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Career Story: Pediatric Nurse Practitioner In A Neurobehavioral Unit

Pediatric Nurse Practitioner In A Neurobehavioral Unit

Job Title: Pediatric Nurse Practitioner

Education: BSN in Nursing, Vanderbilt University, •• MSN in Nursing, Pediatric Clinical Nurse Specialist, Catholic University of America, •• Post Masters Certificate, Pediatric Nurse Practitioner, Catholic University of America

Previous Experience: I worked on an adolescent medical-surgical unit for three years after graduation from nursing school. Then, I worked on an in-patient hospice unit for one year. I then started graduate school and worked in hospitals and home care in pediatrics to pay for school. I then worked at a hospital as a Pediatric Clinical Nurse Specialist for one year before going back to school. I again worked in hospitals and home care in pediatrics to pay for school. I then started at the hospital I am currently still working for the last 15 years.

Job Tasks: I work at a pediatric rehabilitation hospital, and am full-time, working on an in-patient neurobehavioral unit.

At any one time, there are 16 patients who have severe behavioral problems and were born with developmental disabilities. The majority of the patients have autism and are intellectually challenged, but any diagnosis is acceptable. Criteria for admission to the unit is generally risk of self injury or injury to others that is severe enough to pose a danger to self (the patient) or others. The average time that each child is a patient on our unit is four months, but may be for a year if this is needed to control problem behaviors.

My job is to manage any and all medical problems that occur during the admission. I work with the primary psychiatrist, behavioral psychology team, speech therapist, social worker and educational specialist to help manage the children.

Examples of medical problems that I treat include behaviors that cause wounds (hitting head on hard surfaces, biting self, picking skin, pulling off nails), common illnesses (cold, flu, ear ache, sore throat, stomach virus), need for regular immunizations, problems related to disability (sleep apnea, sleep problems, seizures) and nutritional problems (low blood iron, refusal to eat, over weight, under weight, constipation, diarrhea).

If a patient gets an illness that makes him/her very sick, I may send them to the emergency room, or arrange for a doctor's appointment, or order tests such as X-rays, MRI's or CT scans. I work with doctors and nurses from the hosital nearby so that my patients stay healthy enough to be able to have their behavioral and psychiatric problems addressed.

I attend meetings with families, insurance companies paying for the admission, those who provided medical care before the admission, and those who will do this after the admission. I do the history and physical exams when a patient is admitted, plan for any medical needs after discharge (nursing care, equipment), write prescriptions for medicines needed after discharge, and coordinate with school nurses for needs after discharge.

Best and Worst Parts of the Job: The best part of the job is is working directly with the patients and their families, being able to make a difference in the child's life and help him/her be the best that they can be.

The worst part is fighting with insurance companies to try to convince them to pay for the hospital stay. The saddest part is seeing the patients hurt themselves and others so badly, and seeing how hard it is for families to see their child or children so affected by their problems.

Job Tips:
1. To work in my job, you have to really want to be a nurse, to work hard, to know you can't always "fix or cure" a patient, and to be patient with families who are in crisis, who can be angry or unhappy with you, when really they are angry that their child is never going to be "normal".

2. To be a nurse practioner, you should love to learn, and realize that the studying, reading and learning never ends.

3. It is my opinion, that you should work as a nurse in a hospital for several years before becoming a nurse practitioner, because learing the basics is so very important to be able to really understand diseases and illnesses before you have the responsibility of being in charge of the patient.

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