Dr. Michaela Lewis: A Career in Pediatric Nursing

Dr. Michaela Lewis: A Career in Pediatric Nursing

Pediatric nurses often say the field of pediatric nursing is something that calls to them for varied reasons, but helping children and their families is a top goal. Michaela Lewis, DNP, ARNP, CPNP-AC/PC, PMHS, CPN, CPEN, CNE, CNE-cl,VA-BC, CCRN is an assistant professor at the University of Colorado, Anschutz Medical Campus, College of Nursing, and says making a positive difference for the children and families she cares for is so rewarding. headshot of Michaela Lewis in a red and blue top for pediatric nursing

But pediatric nursing also offers opportunities to use cutting-edge data, equipment, and processes that advance her day-to-day nursing practices. Dr. Lewis, who is a member of the Society of Pediatric Nurses’ Board of Directors, also finds pediatric nursing provides pathways to pursue her professional interests including pediatric hospital medicine, quality improvement, instructional design, and initiatives that promote diversity, equity, inclusion, and belonging. She shared some of her thoughts about a career in pediatric nursing in time for the annual celebration of Pediatric Nurses Week which runs from October 2 to 6.

Please tell Minority Nurse a bit about yourself.
I completed my undergraduate nursing studies at Gardner-Webb University in 2008 and earned my Doctor of Nursing Practice degree at the Medical University of South Carolina in 2015. Additionally, I completed post-graduate studies in pediatric acute care at the University of South Alabama and completed the Advanced Practice Provider fellowship offered by Seattle Children’s Hospital in 2019.

I have over 17 years of nursing experience and hold multiple national certifications in pediatric emergency, critical care, and mental health specialties as well as in nursing didactic and clinical education and vascular access. Personally, I enjoy reading, weightlifting, yin yoga, traveling, and spending time with friends and family.

How did you find your career path to pediatric nursing and what makes it rewarding?
I was drawn in by the ethical maxims and caring science of the nursing profession and by the opportunity that it offers to interface with children and their families in a way that makes a positive difference. It is most rewarding to see and know that your actions, as a pediatric nurse, have contributed to the healing of a patient and family. A career in pediatric nursing has also afforded me opportunities to work across the country and overseas; to learn and work with brilliant intra- and interdisciplinary colleagues; to advance professionally; and to grow personally.

You work with a fragile population and their families. What nursing skills do you rely on most heavily?
I rely most heavily on my ability to assess patients and families, the process of gathering data using senses. Many of the patients I care for, due to developmental or health-related considerations or other barriers, are unable to communicate using words. Receptivity to and accurate processing of body language, paralanguage, and other signs and symptoms that patients and families consciously or unconsciously share are the foundational of most successful outcomes.

Why is it so essential to have a diverse representation of nurses in pediatric nursing?
Person-centered care focuses on the individual within multiple interwoven and complicated contexts. Foundational to person-centered care is respect for diversity, differences, preferences, values, needs, resources, and the determinants of health unique to the individual. Inclusivity and representation are essential to providing person-centered care to increasingly diverse populations, care that requires seeking to understand the totality of the individual’s lived experiences and connections to others.

Diverse representation is the only means by which we can create healthcare systems that empower individuals to make informed decisions about health maintenance and illness and injury prevention behaviors within the context of their own cultures; systems that recognize and value the undeniable influence of culture on the biology, attitudes, beliefs, and practices of patient populations and healthcare delivery alike.

What kinds of technological or medical advances have you seen in your career and what do you expect will develop in the future?
As advances in portable and wireless technologies have developed and expanded, so has the provision of home health and telehealth services. These advances have expanded the reach of healthcare providers and services, making some forms of care and treatment more accessible and conducive to improving the quality of life of patients and families. It will be interesting to witness the evolution of artificial intelligence and its application in the detection and diagnosis of disease, as well as its role in information generation and sharing.

What would you like readers to know about pediatric nursing?
The nursing profession is facing some longstanding and unprecedented challenges; pediatric nursing is not immune to those challenges. Every challenge, however, presents an opportunity for growth. Child health is the foundation of health and well-being for societies. Pediatric nurses are uniquely poised to lead the charge in reshaping healthcare systems across all care settings and levels of impact.

Pediatric Nursing: Treating the Family

Pediatric Nursing: Treating the Family

When nurses think of going into pediatric nursing, they often think of working with a specific age in the wide range of newborn baby to 18-year-old young adult. But what many might not realize is how working with a child also includes working closely with a family as well. In fact, when pediatric nurses think of caring for a patient, they consider the care of the family as part of the whole child, says Shirley Wiggins, PhD, RN, president of the Society of Pediatric Nurses.

As families have evolved to range from the traditional family of a mom and dad with kids, today’s family structure takes on a whole new shape. It can include same gender parents, grandparents as primary caregivers, parents living together or apart, foster parents, aunts, uncles, cousins, and even close friends who comprise the family unit.

So while pediatric nurses tend to the needs of the child, they also remain mindful of the emotions and experiences of the child’s family. “Education is a critical point with families, and it’s what they need,” says Wiggins. But not all families are ready for specific information at the same time. A pediatric nurse’s job includes being able to read a family’s readiness. “What is the capacity of that child and that family both developmentally and at that time,” says Wiggins.

When families have information, they can help support the child even more, and pediatric nurses are there to help them through that process. “You see how powerful the family is in our society,” says Wiggins. “In difficult times, you see how amazing they are. They dig deep.”

Although Wiggins says many pediatric nurses come right from nursing school, there are many who choose the field during a mid-career change. Wiggins says it’s often the call of working with children and in partnership with families that draw nurses in. “Sometimes what drives it is they encounter a family and a child speaks to them,” she says.

Wiggins says no matter where you are coming from in your career, it helps to have an open mind when you think about how you would fit into a pediatric nursing position. “Be open to the that fact that each family is unique,” she says. “Be flexible to just listen.” Families and children often come as one unit, so pediatric nurses see the whole picture.

Pediatric Nursing: Treating the Child

Pediatric Nursing: Treating the Child

Of all things pediatric nurses might have in common – the education, experience, and common patient group – what really knits this group together is one thing, says Shirley Wiggins, PhD, RN, president of the Society of Pediatric Nurses.

I have to say we look at this as our passion where others might see it as a challenge,” she says. “Integrating the care of the child and family is our passion.”

In fact, at a recent meeting Wiggins asked what brought the nurses in attendance to the pediatric nursing field, and many nurses reported that they decided on pediatric nursing fairly early on.

What does it mean to be a pediatric nurse? “The whole emphasis on the Institute of Medicine’s patient centeredness is what pediatric nursing is,” says Wiggins. “It’s what we love to do, and it’s what keeps us there.”

Pediatric nursing works with an age range of patients that encompasses newborn babies all the way to the young adults of 18 years of age, so centering care on the patient means taking in a broad cognitive and physical spectrum. “The approach is developmental and we focus on that child and where they are,” says Wiggins. With all work done within the network of the family, pediatric nurses recognize that patient support comes in all manner of people – from the parents of an infant to the close friends of a teenager.

There are currently more than 180,000 professional registered pediatric nurses providing care, in various settings including home care, ambulatory clinics, schools, public health, colleges of nursing, hospice and palliative care, says Wiggins.

And Wiggins says pediatric nurses, who are often seen as working with the more vulnerable age groups, are amazed at the resilience of children. “There is great strength in children,” she says. Pairing that show of strength with a love of fun and goofiness lends to a very unique workday for most pediatric nurses.

We all laugh because there are aspects of pediatric nursing that are really fun,” says Wiggins. In the seriousness of the work they are doing, they can’t forget to add the whimsy that kids often love – whether that’s cat’s ears at Halloween or singing familiar songs with the kids.

And a team approach to nursing children is essential, says Wiggins. Teams of medical personnel and child life specialists offer the support the child and the child’s family need. Wiggins says a good pediatric nurse has the same qualities that make any nurse exceptional. “Be the one that asks questions and sees issues and wants to make it better,” she says. “There’s lots of good communication when we work with others and in the Society of Pediatric Nurses we look at evidence-based standards in pediatric nursing with discussion boards and communication that looks at substantiating what we do.”

Wiggins herself said she knew during her nursing student days that this was going to be her direction. Even at the end of a challenging day in clinical, she thought of what she needed to do to be able to do have days like that for the rest of her career. “It didn’t feel like work,” she says. “It was an opportunity.”

And, yes, pediatric nurses are in a field that could make them prone to compassion fatigue because of the heartbreak they encounter routinely. When nurses mention things only another nurse would understand, pediatric nurses share a special bond of caring for ill children, some of whom do not recover. Because of that, there are lots of protections and processes in place for pediatric nurses to help manage the emotional fallout that can happen and to keep them close to other pediatric nurses who have almost all experienced similar joys and sorrows.

Wiggins points to the DAISY Foundation awards, which recognizes outstanding nurses and the “super-human” work they do with patients and families in difficult times. The awards can help acknowledge that nurses struggle with emotions right alongside families and patients they care for.

If pediatric nursing is something that intrigues you, it’s worth looking into getting some first-hand experience to see if it’s a good fit.

A Proactive Program

Teen pregnancy, once a declining problem, is once again on the rise, particularly in minority communities. To combat the trend, one Massachusetts nurse started a program aimed at educating students and parents about teen pregnancy before it occurs. Anh Lewin, B.S.N., R.N., who works for Pediatrics West, started The Smart Sex Program for Teens in 2008 with a $5,000 grant from Fallon Community Health Plan, an insurance and health care provider. The program is held for two hours over a two-week period while a separate session for parents, called “Let’s Talk,” is a two and a half hour, one-time program.

Located in Groton and Westford, Massachusetts, Pediatrics West provides health care to some schools in those towns as well as in Chelmsford, Lawrence, Pepperell, and Tyngsborough. Lewin also has offered the program in nearby Lowell, which is the fourth-largest city in Massachusetts and has the highest percentage of native Cambodians of any place in the United States. Lawrence, meanwhile, is known as the “Immigrant City” and has always been a multi-ethnic and multicultural gateway with a high percentage of foreign-born residents, according to the city’s website.

The Smart Sex Program for Teens is free. It includes instruction on communication, the reproductive system, puberty, sexually transmitted diseases, protection, abstinence, and relationships.

For the parent workshop, there is a modest fee. “For the parents, we teach them all the facts. Now we want you to teach your kids how you feel about the situation,” Lewin says. “We ask, them, ‘What is your opinion?’ You have to give kids your values. We do not do that. We spend four to five hours with them. You have your entire life with your child. It is not one talk; it is multiple talks. It is talks that should start when they are really young, so you are always comfortable talking about it.”

To learn more, visit the Pediatrics West educational programs website (www.pediatricswest.com/education.htm).

New federal grants help minority infants in Utah

Every newborn enters the world with the unlimited promise and potential of a life yet to be lived. However, alarming research conducted in Utah has revealed that all babies may not have the same chances, particularly those born to African Americans and Pacific Islanders. According to the Utah Department of Health’s Center for Multicultural Health, Pacific Islander infants (those under 12 months) experience about 8.8 deaths out of every 1,000 births, compared to about 4.5 deaths out of every 1,000 births statewide. Utah’s infant mortality rate hasn’t exceeded eight deaths per 1,000 births in over 20 years. In light of these facts, the U.S. Department of Health and Human Services recently decided to provide over $130,000 over a three-year period to help specialists study mortality rates within various populations in Utah.

Center specialist April Bennett says the information gathered from this process will be used to implement many interventions and outreach programs for minority women. Surveys will be conducted to help expecting mothers identify obstacles that they may experience during pregnancy, such as maternal obesity, smoking, poverty, etc. The ultimate goal is to help them lead better lifestyles.

The number of uninsured in the state has risen in the past 10 years, with Hispanics holding the highest number at 35.7%, compared with only 11.1% of all Utahans. In 2001, 25.8% of Hispanics were uninsured. For uninsured mothers, this means inadequate prenatal care, which can lead to premature labor and put the lives of their infants at risk. Various health department surveys have shown that African Americans have the highest rates of pre-term births of all infants in Utah, one of the underlying issues contributing to a higher infant mortality rate in the state. But, the U.S. Department of Health and Human Services is determined to make an impact on this issue immediately, starting with studying the contributing factors, such as insufficient insurance and a lack of access to care.