Kids Come in All Colors

A career in pediatric nursing offers an abundance of opportunities for personal fulfillment. Many nurses choose to work in pediatrics because they have a deep passion for helping children; others did not originally set out to work with kids but later chose to focus on pediatric care. But no matter how a nurse becomes interested in this specialty, the rapid growth of America’s racial and ethnic minority population means that minority pediatric nurses and nurse practitioners are needed now more than ever in a variety of health care settings, from hospitals to schools to daycare centers.

According to Gloria Jones, MSN, RN, manager of clinical operations at Connecticut Children’s Medical Center in Hartford, nurses of color are severely underrepresented in the pediatric nursing workforce. “Overall, only about 2-3% of all [pediatric] nurses are minority. It’s a very, very low representation,” she says.

Another reason why culturally and linguistically competent minority nurses are so urgently needed in pediatrics is that caring for children often means caring for the child’s family, too.

“The one thing I’ve found with pediatric nursing is that you treat the whole family. The parents and extended family are also considered your patients because they’re going to be in the room with that child,” says Angela Bryant-Curry, RN, who works in the Kohl’s School Nurse Liaison/Consultant Program at Children’s Healthcare of Atlanta. “With 90% of the kids who are in the hospital, there’s going to be an adult—or we hope there will be an adult—who will remain in the room with that child. So that person becomes your patient as well.”

Making a Difference

Ask any pediatric nurse what they love most about their chosen specialty and there’s a good chance the answer will be: “the opportunity to make a difference in children’s lives.”

Association of Pediatric Hematology/Oncology Nurses (APHON) Beena Mathew, RN, a nephrology nurse at Children’s Medical Center Dallas, was inspired to pursue a career in pediatric nursing after hearing a speech by Mother Teresa at her college in India. The lecture was about finding your focus in life, serving humanity and using your unique qualities to find a profession that is also a passion. Mathew decided to focus her passion on helping others by becoming an educator and a nurse. Since immigrating to the U.S. in 1994, she has dedicated her career to working with children.

Although most nurses don’t have the opportunity to be personally inspired by someone like Mother Teresa, many find that working with children as a pediatric nurse brings tremendous personal rewards.

“I chose pediatric nursing because even as a teenager I wanted to make a difference in the life of a child,” says Bryant-Curry. “My mother is a registered nurse and so my summers were spent at the office with my mom, where I had a chance to interact with nurses and patients early on.”

“During my clinical rotation I really loved working in the labor and delivery unit and working with the babies specifically. I just gravitated toward pediatrics,” says Valerie Caraballo Perez, MSN, RN, BS, senior research coordinator at the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention. “It’s nice that we can have a hand in helping kids get better and also working with the parents so that they understand what they need to do to keep their kids safe. That’s what I got interested in.”

Tommy Covington, RN, a hematology/oncology nurse at Childrens Hospital Los Angeles, has been working in pediatrics for nearly 40 years, even though it was not what he initially set out to do. “I was reluctant to go into pediatrics at first, because I had planned to work at the veterans’ hospital after I graduated,” he explains. “I wanted to work with the vets because I was recently out of the Navy. But I gave Childrens a try with their encouragement and have enjoyed my 39 years here. My wife has worked here for 27 years, so we are a Childrens Hospital family now.”

Where the Jobs Are

Whether you’ve always wanted to work in pediatrics or are contemplating a career change, this specialty offers virtually limitless opportunities and practice settings, including hospital pediatric units, children’s hospitals, pediatricians’ offices, schools, daycare centers, community health care organizations, home health care, insurance companies and more.

“We are seeing a great job market for nurses,” says Linda Matzigkeit, senior vice president of human resources at Children’s Healthcare of Atlanta. “There will continue to be sick children who need top-of-the-line care, and that means trained pediatric nurses are in high demand. This includes specialist positions, such as critical care and cardiac, as well as general patient care positions.”

There are also new and emerging career options in which nurses work in a combination of settings to provide care for children. For example, Bryant-Curry’s position combines work with both health care facilities and schools. As a school nurse liaison/consultant, she helps chronically ill children transition from the hospital back into the school setting. The transition process can range from a simple phone call to the school’s nurse or mental health monitor to sharing pertinent medical information about a particular child to conducting a medical in-service to educate school staff, or any other adult involved with the child, about the child’s medical condition.

“I’ve educated bus drivers or any school personnel that will have contact with the child that has been diagnosed with a chronic illness,” says Bryant-Curry. “On the consultant side, school nurses call me for information on a particular disease or health issue related to a particular child.” She currently provides consultation to nurses in eight Atlanta school districts.

In 2008, Bryant-Curry educated 2,200 school personnel on medical conditions such as anaphylaxis (severe allergic reaction), asthma, communicable diseases, diabetes, epilepsy and sickle cell disease. Her role as a hospital/school liaison gives her the opportunity to develop medical presentations for state conferences, serve as a mentor for school nurses and write fact sheets for school personnel on children’s health issues such as allergies versus colds.

Research is still another career path pediatric nurses can follow. Caraballo Perez, who is the current treasurer of the National Association of Hispanic Nurses (NAHN), calls her injury prevention research job the CSI of nursing.

“I work pretty much like a crime scene investigator,” she explains. “We assess children who were injured in motor vehicle crashes. We assess the injuries and the vehicle, and we present the information we gather at meetings, to see how we can use this data to improve things like vehicle [safety] design and the way the physicians treat patients. There is great opportunity in injury prevention education. There are a lot of research positions here at Children’s Hospital for nurses to get into.”

Caraballo Perez, who received her master’s degree in public health nursing in 2004, also conducts community education programs on child passenger safety, as well as giving presentations at injury prevention conferences.

Nurses who are interested in advanced practice careers will find that opportunities for pediatric nurse practitioners are plentiful, especially in emerging practice settings such as retail clinics in pharmacies. But Carolyn Jaramillo de Montoya, MSN, CPNP, immediate past president of the National Association of Pediatric Nurse Practitioners (NAPNAP), emphasizes that traditional basic care for children and their families will continue to be at the forefront of the profession.

“I believe there will be an increased demand for pediatric nurse practitioners who are capable of providing first-line quality care for children and families to help tackle preventable illnesses such as type 2 diabetes, obesity and essential hypertension,” she says.

The Demand for Diversity

Minority pediatric nurses and nurse practitioners can play a vital role in the lives of young patients of color by helping them bridge communication gaps resulting from cultural differences and language barriers. As the U.S. becomes more and more multicultural, minority nurses will be in increasingly high demand to advocate for patients and their families.

“As the population becomes more diverse, it is important that the health care workforce represents the people they are serving,” says Jaramillo de Montoya. “For example, it is helpful for a child who may only speak Spanish or Navajo to have a nurse who can explain what is happening to them in their own language. Additionally, nurses of color help other nurses to understand their culture, thus improving the care of minority children.”

To effectively address the needs of the changing communities that hospitals serve, nurses should know the dynamics of that community, believes Caraballo Perez. “Minority nurses bring rich experience and knowledge of their own communities,” she says. “[We come from communities that] have vibrant traditions, histories and cultural beliefs. To influence change in health care and advocate for our minority pediatric patients, minority nurses must recognize these attributes and move into positions of leadership [so we can] have a place at the table where decisions are being made.”

Diversity in the pediatric nursing workforce becomes even more important when the unique challenges of treating the ever-increasing population of minority children are factored in. Today, one third of all Americans under the age of 18 are classified as a racial or ethnic minority, creating a high demand for knowledgeable nurses who understand the health disparity issues these populations face. For example, minority children are more prone to conditions such as obesity and type 2 diabetes. They are also more likely to be without health insurance, resulting in lack of access to important preventive care and treatment.1
“It is simply a matter of time before the U.S. develops some strategy for dealing with the 47 million Americans who lack health insurance,” says Jaramillo de Montoya. “Within this number of uninsured there are approximately 8 million children. The current workforce of primary care providers is insufficient to meet the demand for providing care to these children.”

Seeing the Big Picture

Jones notes that many nurses in general—both minority and majority—are reluctant to pursue careers in pediatrics. “I’ve been talking with minority nurses since 1999 to find out why [so many of them] are not interested in pediatric nursing, especially after I came here [to Connecticut Children’s Medical Center],” she says. “I would say 96% of the 40 to 50 nurses I’ve spoken with say they just felt that they didn’t want to work with sick children or that they couldn’t manage working with children.”

The most common reason for this resistance to working in pediatrics, Jones adds, is that many nurses find it heartbreaking to see children who are sick and in pain. But pediatric nurses who are passionate about their specialty argue that having the opportunity to help sick kids get well and live healthier lives outweighs the negatives and truly makes this career worthwhile.

While working with children can be emotionally difficult at times, Bryant-Curry remains focused on the larger picture. “It is emotional and sometimes you feel like you’re doing things that are painful, such as giving a child an immunization,” she says. “But that’s only going to be 30 seconds of pain to prevent a life-threatening disease.”

References

1.  Hockenberry, M.J., Bryant, R. and Rodgers, C. (2006). “Pediatric Nursing: Recent Changes and Current Issues.” Current Issues in Nursing, Seventh Edition, Cowen, P.S. and Moorhead, S. (Eds.), pp. 204-211. Elsevier Health Sciences.