EXPANDED AND EXTENDED

ROLE OF PEDIATRIC NURSE

S. K Mohana sundari
Introduction
Pediatricnursing is a specialized area of
nursing practice
Itconcerning the care of the children from
conception till adolescent
 Itincludes 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
Role of the pediatric
nurse
It includes both caring and curing
Caringis the continuous process in both illness
and wellness
Curingrefers 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
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 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
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 familyfor necessary social
Team coordinator and collaborator
Pediatricnurse 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 outcomewith better prognosis and
good health
Child care advocate
Childor family advocacyin basic aspects to
comprehensive family centered care
As an advocate the pediatric nurse can assist
the child to obtain the best care possible from
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.
Pediatricnurse 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
Ethicaldilemmas 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
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
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
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
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
Provideanticipatory 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
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
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
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
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
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
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)