Term Paper: Pediatric Nurse Practitioner

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[. . .] Beyond graduate education, certification through a professional nursing organization and state licensure are also necessary to legitimately practice as a pediatric nurse practitioner, or any advanced practitioner nurse for that matter (Teicher et al., 2001). A strong background and knowledge in pediatrics and terminal illness is also required. In addition, pediatric nurse practitioners should enforce their unique role through continual collaboration with physicians and other healthcare professionals (Teicher et al., 2001). Also, active research continues to develop and establish the crucial role played by pediatric nurse practitioners (Teicher et al., 2001).

The true value of the pediatric nurse practitioner role must be demonstrated through the evaluation of patient outcomes, and patient and family satisfaction (Teicher et al., 2001). Teicher et al. (2001) explained how this evaluation could be conducted through "structure factors, process evaluations, outcome measurements, and through evidence of cost effectiveness." The essential elements involved in performance evaluations include education, clinical practice, consultation, professional development and research (Teicher et al., 2001).


The important role that pediatric nurse practitioners play, with their abilities to incorporate knowledge and skills necessary for the management of the needs of the ill child and his or her family, is increasingly recognized among all healthcare professionals (Wyatt, 2001). However, there are obstacles that may prevent the acceptance of pediatric nurse practitioners as essential to multidisciplinary healthcare teams. One of the most prominent barriers is a lack of a clearly defined role for pediatric nurse practioners among other healthcare professionals. One of the most important strategies for overcoming this barrier is active collaboration with various other healthcare professionals to make the responsibilities and service benefits of pediatric nurse practitioners known to others. Awareness of the influence that pediatric nurse practitioners have on positive patient outcomes and satisfaction among patients and their families is essential. Teicher et al. (2001) suggested that existing barriers could be overcome through the utilization of appropriate marketing strategies, continued education, evaluation outcomes, and an overall dedication to the direct care of patients.

Importance of the role of pediatric nurse practitioners in context

The pediatric nurse practitioner role in the context of terminally ill children is important in ensuring that the complex needs of these children and their families are attended too, and that the best possible outcomes are provided. With children facing terminal illnesses, the best possible outcome that a pediatric nurse practitioner can offer is sometimes comfort and support for the patients and their families as they prepare for death. The responsibilities involved in the roles of pediatric nurse practitioners must be Acknowledged as crucial and unique among the services provided in the healthcare setting. Essentially, the pediatric nurse practitioner role was initially developed in response to the fact that the primary care needs of ill children and their families were not being appropriately addressed through existing healthcare settings (Wyatt, 2001). Furthermore, specialized units, such as pediatric oncology, respiratory, and cardiovascular departments, have been developed in many hospitals in response to the growth in the multifaceted health care needs of ill children (Wyatt, 2001).

I believe the strengths, competencies and interests I possess are aligned with those that are necessary for successful practice as a pediatric nurse practitioner. I strongly believe that a nurse practitioner's role encompasses not only the needs of the patient, but also the needs of the family as a whole. Moreover, the educator role played by nurse practitioners is equally as essential in helping families to deal with the stressors involved in experiencing the death of a child. In this respect, the nurse practitioner not only cares for the physical health of patients, but also the psychological and spiritual well-being of patients and their families.

A look forward to the opportunity to build upon the nursing skills I currently possess as a nurse in my new role as a pediatric nurse practitioner. In this new role, I expect that my teaching skills will become more refined, which will aid me in ultimately influencing positive outcomes for patients and their families. New skills attained in the role of pediatric nurse practitioner will continually better prepare me to support terminally ill children and their families as they encounter extremely stressful and trying situations.

Theoretical framework

The services delivered by a pediatric nurse practitioner are done so according to certain theoretical frameworks. One of the most appropriate and effective theoretical approaches in dealing with terminally ill children and their families is the Neuman Systems Model. Knight (1990) described the Neuman Model in terms of Fawcett's four meta-paradigms of nursing, which included person, environment, health, and nursing.

In regards to the person, Neuman understands the client as an open system, who is a dynamic combination of the interrelationships of five variables, including physiological, psychological, sociocultural, spiritual, and developmental factors (Knight, 1990). The person meets personal needs through interaction with the environment. Neuman figuratively represents the person as a core of basic structure and energy resources that are surrounded by three hypothetical circles that are representative of boundaries (Knight, 1990). The boundaries are lines of resistance, normal line of defence, and flexible line of defence (Knight, 1990). A person is continually faced with stressors from within his or her own system as well as from the environment.

According to Neuman, the environment encompasses all factors affecting or affected by a person, both internal and external (Knight, 1990). The environment is the source of stressors, but also provides the tools required to effectively deal with stressors. Furthermore, stressors can be either beneficial or harmful in nature (Knight, 1990).

In regards to health, Neuman indicates that it is the "condition in which the flexible line of defence has prevented penetration of the normal line of defence and all parts and subparts are in harmony with the whole of the person (Knight, 1990)." Health occurs when all of the person's needs are met, while illness is a state of insufficiency or instability (Knight, 1990).

Neuman defined nursing as concerning the total person with the aim of attaining and maintaining overall stability in the patient (Knight, 1990). The aim of nurses should be to reduce stressors and adverse conditions that affect, or potentially affect, the health of the patient. Therefore, it would be critical for pediatric nurse practitioners working with terminally ill children to create and sustain an environment of equilibrium around the children, with the involvement of the families and other health care professionals.

In order to effectively attain optimal environmental conditions for a terminally ill child, it is necessary for pediatric nurse practitioners to observe the family involved and identify specific needs of the patient and family, including cognitive, affective, physical, and spiritual needs (de Moutigny, 1995). An appropriate care plan is then developed through the validation of the needs held by the patient and his or her family (de Moutigny, 1995).

Pediatric nurse practitioners perform a multifaceted role in the deliverance of healthcare services, which is integral to the attainment of positive patient outcomes and satisfaction in a cost-effective manner. The complex needs of terminally ill children and their families require the expertise and resourcefulness provided by an advanced practitioner nurse. In this respect, the pediatric nurse practitioner performs a unique function as they identify, appraise, and manage the conditions of ill children in the context of a multidisciplinary healthcare team (McAtee & Silver, 1974). This role will continue to grow and evolve as new demands are placed on nurses due to changing trends in patients, illnesses, and healthcare reform.


Knight, J. (1990). The Betty Neuman Systems Model applied to practice: A client with multiple sclerosis. Journal of Advanced Nursing, 15, 447-55.

McAtee, P. & Silver, H. (1974). Nurse practitioners for children:… [END OF PREVIEW]

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