The Most Reliable Assistant

Mary Grace Reynolds

English III Honors Pd. 2

Mr. Piatak

February 23, 2017

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Doctors and nurses take a deep breath as they feel the life escape the room as the patient

flatlines. The electrocardiogram continues to beep, even as the patient's chest no longer rises and

falls with their heartbeat. Imagine a career where everyday brings a new challenge, going into

work not knowing what the day holds. Nurses alter the lives of their patients each and every day

by helping them with anything and everything they need in order to make their stay at the

hospital as comfortable as possible. Nursing provides the skills and necessities for people to

receive the help they need from professionals.Nursing, the practice of providing care for the sick,

means all people act as nurses in some way. Nursing provides endless rewards from the little

things like making someone smile, to big things like telling a family their loved one will survive.

However, pediatric nursing differs from adult health care in many ways, certain medicines and

procedures might be recommended for adults might not be advised for children. Pediatric nursing

has become an intriguing career based on the numerous opportunities, ones educational

background, and how much time one devotes to their career.

Nursing originated with the care of infants and children, therefore the earliest nurses

classify as mothers. In the earlier centuries, nurses consisted of women volunteers with little to

no training, as most nursing was tied to religious affiliations (Nursing:). In the 18th century,

many believed that nursing was an unsuitable occupation for proper young women, mostly due

to the lack of resources and poor sanitation levels which did not meet the requirement to give

proper care to patients. Therefore, a great deal of patients who went to the hospital inevitably

died. Until the 1880s, nurses became educated by apprenticing with already practicing nurses,

their education eventually moved to more formal education teaching programs. As hospitals
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began developing programs, they hired young nursing students because they provided low-cost

services. In 1920, a report conducted by the Rockefeller Foundation, also referred to as the

Goldmark Report, recommended that schools of nursing operate separately from hospitals and

they should no longer be used as cheap labor (Nursing). After the publication of this report,

several new university schools of nursing opened. As times changed, so did the field of nursing;

the first nurse practitioner program started in 1965 at the University of Colorado by Loretta Ford.

This program gave trained registered nurses new responsibilities and roles in the healthcare

system.

As education and technology evolved, so did nursing and the nurses roles in colleges. In

1886, the first college health infirmary opened at Iowa State University (Warren Forsythe,

Journal of the American Medical Association). An infirmary was one of the first versions of a

hospital, so it became a place for people who were ill to get the care they needed. Warren

Forsythe compared the number of beds, cost, and utilization of infirmaries from eight different

universities. Infirmities provided inpatient care for sick students but early college health centers

provided cost effective outpatient care and inspection of students physical abilities (Journal of

American College Health). In the 1970s, infirmaries flourished, but the number of centers

decreased over time. By the early 1980s, infirmities became too expensive for most universities

and very few remained. Current health care programs in college have health centers with

specialized nurses and doctors to provide care for students. College nursing has become a huge

part in students self-care, health promotion, public health, and consumer advocacy due to the

exponentially growing population of students who attend colleges and universities. College

nursing has become so popular that while nursing students have to do their clinicals college
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nursing became one of the specialties they must complete to become a registered nurse. During

the time of one's nursing education all prospective nursing students have requirements they must

do, such as clinicals. Clinical studies show nursing students different kinds of work in all

possible fields, after they finish clinicals they have the ability to choose where they want to

specialize and spend their residency.

To properly prepare for the tedious nursing programs one should prepare in high school

in order to succeed. High school courses that may help students interested in nursing include

chemistry, biology, and psychology. Theses classes provide information that would help with the

basics of nursing. Even though a strong educational foundation remains extremely important to

prepare a student for nursing school, there many other things that factor into what makes a good

nursing student, such as time management, friendliness, compassion, the ability to stay calm

under stress, along with having a good understanding of child development help people succeed

in nursing (Alburger). Each nurse provides a different experience for patients during their time in

the healthcare system.

All nursing programs have their differences and the quality of them always changes due

to economic and technological advances in specific programs. The University of Pennsylvania

and Duke have two of the best nursing programs in the country. The University of Pennsylvania

provides an amazing state of the art simulation lab, alongside a team of extraordinary healthcare

professionals. University of Pennsylvania and Johns Hopkins work together; because Johns

Hopkins has the best medical school in the United States, Johns Hopkins arranges students

clinical placement for University of Pennsylvania students (Bachelor of Science in Nursing

(BSN)). During the first and second year of college, students on the pre-nursing path will take
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general education classes; in the first year, students focus mainly on biology courses and in the

second year nursing students will get clinical experience at some of the best hospitals not only in

the Pennsylvania area but in the United States. Some of the best hospitals they have access

include the Childrens Hospital of Philadelphia, the Penn Medicine research complex and the

Philadelphia Veterans Administrative Medical Center. The University of Pennsylvania has an

interest in more than the academic side of students nursing careers, collaboration both in school

and outside help students develop the necessary skills to take on the professional work once they

become a registered nurse.

Duke University, a renowned medical school, has an amazing nursing program along

with other medical and non medical programs. Duke offers a state of the art simulation center

that provides a variety of opportunities for students; sim labs allow students to experience what

it would be like to work at a real hospital (Duke School of Nursing). Once nursing students

receive their registered nursing degree and continue their career at Duke, they can choose from

many different paths. The two main paths one could choose is either a more research driven or

discovery path. The Center of Nursing Research (CNR) gives practicing nurses and those on that

path more of a technological and research based career. The nurses in the CNR program work

hand and hand with other staff members to do groundbreaking research. The four main areas of

research include clinical innovation, population health and chronic illness, precision health, and

methods and analytics. All four of the areas offer different assets to the community and those

who need help. Clinical; Innovation has an advanced approach for ideas, processes, products,

procedures or interventions and health care system changes to benefit the health of America and

other countries around the world (Center for Nursing Research). Population health and chronic
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illness research deals with the increasing health outcomes of a group of individuals families or

communities, and reducing health disparities within the group (Center for Nursing Research).

Precision health research creates new evidence-based approaches to health that incorporates

genomics, environment and lifestyle. Methods and Analytics deal with optimizing the use of

cutting edge approaches to study design and analytics. If one chooses to do the discovery path

they will be taking a more active approach to the higher education of nursing at Duke. Dukes

Center of Nursing Discovery (CND) increases learning by providing students with hands-on

experience through problem solving, critical thinking and clinical reasoning/judgement. Those

who participate in the discovery program at Duke work toward developing their own evidence

based nursing practice, achieving most of the main goals of the program, which include creating

reliable and hardworking clinical leaders, providing both personal and professional relationships

with their patients to give them the best care they can. The CND also functions as a mock

hospital, which allows nurses to become more confidant before they work on real patients with

real lives on the line. The CND, not just for nursing programs, also provides opportunities for

team training with medical, physical therapy, and physician assistant using simulations and

role-play in their learning program. The CND cares a lot about collaboration and working with

the community, therefore they become very involved with local organizations both pre-medical

and non-medical programs. The CNDs relationship with the Duke Area Education Center

(AHEC) benefits both programs because the AHEC hosts the CND high school and middle

school students participating in health careers summer camps, so those students can experience

patient simulations and have the ability to observe the hospital. Another great opportunity that

Duke provides the Office of Global and Community Health Initiatives, an organization to
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improve health outcomes education research and service for people across the world. Studying

abroad plays a big part this program, students have the amazing opportunity to study abroad for a

two-week immersion experience that occurs during a break in the school year. Even if one does

not have the interest in studying abroad but they still want to get involved in this program, Duke

provides many local opportunities in Durham.

Nursing offers over 30 fields one could go into, though most fields require graduates of

universities to get either their Registered Nurse license (RN) or their Bachelors in Science in

nursing (BSN). In order to receive ones RN, one must pass the NCLEX-RN exam upon

completing the necessary courses in a nursing program. Nursing students spend their whole

education preparing for the NCLEX-RN; if one passes the exam they become a registered nurse

and can begin to practice immediately after. Practicing nurses only have to take the exam once in

their career if they stay up to date with their courses (Alburger) in order to continue to learn

about the changes in technology and improving methods of treatments. Most standard nursing

jobs require an RN degree, but if one would like to further their education in the nursing field, a

nurse practitioner could become next step. A nurse practitioner can prescribe medicine, examine

patients, diagnose illnesses, and provide treatment (Part One: What Is a Nurse Practitioner?).

On the other hand, nurses duties consist of monitoring, recording, and reporting symptoms or

changes in patients conditions (RN or Nurse Practitioner?). Becoming a nurse practitioner

provides better job security than regular nurses, even though the nursing industry remains fairly

stable. If nurses did not have the opportunity to further their education by becoming a nurse

practitioner there would not be enough doctors to help all those in need. For one to become a

nurse practitioner they must enroll in a school and earn their Bachelor's of Nursing Science
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degree, if they do not already have one. Once one receives their BNS they must enroll in an

MSN program, these intense programs take a minimum of two years to complete. After one

earns their advanced nursing licensure in practical nursing, they can begin working as a nurse

practitioner.

Both nurses and nurse practitioners have an extremely important role in society, they both

help those who need it most. The nursing industry grows faster than the national average (RN or

Nurse Practitioner?). People will always have a need for health care providers, resulting in high

demand for nurses and nurse practitioners. Due to the higher education of a nurse practitioner

,they usually earn over $30,000 more than RNs. The average RN in North Carolina earns $28.51

an hour or $59,290 per year, while the average nurse practitioners makes about $98,566 a year

(Nursing salary facts). Nurses in each state earn different salaries due to the amount present in

each state. Other factors that affect how much nurses make has to do with the hospital, the

location of where they work and their patient population. The hours for nurses, though usually

somewhat flexible, depend on each hospital's policy. A normal full time nurse works 36-40

hours/week and part time usually entails 12-24 hours/week. One may not have a choice if one

works days or nights; most nurses start off rotating, then transition to either only days or only

nights (Alburger). All hospitals have their own rules and guidelines regarding shift times,

depending on the hospital ones hours my differ each payment period. Nurses who have more

experience and have more education in the field may receive the opportunity to choose their

hours.

A normal day practicing on a hospital floor mostly entails the same events day to day.

Even though every day may bring something new, most days consist of the same processes. A
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normal shift starts at 6:30am or 7:00am, nurses get reports on their patients from the previous

day, things such as name, age, weight, the reason for their visit and any other special needs they

have. They also get informed of what happened on the last shift. Nurses look up their orders and

what medication their patients need and when they need it. Then nurses would then start their

rounds (usually 3-5 patients) and start their assessments, which consist of listening to their

hearts, lungs, bowel sounds, and checking their circulation among other things. Rounds

document patient's changing vitals and update the technology programs within the healthcare

system. Nurses check their patients IVs, give them the medications if needed and answer any

questions the patients or family members have. When nurses get a break from checking on their

patients, they have to document all the research and procedures they conducted during their shift.

In between rounds, which takes about 4 hours, nurses check on their patients again every hour to

check various things about their patients. Nurses repeat that cycle throughout their whole shift,

though they might have to change some aspects of their routine to accommodate to their patients

needs during that specific shift.

Pediatric nursing provides care to infants, children and adolescents. After graduating

from nursing school and passing the NCLEX exam, most nurses complete an internship program

that may last weeks or months depending on the program itself. Nurses can then specialize in

pediatrics by finding a job in the healthcare system that serves pediatric patients (Your Future in

Pediatric Nursing). This could take place in a hospital, clinic, school, doctors office,

emergency room, hospital floor, or intensive care unit. Pediatric nurses have knowledge about

growth and development as they interact and care for each individual childs need and

developmental level (Becoming A Pediatric Nurse). The general pediatric care unit provides
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care to children with a wide range of medical and surgical conditions. Some patients require

constant and intense observation such as those with severe, critical, or life-threatening

conditions. These patients require their own section called the pediatric intensive care unit

(PICU) where staff with advanced knowledge and training care for the critically ill children.

Intermediate care for those with acute illness require more frequent assessment and monitoring

than what nurses provide on a general unit, but less than standard in the PICU. Most of the

intermediate care facilities transition between critical and general pediatric units. The staff that

takes care of those patients have special training to recognize early signs of problems and solve

them immediately before they worsen. Nurses working in pediatric rehabilitation units provide

care in the rehabilitation process and preparing the child and their family for their return home.

They also help with childrens reentry to the community and school if they remain with a

disability. After one finishes their internship and gains experience in the pediatric unit, pediatric

nurses can take an exam to become a Certified Pediatric Nurse (CPN). By getting their CPN,

nurses further their education and knowledge on pediatric nursing by reading medical journals,

participating in educational classes, and attending conferences. Getting the certification

represents that one has gone through the necessary courses and attended a level of experience

that qualifies them to take the CPN. The certification tests ones knowledge and critical thinking

skills in clinical decision making. The Society of Pediatric Nursing supports and encourages this

further education step for nurses at both basic and advanced practice levels (Becoming a

Pediatric Nurse). The two organizations, Pediatric Nursing Certification Board and American

Nurses Credentialing Center both support the certification programs. They both support and

value the opportunity to excel in pediatric nursing. After getting a Bachelor of Science in
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Nursing (BSN) a nurse can earn their masters degree and become a Pediatric Nurse Practitioner

(PNP) or Clinical Nurse Specialist (CSN) in Pediatrics. After completing the masters degree,

PNP and CNSs apply to the state board of nursing for recognition as an advanced practice nurse

and take the national exam for official certification. Pediatric advanced Practice nurses provide

care primarily for well and ill children from birth to the age of 21. PNPs have the additional

knowledge and skill to diagnose and treat episodic illnesses, manage ongoing care of children

with chronic conditions, and provide for children's ongoing health maintenance needs. Some

examples of maintenance needs include the medical, surgical, and nursing care for children

during their hospitalization in general, or in intensive care units. All PNPs practice in

collaboration with physicians who provide help and information to PNPs and referral as needed.

Clinical Nurse Specialists function in a variety of settings with both direct and indirect roles.

They deal with more direct family centered patient care. They also influence nursing care

outcomes by providing education, expert consultation, and leadership in defining evidence-based

practice for the staff. Pediatric CNS may identify terms of a setting, a subspecialty, a type of care

of patient problem. They work with other disciplines to contribute to the improvements in the

health care delivery systems.

Pediatric nursing has evolved into one of the most rewarding careers in the world, as it

provides numerous opportunities and fields of specialities. As proven through history nurses not

only comfort individuals with their illness, they also connect with their patients emotionally and

advise them in understanding their condition or recovery.

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Works Cited

Alburger, Lindsey. E-mail Interview. 4 Feb. 2017.

"Bachelor of Science in Nursing (BSN)." Academics Penn Nursing. Web.

22 Feb. 2017.

http://www.nursing.upenn.edu/academics/bachelor-of-science-in-nursing-bsn/

"Becoming a Pediatric Nurse." Society of Pediatric Nurses : Becoming a Pediatric Nurse.

Web. 22 Feb. 2017.

http://www.pedsnurses.org/becominganurse

Bagay, Joann Marie. "Promoting Positive Pediatric Experiences For Nursing Students At

The Children's Hospital Of Pittsburgh Of UPMC." Pediatric Nursing 40.3 (2014): 148-154.

Academic Search Complete. Web. 2 Jan. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455861&d

b=a9h&AN=96973112&site=ehost-live&scope=site

Crihfield, Connie and Ted W. Grace. "The History of College Health Nursing." Journal

of American College Health, vol. 59, no. 6, Jun/Jul 2011, p. 470.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455861&d

b=f6h&AN=61157874&site=ehost-live&scope=site

"Duke School of Nursing." Duke School of Nursing. Web. 22 Feb. 2017.

http://nursing.duke.edu/

"Nursing." Funk & Wagnalls New World Encyclopedia (2016): 1p. 1. Funk & Wagnalls
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New World Encyclopedia. Web. 3 Feb. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455861&d

b=funk&AN=NU070200&site=ehost-live&scope=site

"Part One; What Is a Nurse Practitioner?" Nurse Practitioner Career Guide, Salary, and

Outlook. Web. 22 Feb. 2017.

http://nurse.org/resources/nurse-practitioner/

"RN or Nurse Practitioner?" Charter College. Web. 22 Feb. 2017.

http://nursingschool.chartercollege.edu/rn-or-nurse-practitioner

White, Diana L. and Patricia K. Hamel. "National Center for Nursing Research: How It

Game to Be." Nursing Economic$, vol. 4, no. 1, Jan/Feb 86, pp. 19-22.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455861&d

b=a9h&AN=12277055&site=ehost-live&scope=site

"Your Future in Pediatric Nursing." Pediatric Nursing Careers. Web. 22 Feb.

2017.

http://www.pncb.org/ptistore/control/about/forstudents
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