreth, M., Trabosh, T., & Gigli, K. H. (2023). Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners. Journal of Pediatric Healthcare, 37(3), 319–327. https://doi.org/10.1016/j.pedhc.2022.12.005Links to an external site. GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion
Horner, D. K. (2020). Mentoring: Positively Influencing Job Satisfaction and Retention of New Hire Nurse Practitioners. Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses, 40(3), 150–165.https://doi.org/10.1097/PSN.0000000000000333Links to an external site.
Musselman, E., Shea, K., & Johnson, L. (2023). Developmentally Appropriate Care of Pediatric Patients in the Perioperative Setting. AORN Journal, 117(2), 98–108. https://doi.org/10.1002/aorn.13863
GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion sample 4
Main Discussion Post Week 1
Strengths and Challenges as they Apply to Pediatrics
Pediatrics is a specialized field within the medical profession in which I have very little to almost no experience other than raising two children who are now young adults. All my nursing experience is in addictions and the adult psych in a state-run hospital working 3rd shift. My explanation of my strengths in the pediatric population would be the ability to connect with the patient, give a comfortable and trusting environment, be compassionate and caring while offering a therapeutic relationship with the child and parents, have excellent communication skills, and, most importantly, have patience. Not having these strengths opens you up to facing various challenges. For example, if the provider knows a child has a history of feeling scared or anxious about visiting a healthcare provider’s office, it would be wise to make the child feel safe and comfortable in the environment they are visiting by being approachable and communicating on the child/adolescence level of development. An explanation of my challenge would be dealing with the parents who struggle with complying with medical advice who have a different view on treatment. With this challenge, you must be culturally sensitive to others while having great communication skills at conveying your reasons for your recommendations; this may be effective if up-to-date research with statistics is available to the parents (Hockenberry et al., 2021).
The Role of a Family Nurse Practitioner
Because pediatrics focuses on the healthcare and well-being of children, the role of a Family Nurse Practitioner should focus on combined elements of primary care, patient advocacy, and advanced nursing practice to deliver high-quality and patient-centered care (Buppert, 2020). One of the primary responsibilities of a family nurse practitioner is to provide primary care services to individuals across the lifespan. This includes conducting routine physical examinations, diagnosing and treating common illnesses and injuries, and ordering and interpreting diagnostic tests. FNPs also manage chronic conditions often seen in pediatric patients, such as diabetes, hypertension, and asthma (Cooper et al., 2019).
Career Goals and Objectives
My career goals and objectives revolve around a comprehensive and holistic care to individuals and families across the lifespan. My objective is to become a trusted healthcare provider for patients and their families, build a strong patient-to-provider professional relationship by building on trust, respect, and open communication, deliver evidence-based care, and promote health education and preventative measures. Coats et al., 2018 conducted a study that revealed patient trust in providers was 71.2% to 81.4% when it came to building a relationship. Communication, spiritual belief, and other factors were just a little behind.
Accomplish Goals and Objectives as a Family Nurse Practitioner
To achieve these goals, I recognize the importance of continuous learning. I plan to stay up-to-date with the latest research and required readings and collaborate with other colleagues in this class. Hands-on training and real-life scenarios in the practicum portion of this course can help me achieve my goals and objectives. By constantly expanding my knowledge, I can provide my patients with the highest quality of care and serve as a valuable resource within this course rotation.
References
Buppert, C. (2020). Nurse practitioner’s business practice and legal guide. Jones & Bartlett Learning.
Coats, H., Downey, L., Sharma, R. K., Curtis, J. R., & Engelberg, R. A. (2018). Quality of communication and trust in patients with serious illness: an exploratory study of the relationships of race/ethnicity, socioeconomic status, and religiosity. Journal of pain an d symptom management, 56(4), 530-540.
Cooper, M. A., McDowell, J., Raeside, L., & ANP–CNS Group. (2019). The similarities and differences between advanced nurse practitioners and clinical nurse specialists. British Journal of Nursing, 28(20), 1308-1314.
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2021). Wong’s essentials of pediatric nursing-e-book. Elsevier Health Sciences. GETTING STARTED WITH PEDIATRICS NRNP-6541 Week 1 Discussion