What You Need to Know Before Becoming a Pediatric Nurse

illustration of nurse with mother and child 

When you envision yourself as a nurse, you see yourself caring for children. From what you can tell, pediatric nursing seems like a perfect fit for you. You get to be around little ones and make those big, scary medical procedures seem not so bad.

While that sounds amazing, you still want to know all you can before you dive in. To help with that, we’ve connected with several pediatric nurses and nursing experts for an inside scoop on what they think you should know before getting started in pediatric nursing.

But before we get too far into that, let’s nail down the basics of pediatric nursing.

What does a pediatric nurse do?

Pediatric nurses are registered nurses who specialize in caring for patients from birth through adolescence. They must have a deep knowledge of child growth and development as diseases and conditions in children often present and are treated differently than in adults.

Because their patients are so much younger, pediatric nurses often form strong relational-ties with them in different ways than they would with adult patients—by playing games with them, being goofy, or holding their hand during tough procedures.

Though some pediatric nurses may perform similar duties to what they would perform in a nursing unit for adults, they must carry out their duties with extra care and attention. “Pediatric nurses have a greater influence on their patient’s future— from growth and development to health promotion and practices,” says Rasmussen College Nursing Instructor Brooke Cobb.

Pediatric registered nurse duties

Though there are many different positions nurses can hold in pediatrics, the most common title is that of a pediatric registered nurse. Pediatric registered nurses perform many of the same functions of registered nurses, though the way they perform them is often very different since their patients are often more vulnerable and require great family and guardian support.

A pediatric registered nurse may perform the following duties, according to the Bureau of Labor Statistics:1

  • Assess patients’ conditions
  • Record patients medical histories and symptoms
  • Observe patients and record the observations
  • Administer patients’ medicines and treatments
  • Help perform diagnostic tests and analyze the results
  • Teach patients and their families how to manage illnesses or injuries

Pediatric nurses have a lot of options as they can work in many subspecialties within pediatrics throughout their careers. Their work includes substantial patient contact time and these nurses may form close relationships with the patients and their families.

Pediatric nursing specialties

Under the umbrella of pediatrics you may find opportunities for even more specialized nursing work. Let’s take a closer look at two relatively common areas—pediatric oncology and pediatric intensive care unit nursing.

Pediatric oncology nurse duties

Pediatric oncology nurses are focused on treating young patients facing complications from (often cancerous) tumors. Though nurses who work in adult oncology units have many comparable duties, it’s important to note that treating children with cancer is not the same as treating adults. The same type of cancer may call for different treatment protocols in children than in adults, and even the side effects of treatment may take on more weight if there’s a possibility it could stunt the child’s expected growth and development. In addition, some cancers only exist in children and require additional knowledge and specialization from the medical staff.

Duties unique to pediatric oncology nurses may include:

  • Complete assessments on children prior to having chemotherapy administered to make sure they are healthy enough to tolerate the treatment
  • Administer chemotherapy as ordered by the doctor
  • Monitor children being treated with chemotherapy for signs of any life-threating side effects
  • Educate families about their child’s condition, treatments and how they can manage side effect at home

Pediatric intensive care unit (PICU) nurse duties

Like nurses who work with adults in the intensive care unit, these nurses focus on treating patients with serious, life-threatening conditions. Many of the core duties remain the same—monitoring and assessing patient statuses, administering medications or treatments and working quickly to help stabilize a patient’s condition if they take a turn for the worse.

One primary difference is that typically PICU nurses have a smaller number of patients to care for during their shifts. While that might sound like it could be “easier,” remember that treatments are less uniform in a pediatric unit as patients are at varying stages of development—medications and treatment plans need to be tailored for the patients’ stage in development.

As you might imagine, these specialized nursing area can have some incredibly emotionally taxing moments. It’s not easy to see young children losing their fight with cancer or a serious illness, nor is it easy to witness the impact on their families. But it’s not all emotional low points—aiding young patients on their way to a full recovery can be an incredibly rewarding experience.

Where do pediatric nurses work?

Pediatric nurses have many workplace options depending on what subset of care they are interested in. According to the Institute of Pediatric Nursing, the three most common workplaces for certified pediatric nurses include:2

  1. Free-standing children’s hospitals (30.3 percent)
  2. Children’s hospitals associated with a major medical center (28.3 percent)
  3. Outpatient specialty care (11.7 percent)

As you might expect, facilities devoted to pediatric care like children’s hospitals are a primary employer of pediatric nurses—but that doesn’t necessarily mean you’re out of luck if you don’t live near one. While it’s not a given, large hospitals and healthcare networks may have specialized pediatric nursing opportunities as well.

What you should know before becoming a pediatric nurse

Now that you’ve got the basic lay of the land down, here’s what the experts think you should know about the day-to-day life of a pediatric nurse.

1. Listening and observation is key

Nurses interact face-to-face with patients more than any other provider. With adult patients it’s relatively simple to get information about what ails them—but working with young patients can bring unique challenges on this front. Though a child’s medical chart may cover quite a bit, many crucial pieces of information still need to be gathered from the patients and the family. Factors like lack of financial resources, additional life stressors and transportation concerns can greatly influence the patient’s care plan.

Additionally, pediatric nurses will need to keep a close eye out for non-verbal clues. “Patients in all age ranges need nurses to listen, but our pediatric patients cannot always articulate their specific needs through verbal communication,” says Cobb.

Once you get comfortable in your role as a pediatric nurse, it may be tempting to tune out what you might think is extraneous chatter. Listening to the concerns of both parent and child will only further assist you in giving the best care possible for your patient.

2. Kids are resilient

“Kids are very resilient and they heal more quickly than adults. This can be an advantage as health outcomes are generally more promising in pediatrics,” says Tyler Dean, certified pediatric nurse and Associate Professor at Rasmussen College.

A 4-year old can go from crying about an IV stick to giggling a minute later. Working in pediatrics allows you to play a huge part in those giggles. “The most rewarding aspect of working in pediatrics is that you can play, make jokes and be a little goofy at times,” Dean says. Not only is that good for the kids, it’s good for you too. Nursing can be very stressful and these interactions can bring joy to a normal day.

3. You’ll be working with families just as much as you will with children

A patient’s family is an integral part of their recovery, so it’s key that you communicate with them just as effectively as you do with the child.

“Pediatric nurses utilize a family-centered approach, which means you include, engage, and educate all members of the family along with the patient,” Dean says. And don’t forget the patient’s siblings! Often, as the family is stressed and focused on the patient, siblings get ignored, so it means a lot for nurses to acknowledge the siblings’ emotions and presence.

4. You can further specialize with pediatrics

Just as nurses can specialize when working in adult care, pediatric nurses can too. Whether you’re interested in intensive care, emergency care, orthopedics, oncology, trauma, gastroenterology, home healthcare, the NICU or case management, it’s likely you’ll be able to find a pediatric department that aligns with your interests.

The duties are typically similar to the adult equivalent specialty you may be more familiar with, though the ways you communicate and interact with the patient will be different. You’ll look for different developmental markers and rely on information communicated by the patient’s family. You may also need to be more observant of visual and behavioral clues since younger patients may have trouble articulating exactly how they feel or what they need.

5. You’ll have to take care of yourself too

Depending on where you work as a pediatric nurse, you may be caring for children with terminal illnesses or other very serious health issues. While you won’t be the one delivering the bad news initially or working with the family in the long run, learning how to navigate these situations in a positive way can have a positive impact on the family.

But even if you handle tough situations with families perfectly, seeing the pain in family members’ faces in tough medical situations can be emotionally taxing especially as you listen and stay present with them as they grieve. “As with all types of nursing, it is important to take care of yourself and have a professional relationship with your patients and their families so you can return the next day and dedicate yourself 100 percent to those patients as well,” Dean says.

Your team will be able to relate to what you’re going through and members may be able to help you verbally process your thoughts, emotions and feelings after stressful days. The charge nurse or chaplain may also check in with you as well. On your own, finding time to refuel, spend time with loved ones and invest in your own hobbies is key to prevent burnout. “We are still human—it’s okay to cry or ask for help,” says Dean.

Do you have a future in pediatric nursing?

There’s a lot that goes into becoming and working as a pediatric nurse, but there’s no denying that reaching that goal after years of hard work will be more than worth it. Your first step toward working in pediatrics is becoming a registered nurse. Our article, “How to Become a Registered Nurse: Your 4-Step Guide” will help walk you through what you can expect on the way.

1Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, [accessed September, 2019] www.bls.gov/ooh/. Information represents national, averaged data for the occupations listed and includes workers at all levels of education and experience. Employment conditions in your area may vary.
2Institute of Pediatric Nursing, Pediatric Nursing Workforce Data, Pediatric Nursing Certification Board 2017 Job Task Analysis Study [accessed September, 2019] http://www.ipedsnursing.org/pediatric-nursing-workforce-data

EDITOR’S NOTE: This article was originally published in October 2017. It has since been updated to include information relevant to 2019.

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Kirsten Slyter

Kirsten is a Content Writer at Collegis Education where she enjoys researching and writing on behalf of Rasmussen College. She understands the difference that education can make and hopes to inspire readers at every stage of their education journey.

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