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The joy of pediatrics
PH C
EDITORIAL
The Joy of Pediatrics: Working With Children
B o b b i e C r e w N e l m s , P h D, R N , C P N P
E
very now and then, I find myself thinking back over my professional career. Although there are certainly things I would change if given another opportunity, one aspect I would never change is my decision to work in the field of pediatrics. I honestly think those of us who have the opportunity to provide health care for children have been given a special gift. We have the joy of working with children; not everyone is so fortunate. As we know, working with children is certainly not all filled with happy and uplifting experiences. We see children who are in chronic pain, children who cry furiously, fearing the next diagnostic test, and children who bravely face each day with a chronic or terminal illness. Those aspects of pediatrics can hurt us to the core. However, even in these types of circumstances, we are working with children, and that makes these experiences (and all the positive ones) unique and something that fills me with pride. I’m glad to be in the field of pediatrics and frequently feel my colleagues who do not get to work with children are in some way deprived. When I consider what it is about working with children that I love so much, two major aspects emerge. The first, a selfish one, is the opportunity to see the world from the child’s perspective, and the second is the opportunity to have an impact on many important areas of a child’s and family’s life, an
March/April 2004
impact that can alter the child’s future physical, emotional, and social development. I have always loved growth and development (well, except for that boring class in my undergraduate nursing pro-
I
’m glad to be in the
field of pediatrics and frequently feel my colleagues who do not get to work with children are in some way deprived.
gram in which all we did was memorize developmental milestones), but even that knowledge came alive when I arrived at my pediatric rotation. I will never forget my first day as a student of pediatrics. I quickly bathed the child
and made the bed, only to find by the end of breakfast that I had to re-bathe the child and remake the bed (I had no idea such a small person could make such a big mess). I also had a half-bowl of oatmeal flowing out of my nursing cap, the result of bending over the cereal bowl in front of a child that wasn’t too happy with me! I quickly realized this clinical experience was something different...it was not traditional medical-surgical nursing, and I loved it! It was then that growth and development came alive, and I truly learned to appreciate that children are not just little adults; they really do think and see the world differently. I really enjoy talking to children and hearing their thoughts, views, and conclusions about the world and life events. Just recently, for example, I went on a plane trip with my 7-year-old granddaughter. While at the airport, she saw the vapor trails from the planes taking off and asked what they were, so I launched into a long explanation of condensation, temperature differentials, etc. She listened carefully and then said, “You mean the plane is passing gas?” So much for my long explanation, but it quickly reminded me of that
J Pediatr Health Care. (2004.) 18, 55-56. 0891-5245/$30.00 Copyright © 2004 by the National Association of Pediatric Nurse Practitioners. doi:10.1016/j.pedhc.2003.11.001
55
PH EDITORIAL C unique view of the world children have, making new situations “fit” into their own reality. Working in pediatrics allows us to enter that world again. Of course, that’s a challenge for us, too, as we must explain things such as illnesses and treatments in a manner that the child can understand, but I think it’s figuring out how to communicate with the child that is one of the great aspects of pediatrics. The second aspect that I love about working with children is the opportunity to have an impact on many aspects of the child’s life. This impact comes from the education and explanations we provide to parents as they strive to help their children grow and develop. Our first encounters with families often occur during the newborn time. At that point, we help promote strong parentchild bonds that will last a lifetime. We can demonstrate to parents how their child responds to them and explain and demonstrate all those unique baby behaviors and cues that can sometimes frustrate and overwhelm new parents. This knowledge helps build parental self-confidence and self-esteem and better prepares them for the challenges yet to come. Thus, I think one of the best things we can do is to help parents become better parents, and that’s a role we play throughout all our experiences with the growing child and family. I’ve always thought one of the strengths of pediatrics is providing families anticipatory guidance (indeed, I always wonder why I don’t receive such guidance from my internist...don’t adults need such guidance too?). The guidance we give families helps them pre-
56
Volume 18 Number 2
Nelms
pare for the challenges ahead, such as the changes in feeding methods or discipline approaches that occur as the child matures. By receiving this knowledge ahead of such events, parents are better able to deal with these daily challenges, maintaining their selfconfidence because they knew what to expect and how to address it. I think we often forget this incredible impact we can have. This influence on children’s lives occurs in all areas (physical, emotional,
S
ometimes after a
particularly tiring or frustrating day, it helps to think about what we love about what we do.
and social). As pediatric health care providers, we are right there to help as new challenges arise, such as tackling the epidemic of childhood obesity with the NAPNAP H.E.A.T. campaign or the psychosocial morbidity issues via the KySS initiative. As nurses, we see the child holistically and can thus help parents and children face problems in numerous areas of their lives, not just the physical arena, and parents want such help. For example, a national survey of
parents of children aged birth-to-threeyears found that parents expressed the need for more information on childrearing, especially behavioral and developmental issues (Young, Davis, Schoen, & Parker, 1998). Although this particular study asked parents about “doctors” and did not mention nurse practitioners, the findings are important, as they give us insight into what parents want and need concerning child-rearing. The aspects of care that the parents identified as weak or missing in this study are the areas of pediatric care that we do so well, and such research findings should boost our efforts to do more. Providing pediatric health care is fun and challenging. As the role of the pediatric nurse practitioner continues to expand, one key aspect remains constant: our focus on the child and family in whatever setting we care for them. I have always been happy to say I am a pediatric nurse and hope that you are too. Sometimes after a particularly tiring or frustrating day, it helps to think about what we love about what we do. I’ve shared a few of my joys about working in pediatrics, and I know you could add to the list. I just hope you are as happy to work with children as I am. Enjoy the opportunities and challenges and realize that you can have a major impact on a child and family’s life! —Bobbie Crew Nelms, PhD, RN, CPNP
REFERENCE Young, K., Davis, K., Schoen, C., & Parker, S. (1998). Listening to parents: A national survey of parents with young children. Archives of Pediatric and Adolescent Medicine, 152, 255-262.
JOURNAL OF PEDIATRIC HEALTH CARE
EDITORIAL
The Joy of Pediatrics: Working With Children
B o b b i e C r e w N e l m s , P h D, R N , C P N P
E
very now and then, I find myself thinking back over my professional career. Although there are certainly things I would change if given another opportunity, one aspect I would never change is my decision to work in the field of pediatrics. I honestly think those of us who have the opportunity to provide health care for children have been given a special gift. We have the joy of working with children; not everyone is so fortunate. As we know, working with children is certainly not all filled with happy and uplifting experiences. We see children who are in chronic pain, children who cry furiously, fearing the next diagnostic test, and children who bravely face each day with a chronic or terminal illness. Those aspects of pediatrics can hurt us to the core. However, even in these types of circumstances, we are working with children, and that makes these experiences (and all the positive ones) unique and something that fills me with pride. I’m glad to be in the field of pediatrics and frequently feel my colleagues who do not get to work with children are in some way deprived. When I consider what it is about working with children that I love so much, two major aspects emerge. The first, a selfish one, is the opportunity to see the world from the child’s perspective, and the second is the opportunity to have an impact on many important areas of a child’s and family’s life, an
March/April 2004
impact that can alter the child’s future physical, emotional, and social development. I have always loved growth and development (well, except for that boring class in my undergraduate nursing pro-
I
’m glad to be in the
field of pediatrics and frequently feel my colleagues who do not get to work with children are in some way deprived.
gram in which all we did was memorize developmental milestones), but even that knowledge came alive when I arrived at my pediatric rotation. I will never forget my first day as a student of pediatrics. I quickly bathed the child
and made the bed, only to find by the end of breakfast that I had to re-bathe the child and remake the bed (I had no idea such a small person could make such a big mess). I also had a half-bowl of oatmeal flowing out of my nursing cap, the result of bending over the cereal bowl in front of a child that wasn’t too happy with me! I quickly realized this clinical experience was something different...it was not traditional medical-surgical nursing, and I loved it! It was then that growth and development came alive, and I truly learned to appreciate that children are not just little adults; they really do think and see the world differently. I really enjoy talking to children and hearing their thoughts, views, and conclusions about the world and life events. Just recently, for example, I went on a plane trip with my 7-year-old granddaughter. While at the airport, she saw the vapor trails from the planes taking off and asked what they were, so I launched into a long explanation of condensation, temperature differentials, etc. She listened carefully and then said, “You mean the plane is passing gas?” So much for my long explanation, but it quickly reminded me of that
J Pediatr Health Care. (2004.) 18, 55-56. 0891-5245/$30.00 Copyright © 2004 by the National Association of Pediatric Nurse Practitioners. doi:10.1016/j.pedhc.2003.11.001
55
PH EDITORIAL C unique view of the world children have, making new situations “fit” into their own reality. Working in pediatrics allows us to enter that world again. Of course, that’s a challenge for us, too, as we must explain things such as illnesses and treatments in a manner that the child can understand, but I think it’s figuring out how to communicate with the child that is one of the great aspects of pediatrics. The second aspect that I love about working with children is the opportunity to have an impact on many aspects of the child’s life. This impact comes from the education and explanations we provide to parents as they strive to help their children grow and develop. Our first encounters with families often occur during the newborn time. At that point, we help promote strong parentchild bonds that will last a lifetime. We can demonstrate to parents how their child responds to them and explain and demonstrate all those unique baby behaviors and cues that can sometimes frustrate and overwhelm new parents. This knowledge helps build parental self-confidence and self-esteem and better prepares them for the challenges yet to come. Thus, I think one of the best things we can do is to help parents become better parents, and that’s a role we play throughout all our experiences with the growing child and family. I’ve always thought one of the strengths of pediatrics is providing families anticipatory guidance (indeed, I always wonder why I don’t receive such guidance from my internist...don’t adults need such guidance too?). The guidance we give families helps them pre-
56
Volume 18 Number 2
Nelms
pare for the challenges ahead, such as the changes in feeding methods or discipline approaches that occur as the child matures. By receiving this knowledge ahead of such events, parents are better able to deal with these daily challenges, maintaining their selfconfidence because they knew what to expect and how to address it. I think we often forget this incredible impact we can have. This influence on children’s lives occurs in all areas (physical, emotional,
S
ometimes after a
particularly tiring or frustrating day, it helps to think about what we love about what we do.
and social). As pediatric health care providers, we are right there to help as new challenges arise, such as tackling the epidemic of childhood obesity with the NAPNAP H.E.A.T. campaign or the psychosocial morbidity issues via the KySS initiative. As nurses, we see the child holistically and can thus help parents and children face problems in numerous areas of their lives, not just the physical arena, and parents want such help. For example, a national survey of
parents of children aged birth-to-threeyears found that parents expressed the need for more information on childrearing, especially behavioral and developmental issues (Young, Davis, Schoen, & Parker, 1998). Although this particular study asked parents about “doctors” and did not mention nurse practitioners, the findings are important, as they give us insight into what parents want and need concerning child-rearing. The aspects of care that the parents identified as weak or missing in this study are the areas of pediatric care that we do so well, and such research findings should boost our efforts to do more. Providing pediatric health care is fun and challenging. As the role of the pediatric nurse practitioner continues to expand, one key aspect remains constant: our focus on the child and family in whatever setting we care for them. I have always been happy to say I am a pediatric nurse and hope that you are too. Sometimes after a particularly tiring or frustrating day, it helps to think about what we love about what we do. I’ve shared a few of my joys about working in pediatrics, and I know you could add to the list. I just hope you are as happy to work with children as I am. Enjoy the opportunities and challenges and realize that you can have a major impact on a child and family’s life! —Bobbie Crew Nelms, PhD, RN, CPNP
REFERENCE Young, K., Davis, K., Schoen, C., & Parker, S. (1998). Listening to parents: A national survey of parents with young children. Archives of Pediatric and Adolescent Medicine, 152, 255-262.
JOURNAL OF PEDIATRIC HEALTH CARE