A Day in the Life of a Pediatric Nurse

What is it like to be a pediatric nurse? We spoke to pediatric nurses from Essex Pediatrics in Vermont for insights on what practice teams do to inspire, inform, and support their work. From the school system to independent practices, nurses have skills unique to each individual. A day’s work for a pediatric nurse includes connections with patients, cross-departmental support, and even specialty training which makes them valuable for practice revenue and as an essential part of a child’s healthcare team. In this post, we’ll cover the nursing certifications your practice should hire for, and 3 practice management strategies to help your nursing staff achieve their career goals in their daily work at a pediatric practice.

What kind of clinical staff should I hire at my pediatric practice?

Your practice’s size, budget, and patient pool will determine the nursing staff that will best help you succeed. Certifications from established sources and exams like NCLEX are important to verify a nurse’s qualifications. While the specific nursing licensure requirements and responsibilities vary by state, here is a recap of the most common nursing certifications:

• A medical assistant (MA) is certified by the American Association of Medical Assistants. This role is useful when both clinical and administrative support is needed, whether entering EHR data, checking in patients, or performing hearing/vision screenings. See the AAP’s description here.
• A licensed practical nurse (LPN) performs nursing duties under the supervision of an RN, NP, or pediatrician. An LPN can be a great asset for a solo provider or a larger staff for clinical task delegation and are great supports in a family’s care team.
• A registered nurse (RN) requires an Associate’s or Bachelor’s nursing degree, with many nurses completing the latter. RNs may assign tasks to other nurses and support the patient by taking histories, supporting their care plan, and answering families’ questions. A certified pediatric nurse may pursue CME via the American Nursing Association or its accredited partners such as the Society of Pediatric Nurses.
• An Advanced Registered Nurse Practitioner (ARNP) requires a Master’s degree in nursing. Their responsibilities include those already listed as well as the ability to diagnose, prescribe medication to, and treat patients independently or alongside pediatricians in the healthcare team. NPs are accredited by and pursue CME from the National Association of Pediatric Nurse Practitioners (NAPNAP).

Specialties in various roles include further training in family medicine or pediatrics, but some pediatric nurses specialize even further with training in lactation services, neonatal care, mental health, sports medicine, or acute care. 

“I find inspiration in being a part of a practice team that values the whole family unit (in whatever form that takes) from birth through early adulthood. In a healthcare system, where increasing barriers and bureaucratic red tape exists for services, I find motivation in helping our families successfully access what they need. I appreciate being a part of a team that allows nurses to be visionaries, always evaluating how we can deliver care in the best way possible for our patients and families.” -- Jodie Kelley, RN

Empowering Pediatric Nurses

We spoke to pediatric nurses Jodie Kelley, RN and Patty Croce, RN of Essex Pediatrics in Essex Junction, VT for their insights on the ways they’re motivated by their team and patients. They identified key ways providers, managers, and healthcare teams can support and celebrate nurses to help them perform their best work.

Jodie and Kelly say that their motivation for nursing comes from working with a team that values the whole family unit from birth through early adulthood, using critical thinking to produce solutions for their team, and receiving positive feedback from families and their colleagues.

Nurses will need to consistently expand and update their knowledge with continuing education. There are many ways to accomplish this, but the main focus should be enabling time and resources for nurses to complete their required CME, plus supporting career endeavors. and careers are more likely to find meaning in their work, increasing engagement and at the end of the day, improving performance and patient satisfaction.

Specific ways to support training at your practice might include direct actions like nominating a skilled nurse for training in a specialized field or granting staff a certain number of hours to pursue CME. A practice can also empower a nurse’s training goals indirectly: granting flexible hours, allowing them to perform training tasks like QI measures at the practice, and celebrating accomplishments.

Nurses are the first clinical provider patients speak to on the phone and see in person at the practice, and they are also essential contacts for pediatricians and front desk staff, so communication is essential. Jodie and Kelly point out that nurses need managers and providers to be easily accessible to share feedback with. Practices can offer this accessibility with simple habits, like leaving the office door open for a conversation any time, and through more formal methods such as regular huddle meetings to share feedback and concerns.

While working relationships intersect with your individual practice’s history and culture, there are practical ways to help improve communication for nurses at the practice to enable them to get the job done. Your practice might establish subject matter experts for billing, your EHR, or events like flu clinics so a nurse can consult an expert. As mentioned, regular huddle meetings are a great tool for all staff to collaborate on daily schedules, anticipate challenges, and provide proactive solutions. Regular staff meetings can allow staff to share ideas such as workflow improvements, HR questions, vacation schedules, and more.

Practices who have large teams may benefit from systems that enable nurses to collaborate, assist, and mentor one another. There are many ways to do this: you might sponsor a “lunch and learn” for experienced nurses to share career advice and goals with new employees; your practice can encourage or require group projects to promote teamwork; you can build your own custom group chat in PCC EHR just for nurses, and build custom smart phrases and protocols so that everyone can take a note or chart a visit in the way that suits them best.

According to a white paper by the Nursing Alliance for Quality Care, nurses’ role in patient engagement is not only as a contributing member of the healthcare team, but as a patient advocate to prevent harm and improve care. Nurses may get feedback parents or patients don’t offer to physicians; they act as the practice’s point of contact in triage patient calls and recall endeavors, both opportunities for improving relationships and gaining healthcare insights; they are also advocates and educators for healthcare options such as vaccines or birth control based on their patient relationships.

“Nursing as a profession has an ethical obligation to support patients and families being successfully engaged and heard in every health transaction. Nurses at all levels, in all care settings and in their work and lives in communities, support engagement by all consumers of healthcare.” NAQC, 2013

There are often bumps in the road in pediatric practice, and a team needs creative solutions to solve them. When a nurse’s hard work and ideas are recognized, morale is improved and creative ideas can keep flowing. Recognition in every practice varies, but could be anything from a celebratory lunch for the completion of a project to a shout-out to say thank you for excellent work.

“My inspiration comes from so many different entities,” says Patty Croce, RN. “Some of the wonderful nurses that have walked before me to some of the hard working nurses I have the wonderful opportunity to work with today. It is a profession where you receive a renewed sense of job satisfaction everyday as you continue to provide caring and compassionate care. Due to past experiences and the training my workplaces have sent me to, I challenged myself to try new things including phlebotomy, lactation and care coordination. I have also been able to mentor and coach others allowing me to use more of my creative ideas. I appreciate being a part of a team that values all the duties and vital roles that nurses possess.”

Recognition is not only about celebrating nurses’ work, but acknowledging and acting upon their experience and ideas. In their role of triage and communication with patients, Kelly and Jodie note that nurses often have ideas that could turn out to be visionary solutions, and managers that empower these ideas and help to implement them can help improve both patient experience and office workflows. These are also great opportunities for mentorship, constructive feedback, and for recognition of a nurse’s growth or great work.

While this post has focused on the tools and strategies available to pediatric practices who employ nurses on their staff, nurses are powerful advocates and industry leaders in their own right. Some practices are led, managed, and owned by nurses, while others have nurses who have been long standing partners and anchors for the practice and community. Supporting nurses’ work and advocacy not only helps make a nurse’s job more valued, but improves the work of the entire practice.

Wondering how you can hire the best nursing staff for your unique team? Interviewing isn’t only about the resume -- you want to make sure that a potential nurse matches your practice’s values and goals. Learn how to hire the right people for your practice with this webinar by friend of PCC Tim Rushford.