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

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.
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 certificate or an Associate's Degree.
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.
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.

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How does one become a pediatric nurse?

Basically, you apply to work in a site that serves pediatric patients and receive your specialized training there. There are no specialized nursing programs specifically for
pediatrics. 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. 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).

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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?

Now, lets talk about money. 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 is around $30,000/year. This range
can go from closer to $20,000 to more than $50,000. The average salary for
Nurse Practitioners is around $50,000. Again, this can vary from $40,000 to
around $100,000.

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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
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?

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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