Nursing: Transitions in Pediatric Nursing

What does the future appear to hold for pediatric nurses?

Transitions are inevitable in all aspects of nursing, including pediatrics. Previous transitions in pediatric nursing may shed some new light on what pediatric nurses may expect in the future and reveal how they can prepare for this transition. 

Pediatrics has always been one of the chosen careers, for many registered nurses who have children of their own or others, who love children and enjoy working with them. Pediatrics can be exciting and interesting.

Not too many years ago, pediatric wards were overflowing with children of all ages. Sometimes, there were barely enough beds for all of the children requiring nursing care. There was one admission after another. Many of the children were quite ill and needed lengthy hospitalization, while others were being admitted for minor or major surgery. The bed shortage on pediatric wards increased. Many of the older children had to be admitted to medical or surgical floors, because there were no rooms available on the pediatric floors.

There was a marked shortage of pediatric nurses and the demand for registered nurses was high. Pediatric wards everywhere were hiring registered nurses.

In the early 1970's, pediatric floors in hospitals underwent a sudden transition, as hundreds of women began to have abortions. There were few children being born and the number of children needing to be hospitalized for nursing care was reduced. There were barely enough children to keep pediatric wards open. Pediatric floors were closed completely in many general hospitals. In some cities, all of the pediatric facilities from the various hospitals were re-located to one hospital.

On pediatric wards, the beds were filled with elderly people, in need of medical nursing care. Pediatric floors were turned into medical wards. Hospitals were in turmoil, as head nurses from medical floors began to take charge of pediatric wards.

There was no longer a demand for pediatric nurses and there were few pediatric jobs for them. There was no job security. This was devastating to many pediatric nurses, particularly those who had specialized in pediatrics, as they found that their jobs were cut.

Many pediatric nurses were forced to seek employment in other areas of nursing. Some pediatric nurses left hospitals and found employment in other areas, like family practices, long term child care facilities or day care centers. Other pediatric nurses moved on to seek higher education in other fields, unrelated to pediatric nursing.

During this era, pediatric nursing is in a state of flux, but the number of children needing nursing care is gradually increasing again.

Pediatric nursing is a wonderful occupation for registered nurses, particularly for those who love working with children. Pediatric wards are happy places. Children are either really ill or they are up and running about. There is no middle ground. Pediatric wards are full of life, energy and fun. The unexpected is always waiting to happen.

The demands on registered nurses in pediatric wards can be high, at times. Pediatric nursing requires a lot of energy. Keeping up with children who are healthy can be a challenge, but working with children, who are ill, can be extremely demanding.

While in the hospital, children need all of the care that they get at home and then some, particularly when they are ill, so pediatric nurses require child-specific, nursing skills and expertise. This can be related to medication, treatment and procedures of various kinds. Of course, these realms are continually changing, too.

Pediatric nurses require advanced interaction and interpersonal relationship skills. Sometimes, parents need more attention than the children do because of fear, frustration, anger, guilt or other problems related to health concerns, medical problems, surgery or various kinds of procedures or treatments for their children.

Many times registered nurses have to fill the role of the parent or parents, who are absent. Children can become very upset, lonesome or homesick, when hospitalized and tender love and care is needed.

Registered nurses are called upon to function as child and family counselors, particularly when children are seriously ill. Pediatric palliative care requires a lot of compassion. Taking care of children can be a joyful experience for pediatric nurses, but at the same time, it can be stressful when children are dying.

When children are admitted, there may be evidence of child abuse or neglect that results in hospitalization. Sometimes, social service agencies have to become involved. In hospital settings, children have to be protected even from family members, at times.

Fortunately, the health and welfare of children is becoming increasingly important, globally.

One of the current transitions has to do with the increased number of children being born.

For example, in Canada, there have been recent changes with respect to additional child support for parents with children. Part of the financial burden of raising children has been lifted and parents are being encouraged to bring children into the world.

There are increasing numbers of single parent families, which means that there may be only one parent with a child who is hospitalized. The need for pediatric nurses may increase because of this.

There is a growing emphasis on improved health care for children, particularly First Nation children. More native children are being born.

Many children are coming into the country from other cultures, through adoption or due to the increased immigration from other countries, particularly third world countries.

The increase in the number of children leads to more children needing nursing care in hospital settings or in their homes. The number of pediatric wards is likely to increase. A demand for registered nurses specializing in pediatric nursing can be anticipated.

One major transition is the shift in the focus of health care, from predominantly white, Caucasian children, to native children and children from different cultures. This will require pediatric nurses to have advanced education with respect to other races, religions and cultures.

Another transition has to do with increasing global health concerns, like AIDS/HIV. No country is exempt from the spread of disease and this includes children.

Yet another transition has to do with the length of time that pediatric patients will be hospitalized. The length of a hospital stay is being reduced for pediatric patients. It would seem that in the future, the trend will be towards more pediatric nurses, giving pediatric nursing care in patient's homes. This may even prove to be on a nurse practitioner basis.

In conclusion, one might suggest that the horizon of pediatrics is expanding. The future looks bright, particularly for those trained in advanced, pediatric nursing.