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How does one become a nurse? What types of nurses are there?

Become an LPN
There are several paths that can be taken to become a pediatric nurse. You can become a LPN, an RN, or obtain your Bachelor's in Nursing. A Licensed Practical Nurse (LPN), takes approximately one year. Your scope of practice varies with the state that you live in. In my state, Tennessee, LPNs can start IVs and give medications, with the exception of a few specific medications. They can take care of many types of patients except the most critical patients that present to our ED. While the track to becoming an LPN is the shortest, your opportunities are also limited.

Become a Registered Nurse (RN)
A Registered Nurse (RN) is the next type of nurse that you can become. Typically, this takes approximately two years to achieve. Nurses who go through a RN program receive either a nursing certificate or an associate's degree in nursing (ADN or ASN). Registered nurses can work in many areas and have a wide range of privileges. RNs are the most flexible when it comes to areas in which you can work. Another option is to complete a four-year program in nursing which gives you a bachelor's Degree in Nursing in addition to an RN license. More and more facilities prefer nurses with their BSN. To obtain your BSN you can either go to a four-year college or you can obtain your RN and then go to a bridge program and obtain your BSN.

How to Decide
Which path you decide on depends on your short and long term goals. If you eventually want to enter management, education, or advanced practice, then you should definitely go for a Bachelor's degree from the beginning. This will save you in the long run. If you do not aspire to any of the above pursuits, then an RN is adequate. If you must get out in the work force as soon as possible and are willing to earn less, then you can become an LPN. Remember, your options are limited with this.

Find a nursing school near you to get started:

Nursing Diploma Programs
Associate Degrees in Nursing (ASN or ADN)
Bachelor's Degrees in Nursing (BSN)
Master's Degrees in Nursing (BSN to MSN)

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How does one become a pediatric nurse?

On the Job Training
The easiest way to become a pediatric nurse is to apply to work in a site that serves pediatric patients and receive your specialized training there. The hospital where I work offers a 3 month intern program for new nursing graduates that includes both classroom and clinical training specifically in pediatrics.

Become a Certified Pediatric Nurse (CPN) Once you have graduated, you can also take an exam to become a Certified Pediatric Nurse. There are also special classes that address Pediatrics. These include Pediatric Advanced Life Support (PALS) through the American Heart Association, the Emergency Nurse Pediatric Course through the Emergency Nurses Association (see: www.ena.org), and Emergency Medical Services for Children. You can also become involved in the Society of Pediatric Nurses (see: www.pednurse.org).

First Step: Become a Nurse The important thing to remember, however, is that you must become a nurse before you can even begin your training in pediatrics. If you have not yet chosen a nursing school, here are a few programs that can help:

Nursing Diploma Programs
Associate Degrees in Nursing (ASN or ADN)
Bachelor's Degrees in Nursing (BSN)
Master's Degrees in Nursing (BSN to MSN)

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How did you become a Nurse Practitioner?

After obtaining my BSN and working for approximately 6 years as a nurse, I went back to school and obtained my Master's Degree in Nursing and was trained as a Family Nurse Practitioner. I then took certification exams in both Family and in Pediatrics. I have a unique position as a Nurse Practitioner in a Pediatric Emergency Department- a new role in my hospital. This additional training took approximately 16-18 months. As a NP, I can diagnose, treat, and prescribe for the patients that I care for.

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How much money do nurses make?

This is a very popular questionand a good one. Before you invest in nursing school, you undoubtedly want to know you can look forward to salary-wise. The salaries for nurses vary greatly depending on the area of the country in which you live and the type of facility that you work in. The average salary for an RN can range from about $30,000 each year to more than $50,000. The average salary for Nurse Practitioners can vary from $40,000 to around $100,000.

Nursing School Helps You Earn More
In general, the surest way to earn more money is to advance your education. An RN typically earns more than an LPN, for instance, so it makes sense that getting your BSN will mean more money than getting your associate degree alone. Likewise, a nurse practitioner earns more than an RN, so enrolling in a BSN to MSN program makes sense.

Find a nursing school near you to get started:

Nursing Diploma Programs
Associate Degrees in Nursing (ASN or ADN)
Bachelor's Degrees in Nursing (BSN)
Master's Degrees in Nursing (BSN to MSN)

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What do you do on the job as a pediatric nurse?

As a Pediatric Nurse in an Emergency Department, I start IVs, perform catheterizations to collect urines, collect stool samples, perform basic eye exams, obtain vital signs (temperature, heart rate, respiratory rate, and blood pressure), perform head to toe assessments, administer medications (Intravenous, intramuscular, rectally, and by mouth), do a lot a parent and patient teaching, perform CPR, administer blood, help with splinting of broken bones, and a variety of other duties.

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What tools does a pediatric nurse use on the job?

The basic tools that a nurse uses are her eyes, her hands, and her ears. Assessment is very important in nursing. I use a stethoscope to listen to a child's lungs, heart, and abdomen. I use a blood pressure cuff (called a sphygmomanometer) to obtain their blood pressure and a thermometer to obtain their temperature. We also use cardiopulmonary (CP) monitors that keep track of the patient's heart rate and respiratory rate. We use a Snellen chart to test their vision. There are many tools that we use, but this is a list of some of the more common ones.

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What part of your job do you like best? Why? What part of it do you
     wish you didn't have to do? Why?

The part of my job that I like best is making children feel better and reassuring their parents that their child is going to be OK. Often, I have a parent come in who is desperately worried about their child, and by talking with them and listening to them I can allay a lot of their fears. This can be very rewarding. The part of my job that I hate the most is when children are critically injured or die. We deal with this a lot. It is especially frustrating when the injury was preventable (for example, the child wasn't wearing their seat belt). I hate to see children suffer and I hate to see a young life taken away.

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Was this your first job choice? Why?

No, this was not my first job choice. When I was younger, I was going to be a Pediatric Neurosurgeon. Later, when I started college, I was going to be a Physical Therapist. I did not decide to be a nurse until my junior year in college. I am not exactly sure what made me decide to become a nurse. I think it was the rewards of the jobs, the flexibility, and the pay.

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Who depends upon your work? Upon whom do you depend for your      work?

My patients and their families depend on my work. Also, of course, my boss. If I didn't come to work either someone else would have to go out of their way to work for me or children would not be taken care of. For my work, I depend on a lot of people. I depend on people who work in the laboratory who perform the various blood tests that I order. I rely on the people who work in XRay who perform the XRays that I order. I depend on the nurses and their assistants who carry out my orders. I depend on the patients and their families because they are my clients. I depend on insurance companies to reimburse the hospital and me, otherwise I wouldn't get paid. I rely on people who work for the Fire department to take care of children appropriately before they reach the hospital. I am sure there are many other people that I am leaving out.

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Is special training required? If so, how do you get that training? Did
     work?you get paid during the training period?

The answer to this question depends on where you work. Of course, there was the training I received in college. I am also trained in CPR and Pediatric Advanced Life Support by the hospital where I work. I am also trained in Basic Trauma Life Support, Pediatric Basic Trauma Life Support, and Advanced Cardiac Life Support by our local fire department. Yes, I was paid for this training.

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What did you learn in school that helps you in your present job?

Nursing school taught me the fundamentals of my profession. This included basic disease processes, anatomy and physiology, Pharmacology, assessment, and research.

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How does your job affect your personal life? Do you have to work
     nights?

For me, my job affects my personal life greatly. This is because I love what I do and tend to be a workaholic. My current shift is evening (5pm to 2am). Because of this, it seems I rarely get to see my children during the school year. During the summer it's a great shift because I am home during the day and we can do a lot of things together. I have worked every shift including days, evening, and night. I also work about 2 weekends a month. Many nurses do not have the schedule that I have. You can basically work whatever shift you want to, depending on what you want to do.

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Are you tired when you get home? Do you have noise during the day?

I am physically tired when I get home, but usually it takes me a while to wind down mentally. My job is very mentally and emotionally challenging and often this is hard to leave at work. When I work nights, I do have some noise during the day. It depends on if my kids are home, how many times the phone rings, and how often my dog barks

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What kind of hour do nurses work? Can they pick their own hours?

Nurse can work a variety of hours and days. A lot depends on where you work and what you do. In the hospital setting, most nurses work 8 or 12 hour shifts. The 8 hour shifts typically go from 7am to 3pm, 3pm to 11pm, and 11pm to 7am. Nurses who work these shifts usually work 5 days a week (40 hours a week). The 12 hour shifts typically go from 7am to 7pm and from 7pm to 7am. Nurses who work these shifts typically work 3 or 4 days per week. In any hospital where you work, you will find a great variety of shifts available. Some nurses work only on weekends, some nurses alternate their shifts from days to nights, and some nurses take call.

If you work in a setting outside of a hospital (e.g. a clinic or Doctor's office), your hours will usually be day hours.

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What special skills are required when working with children?

In an emergency room we treat the child based on what is wrong with them when they come in. It is very important for us to consider basic child development when treating children and to communicate with them based on their developmental level. This requires an extensive knowledge base not only about basic cognitive levels and developmental milestones but you also have to know what equipment is appropriate to use for children of different ages and sizes.

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Can you tell me about what all do you do at work as a Pediatric Nurse      Practitioner in an Emergency Department?

I take a history from the child's caregiver and often the child, depending on their age. I then examine the child and make a diagnosis based on my assessment. Sometimes, I don't know immediately what is wrong with a child. If that is the case, I may order additional tests such as lab work or XRays. Based on these results, and again, on my assessment I decide if the child can go home or needs to be admitted to the hospital and I also decide on how they should be treated (e.g. with antibiotics). The nurses perform an initial assessment of the child, take a set of vital signs, and place them in a room so that I can examine them. They then either discharge the patient if that is what I determine can be done or carry out my orders (e.g. start an IV, obtain a urine, administer a specific medication).

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Can you tell me about the education needed to be a pediatric nurse?

All nurses must go to a nursing school or college. The can be trained in various ways The pediatric training is obtained at the hospital itself.

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Can you tell me about the responsibilities of being a pediatric nurse?

I have already discussed many of the responsibilities. A few more include being a patient advocate, always maintaining confidentiality for your patient and their families, ensuring that the family and patient understand what is being done, always maintaining professionalism, now matter how tired or upset you are, and basically performing your duties in accordance with hospital policy. It also your duty to keep your level of knowledge up and to continue learning even after school by reading journals and asking lots of questions.

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