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EXPANDED AND EXTENDED
ROLE OF PEDIATRIC NURSE
S. K Mohana sundari
Introduction
Pediatric nursing is a specialized area of
nursing practice
It concerning the care of the children from
conception till adolescent
It includes preventive, promotive, curative and
rehabilitative care of children
The pediatric nurse involves in giving
assistance care and support to the growing and
developing children to achieve their individual
potential for functioning with fullest capacity
Role of the pediatric nurse
It includes both caring and curing
Caring is the continuous process in both illness
and wellness
Curing refers to the act of diagnosis and
management usually during illness
Pediatric nurse have the responsibilities of
proving nursing care in hospital, home clinics,
school and community
The role of pediatric nurse may vary from one
institution to other institution.
Qualities of pediatric nurse
 Be a loving person and have liking for the children
 Have patience, pleasant appearance, and ability to
understand the child’s behaviour
 Be able to maintain good interpersonal relationship
and to provide safety and security to the children.
 Be friendly, honest, gentle, diligent and humorous
 Have good observation, judgment and communication
ability based on scientific knowledge and experience
 Be well informed, skillful, responsible, truthful and
trustworthy.
Extended role of pediatric nurse
1.Primary care giver
 Pediatric nurse should provide preventive, promotive,
curative and rehabilitative care of children,
 Care in all levels of health services, as therapeutic
agent.
 She act as case finder and compassionate skilled
caregiver as needed by the today's society.
 Primary care includes providing comfort, feeding,
bathing, safety etc.
 Health assessment and immunization is primary care
in the community,
Health educator
The important role of nurse is to deliver
planned and incidental health Care teaching
and information to the patient
It is given to create awareness about healthy
life style and maintenance of health change in
health behaviour
To bring change in attitude and to develop
healthful practices regarding child care
It is initiated by pediatric nurse as change
agent and health educator.
Nurse counselor
 Problem solving approach and necessary guidelines in
health hazards of children to minimize or to solve the
problem
 To help the parents and family member for
independent decision making in different situation
Social worker
 She can do case work especially for children and try
to alleviate social problems related to child health.
 She can participate in available social services
 Can refer child and family for necessary social
support from the child welfare agency.
Team coordinator and collaborator
Pediatric nurse should work together and in
combination with other health care team
members towards better child health care.
She should act as liaisons among the members
and maintain good interpersonal relationship
The nurse interprets the objective of the health
care of to the family and coordinates nursing
services with other services necessarily for the
child
Cooperation and good communication among
team members should be promoted by nurse.
Manager
The pediatric nurse is the manager of pediatric
Care in hospital, Clinics, and community .
She should organize the care orderly for
successful outcome with better prognosis and
good health
Child care advocate
Child or family advocacy in basic aspects to
comprehensive family centered care
As an advocate the pediatric nurse can assist
the child to obtain the best care possible from
the particular units.
Recreationalist
 The supportive role of pediatric nurse is important for
the child to adjust to the crisis imposed by illness or
hospitalization
 She can organize play activities for recreation and
diversion for child’s emotional outlet
Nurse consultant
 she can act as a consultant to guide the parents and
family members for maintained and promote of health
and prevention of childhood illness
 The nurse can help the older children to become
responsible for their own action.
Researcher
Nursing research is the integral part of
professional nursing.
Pediatric nurse should participate of perform
research projects related to child health.
Clinical and applied research provides the
basis for changes in nursing practice and
improvement, in the health care of children
Therapeutic relationship
 It I the essential foundation for quality nursing care.
 She must relate children and family in a meaningful
way, and yet remain separate enough to distinguish
their own feeling and needs in a therapeutic
relationship
 Caring well defined boundaries separate the nurse
from the child.
 This boundaries are positive and professional and
promote the family’s control over the child’s health
care with in a therapeutic relationship.
Restorative role
Nurses are intimately involved with meeting
the physical and emotional need of children,
including feeding, bathing, toileting, dressing,
securing, and socialization
The nurses must aware of normal findings to
identify and document deviation
She should never lose the sight of the child
individually.
Emotional as developmental needed because
these needs influenced the course of the
disease.
Ethical decision making
Ethical dilemmas arise when competing moral
consideration undertaken various alternative.
 parents, nurses, physician and other health
care team members may reach different but
morally defensible decision by assigning
different weight to the competing moral values
Nurses must determine the most beneficial or
least harmful action with in the frame work of
societal morals, professional actions, standards,
the laws, institutional rules, religious tradition ,
the family values and the nurse personal values
Health care planning
Today’s nurses role has expanded beyond the
nuclear of the family to include the community
based- health- driven system.
Traditionally nurses were involved in public
health either on a continuous or episodic basis.
Nurses were involved in health care having on
a political or legislative level frequently.
Health care planning involves not only
providing new services to children and their
family but also promoting the highest quality
in existing services.
The functional role of nurse
The nurse may be described broadly not as a
parents substitute but a ‘father friend”
In this role the nurse may plan and actually
provide comprehensive care to children as in
primary nursing or many function as a member
of a nursing team.
Responsibility to community
To fulfill many of these responsibilities the
individual nurse must function not only in care
of episodic or distribution care but also in
broader community effort.
In this way the nurse can become, consumers,
community officials and planner and
professional and as lawyer , educator, and
other members of the health team.
Legal aspects
Basically the licensing laws have been and
written to protect the health care consumer
from harmful, unsafe or unprepared health care
providers
Consumers now also looking at them law to
determine whether, infact they are providing
this protection.
Nurses are responsible for their own action
The responsibility to use reasonable care in
action directed towards other
Expanded role of nurse
The 1st
expanded role for nurse was developed
during the 190’s at the university of Loroda
with the inception of the pediatric nurse
practitioner practice.
PNP was enacted to provide pediatric care in
ambulatory community health setting.
In 2000 the national sample survey of
registered nurse estimated there were 102,829
nurse practitioner with 14,643 are prepared an
clinical nurse specialist.
Advanced practice registered nurse
{APRN}
 The term APRN is being increasing used by
legislative and governing bodies to desirable the
collection of registered nurse.
 APRN has education beyond 4 years B.Sc (n)
 In addition to increased educators, the APRN role
requires extra responsibility, critical thinking and
judgment.
APRN includes
 Nurse practitioner
 Clinical nurse specialist
 Certified nurse midwife
 Certified registered nurse anesthetists.
Pediatric nurse practitioner
In 15 PNP program was developed and leed to
several specialized ambulatory primary care
role for nurses.
This program provides education beyond B. Sc
(N) preparation in area of child health
maintenance.
PNP are health care provider who are
dedicated to improve child health care by
working with pediatrician and other health care
workers
Functions of pediatric nurse practitioner
Provide health maintenance care for children
including well child examination.
Perform routine developmental services.
Diagnose and treat common childhood illness
Provide anticipatory guidance regarding
common child health concern.
Provide childhood immunization.
Functions of Acute care and specialist
PNP
Perform school physical examination
Provide care to children who are acutely
chronically ill.
Perform in-depth physical examination.
Inspects result of laboratory and diagnostic
test.
Order medication and perform therapeutic
treatment in a variety of setting.
Job duties of PNP
Effectively identifies, evaluates, and addresses
disease prevention and health promotion issue
of the population.
Work with independent and interdependent
relationship with members of the medical staff.
Responsible for the diagnosis and treatment of
acute, chronic and long term health care issues.
Maintaining legible, accurate and confidential
medical records.
Analyze new knowledge gained from
conference, workshops, professional training.
Chronic ill care concentration
The chronic ill care concentration includes
clinical course in specific specialty area
approved by program faculty.
This concentration prepares the PNP students
for a care of children with chronic condition.
The PNP interact with other health care worker
to [provide health care to chronically ill
children
The scholarly inquiry praxis for students is
diagnosed to focus on an issue or top relevant
to care of children with chronic illness.
Advanced pediatric nurse
The curriculum includes classroom and clinical
experience in advanced health assessment,
physiology And pathophysiology management
with common and complex illness condition.
Graduate of the program with a specialization
APPN an preparing to become leader in care of
children across the health and illness spectrum
and across institutional boundaries.
There are eligible for state licensure as a nurse
practitioner and for rational certificate as PNP.
Acute care pediatric nurse practitioner
 It is 2 years program leading to the master of science
degree
 ACPNP are advanced practice who provides expert
clinical care to acute and critically ill children at risk
of dying
 ACPNP is the only course which provides training in
end of life care and palliative care focus as part of
course.
 graduate are eligible for state licensure as a nurse
practitioner
 The program has been approved by pediatric nursing
certificate boadr. .
Goal of ACPNP
To provide advanced nurse who will promote
the health and development of children and
adolescents as individual and as population
group encountering health care system with the
urban and rural environment.
To promote expert clinical care to meet the
specialized physiological and psychological
need of the children.
PNP – primary care
 The PNP – primary care program offers one clinical
specialty treat which involves primary care for
children with acute and chronic illness.
 Graduate of this clinical specialty prepared to provide
comprehensive health care need of infants, children ,
adolescent and their families in a variety of setting.
 Graduate are required to complete 500 hours of
clinical practice.
 The 4 hour graduate program can be completed in one
calendar year of full time study or may be part time.

Family nurse practitioner
FNP is a registered professional nurse with
advanced education and clinical training to
provide health care to individuals across the
lifespan and there families.
Function is to provide multidisciplinary,
culturally competent , community based care
They provide opportunity for students to
acquire current knowledge.
Provide age appropriate , age specific quality
care.
THE CLINICAL NURSE
SPECIALIST
Act as researcher to validate nursing
observation and intervention a change agent
with in the health care system
Provide consultant services.
The CNS role has developed within each of the
traditional specialty area as well a subspecialty
such as cardiovascular, oncology, and
neurology.
Both CNS and PNP are called as advanced
nurse practitioner.
Critical care neonatal nurse
The nurses are theoretically ad technically
prepared to provide effective nursing care
The training and education can be given in
hospital setting in the form of certified
continuous education program.
The program is to prepare nurse to function as
SNN/CCNN
The post basic specialty education will
positively influence the role of SNN/CCNN.
Neonatal nurse practitioner
NMP can be created from the cadre of nurse
who passed out from college of nursing with
b.sc/ m.sc degree with neonatology as specialty
as any b.sc nurse who undertaken
specialization training in neonatal care and has
hands on training in practical care of newborn
for reasonable period of time
In the NICU it is essential to provide highly
desirable quality of care with 24 hours
coverage for each of there roles.
Conclusion
Journal reference
Theory application (general system theory)
Assignment (role of pediatric nurse in
community)
Bibliography

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Expanded and extended role of pediatric nurse

  • 1. EXPANDED AND EXTENDED ROLE OF PEDIATRIC NURSE S. K Mohana sundari
  • 2. Introduction Pediatric nursing is a specialized area of nursing practice It concerning the care of the children from conception till adolescent It includes preventive, promotive, curative and rehabilitative care of children The pediatric nurse involves in giving assistance care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity
  • 3. Role of the pediatric nurse It includes both caring and curing Caring is the continuous process in both illness and wellness Curing refers to the act of diagnosis and management usually during illness Pediatric nurse have the responsibilities of proving nursing care in hospital, home clinics, school and community The role of pediatric nurse may vary from one institution to other institution.
  • 4. Qualities of pediatric nurse  Be a loving person and have liking for the children  Have patience, pleasant appearance, and ability to understand the child’s behaviour  Be able to maintain good interpersonal relationship and to provide safety and security to the children.  Be friendly, honest, gentle, diligent and humorous  Have good observation, judgment and communication ability based on scientific knowledge and experience  Be well informed, skillful, responsible, truthful and trustworthy.
  • 5. Extended role of pediatric nurse 1.Primary care giver  Pediatric nurse should provide preventive, promotive, curative and rehabilitative care of children,  Care in all levels of health services, as therapeutic agent.  She act as case finder and compassionate skilled caregiver as needed by the today's society.  Primary care includes providing comfort, feeding, bathing, safety etc.  Health assessment and immunization is primary care in the community,
  • 6. Health educator The important role of nurse is to deliver planned and incidental health Care teaching and information to the patient It is given to create awareness about healthy life style and maintenance of health change in health behaviour To bring change in attitude and to develop healthful practices regarding child care It is initiated by pediatric nurse as change agent and health educator.
  • 7. Nurse counselor  Problem solving approach and necessary guidelines in health hazards of children to minimize or to solve the problem  To help the parents and family member for independent decision making in different situation Social worker  She can do case work especially for children and try to alleviate social problems related to child health.  She can participate in available social services  Can refer child and family for necessary social support from the child welfare agency.
  • 8. Team coordinator and collaborator Pediatric nurse should work together and in combination with other health care team members towards better child health care. She should act as liaisons among the members and maintain good interpersonal relationship The nurse interprets the objective of the health care of to the family and coordinates nursing services with other services necessarily for the child Cooperation and good communication among team members should be promoted by nurse.
  • 9. Manager The pediatric nurse is the manager of pediatric Care in hospital, Clinics, and community . She should organize the care orderly for successful outcome with better prognosis and good health Child care advocate Child or family advocacy in basic aspects to comprehensive family centered care As an advocate the pediatric nurse can assist the child to obtain the best care possible from the particular units.
  • 10. Recreationalist  The supportive role of pediatric nurse is important for the child to adjust to the crisis imposed by illness or hospitalization  She can organize play activities for recreation and diversion for child’s emotional outlet Nurse consultant  she can act as a consultant to guide the parents and family members for maintained and promote of health and prevention of childhood illness  The nurse can help the older children to become responsible for their own action.
  • 11. Researcher Nursing research is the integral part of professional nursing. Pediatric nurse should participate of perform research projects related to child health. Clinical and applied research provides the basis for changes in nursing practice and improvement, in the health care of children
  • 12. Therapeutic relationship  It I the essential foundation for quality nursing care.  She must relate children and family in a meaningful way, and yet remain separate enough to distinguish their own feeling and needs in a therapeutic relationship  Caring well defined boundaries separate the nurse from the child.  This boundaries are positive and professional and promote the family’s control over the child’s health care with in a therapeutic relationship.
  • 13. Restorative role Nurses are intimately involved with meeting the physical and emotional need of children, including feeding, bathing, toileting, dressing, securing, and socialization The nurses must aware of normal findings to identify and document deviation She should never lose the sight of the child individually. Emotional as developmental needed because these needs influenced the course of the disease.
  • 14. Ethical decision making Ethical dilemmas arise when competing moral consideration undertaken various alternative.  parents, nurses, physician and other health care team members may reach different but morally defensible decision by assigning different weight to the competing moral values Nurses must determine the most beneficial or least harmful action with in the frame work of societal morals, professional actions, standards, the laws, institutional rules, religious tradition , the family values and the nurse personal values
  • 15. Health care planning Today’s nurses role has expanded beyond the nuclear of the family to include the community based- health- driven system. Traditionally nurses were involved in public health either on a continuous or episodic basis. Nurses were involved in health care having on a political or legislative level frequently. Health care planning involves not only providing new services to children and their family but also promoting the highest quality in existing services.
  • 16. The functional role of nurse The nurse may be described broadly not as a parents substitute but a ‘father friend” In this role the nurse may plan and actually provide comprehensive care to children as in primary nursing or many function as a member of a nursing team.
  • 17. Responsibility to community To fulfill many of these responsibilities the individual nurse must function not only in care of episodic or distribution care but also in broader community effort. In this way the nurse can become, consumers, community officials and planner and professional and as lawyer , educator, and other members of the health team.
  • 18. Legal aspects Basically the licensing laws have been and written to protect the health care consumer from harmful, unsafe or unprepared health care providers Consumers now also looking at them law to determine whether, infact they are providing this protection. Nurses are responsible for their own action The responsibility to use reasonable care in action directed towards other
  • 19. Expanded role of nurse The 1st expanded role for nurse was developed during the 190’s at the university of Loroda with the inception of the pediatric nurse practitioner practice. PNP was enacted to provide pediatric care in ambulatory community health setting. In 2000 the national sample survey of registered nurse estimated there were 102,829 nurse practitioner with 14,643 are prepared an clinical nurse specialist.
  • 20. Advanced practice registered nurse {APRN}  The term APRN is being increasing used by legislative and governing bodies to desirable the collection of registered nurse.  APRN has education beyond 4 years B.Sc (n)  In addition to increased educators, the APRN role requires extra responsibility, critical thinking and judgment. APRN includes  Nurse practitioner  Clinical nurse specialist  Certified nurse midwife  Certified registered nurse anesthetists.
  • 21. Pediatric nurse practitioner In 15 PNP program was developed and leed to several specialized ambulatory primary care role for nurses. This program provides education beyond B. Sc (N) preparation in area of child health maintenance. PNP are health care provider who are dedicated to improve child health care by working with pediatrician and other health care workers
  • 22. Functions of pediatric nurse practitioner Provide health maintenance care for children including well child examination. Perform routine developmental services. Diagnose and treat common childhood illness Provide anticipatory guidance regarding common child health concern. Provide childhood immunization.
  • 23. Functions of Acute care and specialist PNP Perform school physical examination Provide care to children who are acutely chronically ill. Perform in-depth physical examination. Inspects result of laboratory and diagnostic test. Order medication and perform therapeutic treatment in a variety of setting.
  • 24. Job duties of PNP Effectively identifies, evaluates, and addresses disease prevention and health promotion issue of the population. Work with independent and interdependent relationship with members of the medical staff. Responsible for the diagnosis and treatment of acute, chronic and long term health care issues. Maintaining legible, accurate and confidential medical records. Analyze new knowledge gained from conference, workshops, professional training.
  • 25. Chronic ill care concentration The chronic ill care concentration includes clinical course in specific specialty area approved by program faculty. This concentration prepares the PNP students for a care of children with chronic condition. The PNP interact with other health care worker to [provide health care to chronically ill children The scholarly inquiry praxis for students is diagnosed to focus on an issue or top relevant to care of children with chronic illness.
  • 26. Advanced pediatric nurse The curriculum includes classroom and clinical experience in advanced health assessment, physiology And pathophysiology management with common and complex illness condition. Graduate of the program with a specialization APPN an preparing to become leader in care of children across the health and illness spectrum and across institutional boundaries. There are eligible for state licensure as a nurse practitioner and for rational certificate as PNP.
  • 27. Acute care pediatric nurse practitioner  It is 2 years program leading to the master of science degree  ACPNP are advanced practice who provides expert clinical care to acute and critically ill children at risk of dying  ACPNP is the only course which provides training in end of life care and palliative care focus as part of course.  graduate are eligible for state licensure as a nurse practitioner  The program has been approved by pediatric nursing certificate boadr. .
  • 28. Goal of ACPNP To provide advanced nurse who will promote the health and development of children and adolescents as individual and as population group encountering health care system with the urban and rural environment. To promote expert clinical care to meet the specialized physiological and psychological need of the children.
  • 29. PNP – primary care  The PNP – primary care program offers one clinical specialty treat which involves primary care for children with acute and chronic illness.  Graduate of this clinical specialty prepared to provide comprehensive health care need of infants, children , adolescent and their families in a variety of setting.  Graduate are required to complete 500 hours of clinical practice.  The 4 hour graduate program can be completed in one calendar year of full time study or may be part time. 
  • 30. Family nurse practitioner FNP is a registered professional nurse with advanced education and clinical training to provide health care to individuals across the lifespan and there families. Function is to provide multidisciplinary, culturally competent , community based care They provide opportunity for students to acquire current knowledge. Provide age appropriate , age specific quality care.
  • 31. THE CLINICAL NURSE SPECIALIST Act as researcher to validate nursing observation and intervention a change agent with in the health care system Provide consultant services. The CNS role has developed within each of the traditional specialty area as well a subspecialty such as cardiovascular, oncology, and neurology. Both CNS and PNP are called as advanced nurse practitioner.
  • 32. Critical care neonatal nurse The nurses are theoretically ad technically prepared to provide effective nursing care The training and education can be given in hospital setting in the form of certified continuous education program. The program is to prepare nurse to function as SNN/CCNN The post basic specialty education will positively influence the role of SNN/CCNN.
  • 33. Neonatal nurse practitioner NMP can be created from the cadre of nurse who passed out from college of nursing with b.sc/ m.sc degree with neonatology as specialty as any b.sc nurse who undertaken specialization training in neonatal care and has hands on training in practical care of newborn for reasonable period of time In the NICU it is essential to provide highly desirable quality of care with 24 hours coverage for each of there roles.
  • 34. Conclusion Journal reference Theory application (general system theory) Assignment (role of pediatric nurse in community) Bibliography