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Nursing at Texas Children's Hospital
Areas of specialization

Nurse examining patient - Texas Children's Hospital

Nurses are an essential part of every patient care team, fulfilling an important role in providing children and families with the highest quality care. Nurses -- who have the closest contact with patients -- assess needs and plan and coordinate care. They administer treatments and monitor progress throughout a child's hospital visit. Many nurses come to Texas Children's to use their skills in specialty care or to gain experience in one of these areas:

  • Advanced practice
  • Acute care
  • Cardiovascular intensive care
  • Neonatal intensive care
  • Pediatric intensive care
  • Primary care
  • Progressive care
  • Renal dialysis
  • Surgery

Learn more about nursing certification at Texas Children's Hospital.

Advanced practice
Advanced practice nurses work in a variety of settings and usually concentrate on a specific area of care, such as cancer, cardiology, intensive care, pulmonary, transplants or neonatology. They coordinate care for patients and, working closely with staff nurses, act as expert nursing consultants. Nurse practitioners have extended education and training in the areas of physical assessment and diagnostic testing. They are involved directly in managing patient care, often carrying a caseload of their own patients. They can prescribe medications, order and interpret lab tests and perform certain procedures.

Acute care
Acute care nurses function as members of a multidisciplinary team to provide care for patients with a variety of health conditions. Each acute care floor in the hospital is designated for a particular type of pediatric care, such as neurology, surgery, renal, pulmonary, adolescent medicine, cardiology, cancer, transplant, and general pediatric medicine. Acute care nurses working in these areas develop an in-depth knowledge of the condition or illness which they help treat, and often form long-term relationships with the children and families under their care.

One example of acute care provided by Texas Children's nurses takes place in the EEG monitoring unit. This unit includes three beds that are staffed by nurses and technicians from Neurophysiology. This staff continuously monitors patients to record information about their seizures. The information is used to prescribe treatment, such as medications, surgery or various other forms of therapy.

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Cardiovascular intensive care
Nurses in the cardiovascular intensive care unit (CVICU) provide care for the post-operative cardiac patient. CVICU patients require constant observation, high acuity nursing care and the use of specialized intensive care equipment. Common diagnoses seen in the unit are congenital heart disease, congenital heart anomalies, acquired heart disease and heart transplants. Nurses in this unit also care for patients on extracorporeal life support systems (ECLS).

Neonatal intensive care unit
Nurses in the neonatal intensive care unit (NICU) are trained to manage highly technical care and to provide an appropriate environment for developing newborns. Neonatal nurses provide breakthrough nitric oxide therapy and extracorporeal membrane oxygenation (ECMO). They also assist in labor and delivery to help stabilize a sick neonate and are part of the transport team.

Pediatric intensive care unit
The pediatric intensive care unit (PICU) staff provides immediate care for critically ill medical and surgical patients. PICU patients require constant observation, high-acuity nursing care and specialized equipment. Common diagnoses seen in the PICU are respiratory distress syndrome, diabetes, seizure disorders, transplants, sepsis and organ failure.

Primary care
Some nurses work for primary care pediatricians who are part of Texas Children’s Pediatric Associates (TCPA). Nursing care at these offices places a special emphasis on patient education and family support, particularly for new mothers. Special services such as the Baby Buddy Program provide expectant mothers with information and instruction on how to care for their babies. TCPA nurses also have embarked on several new outreach programs to lend support and nursing expertise to families in the community.

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Progressive care unit
Patients in the progressive care unit (PCU) are acutely or chronically ill and often are admitted from intensive care. Nurses take the lead in coordinating care for patients who require continuous monitoring and observation, with special emphasis given to respiratory, neurological and surgical disorders. Many patients depend on technological support, notably those with tracheostomies or negative pressure ventilators (also known as "iron lungs"). Nurses in PCU may also teach families to care for their chronically ill child at home.

Renal dialysis/Pheresis
Texas Children’s pediatric nephrology nurses practice in every setting from the intensive care unit to the patient’s home. They have expertise in conservative management, peritoneal dialysis, hemodialysis, continuous renal replacement therapies, pheresis, renal and extra-renal transplantation. Nephrology nurses assess the impact of renal disease on the child and family, deliver renal replacement therapies, educate patients on disease management, and help the end-stage renal disease patient achieve an optimal level of functioning.

Nephrology nurses also perform a full complement of pheresis procedures: therapeutic plasma exchanges; red cell exchanges; leukapheresis; peripheral blood stem cell harvests; plateletpheresis; lymphocyte collections and granulocyte collections.

Surgery
Surgery is frightening for anyone, but even more so for a child. Texas Children’s operating room nurses have excellent organizational and management skills, along with the ability to work independently in a high-pressure situation. Skilled in both circulating and scrubbing roles, operating room nurses coordinate patient care during all phases of surgery, bringing their expertise and compassion to the operating table. Texas Children’s operating room nurses work in fourteen surgical specialties, including: