Issues in children's nursing

Scrub Nurse image by Mary Beth Granger from

Paediatric nurses specialise in providing medical care to minors (that is, people under the age of 18). A career as a paediatric nurse can be extremely rewarding, but it is not without its challenges. Because paediatric nurses work only with children, they face issues that other nurses may not experience.

Realising what these issues are may help a prospective or current nurse decide whether or not to specialise in child care.

Patient Wishes

Adult patients usually have the legal right to make medical decisions on their own unless they are not of sound mind--that is, they have the right to autonomy. In the United States, courts do not afford this right to minors. Instead, they consider parents the legal guardians and let the parents decide what will happen to the child medically. Often this is a good thing, since paediatric patients may be too young to understand their medical issues. Sometimes however, a paediatric patient may be at odds with their parents about what to do. For example, a 17-year old with cancer may want to refuse chemotherapy because he understands his chances of survival are very low, while his parents may want to pursue aggressive treatment. Paediatric nurses have to deal with these conflicts and may need to override what the patient wants, giving treatment even when the patient does not want it.

Patient Advocacy

In some cases, paediatric nurses may suspect that a patient is being abused or mistreated by her parents or guardian. Because paediatric patients are minors with little legal standing, paediatric nurses have to be willing to stand up as advocates for their patients in these instances. This can be emotionally draining and frustrating, since it puts a nurse in the awkward position of interfering in family life.


Paediatric patients are not at the same physical or cognitive developmental level as adults. Consequently, paediatric nurses cannot communicate with their patients in the same way other nurses can. They have to be more patient, use simpler language and accommodate the patient's natural fears and anxieties, according to the Top Nursing Colleges website.

Emotional Attachment

Kids have a way of pulling at heartstrings. Paediatric nurses may become too emotionally involved with their patients, concentrating on the tenderness, youth and fear of the children. They may take it especially hard when one of their patients dies because they understand the potential the child had.

Emotional Detachment and Projection

Nursing is a difficult profession, and nurses are not immune to stressors. Additionally, kids are very sensitive to the emotions and reactions of adults. As a result, paediatric nurses are forced to detach a bit from their own feelings. They have to project a happy demeanour no matter what they are experiencing to establish trust with the child, and so that the patient is calm and doesn't get scared.