Pediatric Nurse Shadowing: Reflections on NP Practice

Introduction to Pediatric Nurse Shadowing

As a student who had only just completed the first semester of my nursing program, I had no experience with pediatric patients prior to the shadowing assignment. The nurse shadowing task was therefore a rather exciting experience, exposing me to several new aspects of pediatric care (Burkitt et al., 2001). Its most heart-rending element, however, was congenital patient care — seeing babies born with illness was a deeply touching experience.

While a few of my peers were fairly well-informed on the subject of pediatric care, I was not. Most of the information I gained and things I observed in the course of the shadowing assignment were entirely new to me. The nurse practitioner (NP) I was tasked to shadow provided detailed information about numerous conditions, offered guidance on clinical practice, and modeled the kind of professional conduct I aspire to emulate.

Pediatric and Congenital Conditions Observed

The NP I shadowed provided me with detailed information about appendicitis, which is apparently a widely occurring pediatric issue that can, at times, take a long time to diagnose (Gaydos et al., 2005). In addition, I gained insights into the issue of mal-rotation — a condition in which the intestines fail to fully rotate within the fetus while in the mother's womb, which can at times create serious complications (Burkitt et al., 2001). This was discussed by the NP with a young, tired patient suffering from the condition, who was surrounded by concerned relatives.

I also learned about Hirschsprung's disease, a congenital condition in which the intestines' ganglion cells do not migrate fully throughout the gut, leading to obstruction and evacuation difficulties (Hopkins et al., 2017). This congenitally determined ailment is diagnosed using samples taken from the patient's rectum, where the illness begins. The patient I observed suffering from this condition also had other congenital ailments (Hawkins & Vialet, 2012).

NICU Experiences and Neonatal Surgery

Visits to the intensive care unit were especially moving. The extreme fragility of pre-term babies was alarming. Their vulnerability — being alone in a room filled with machines — is something I will never forget. Other NICU experiences etched in my mind include a case of an omphalocele, an abdominal wall defect in which multiple gastrointestinal organs lie within a yellow sac outside the patient's body (Gaydos et al., 2005). Fortunately, the baby in question did not have a severe presentation, as I learned by overhearing a discussion between the attending physician and the baby's parents. Another unforgettable memory is witnessing a case of imperforate anus — a congenital condition caused by the absence of an anal orifice, leading to a fistula between the rectum and the urethra, bladder, vagina, or another body part (Hopkins et al., 2017).

My most harrowing moment during the shadowing experience was witnessing an operation performed on an infant who was only one day old. While this was not my first time in an operating theatre — I have previously observed cardiac surgeries on adult patients — seeing such a tiny baby being operated on was an entirely new and sobering experience. I may encounter this on a regular basis someday, but I will always remember my first experience and my sense of awe at witnessing procedures on such a minuscule scale (Hawkins & Vialet, 2012).

NP Leadership, Mentorship, and Role Modeling

Although I had never previously given the pediatric nursing field serious thought, this shadowing experience sparked genuine interest. One of my chief motivators was witnessing the NP's gentle and affectionate interaction with her young patients, and her empathy toward their worried parents (Gaydos et al., 2005). As the NP served as an invaluable source of knowledge, I made the most of my opportunity by asking questions and gaining in-depth understanding of several diseases and aspects of pediatric care. We also discussed the distinct roles of the physician versus the nurse practitioner, and I came to realize how well suited I am to the latter role. The NP's thoughtfulness, kindness, calm demeanor, and professionalism were highly inspirational and reinforced my decision to pursue a career in nursing (Hopkins et al., 2017).

Although I was initially skeptical about entering the nursing field, the shadowing experience convinced me that the NP role is right for me. As parting advice, the NP recommended gaining substantial bedside experience as a registered nurse before pursuing an NP role, noting that taking one small step at a time would help overcome obstacles and facilitate success. As the saying attributed to Swami Bhaktivedanta Prabhupada goes, "Little drops of water wear away stone" (Gaydos et al., 2005).

According to Dr. Berwick, the patient comes first. All actions and changes ought to be directed at safeguarding, maintaining, and improving patient well-being. This is the primary consideration in all patient interactions.

The NP clearly displayed an unreserved, visionary style of leadership. She did not balk when faced with a challenging case. In some instances, I despaired at the condition a patient was in, but she would offer strong words of encouragement and urge me to become more self-confident and not shy away from a daunting task. She was not merely a mentor but a genuine role model (Gaydos et al., 2005). Moreover, she demonstrated superior negotiation skills, particularly evident in cases where patients' parents or other caregivers proved resistant and refused to accept her advice or decisions. While humble in her dealings with patients, she handled all forms of resistance efficiently (Hawkins & Vialet, 2012).

References

Burkitt, I., Husband, C., Mackenzie, J., & Torn, A. (2001). Nurse education and communities of practice. Researching Professional Education Research Reports Series. English National Board for Nursing, Midwifery and Health Visiting, Publications Department, Victory House, 170 Tottenham Court Road, London W1T 7HA, England, United Kingdom.

Gaydos, H. L. B. (2005). Aesthetics, art, and holistic nursing.

Hawkins, J. E., & Vialet, C. L. (2012). Service-learning abroad: A life-changing experience for nursing students. Journal of Christian Nursing, 29(3), 173–177.

Hopkins, A., Dudas, R., Quigley, P., Ashworth, J., & Hernandez, R. G. (2017). An interprofessional multimodal patient experience–focused curriculum. Journal of Graduate Medical Education, 9(3), 384–385.