I knew her before she was born. As a pediatric nurse practitioner (PNP), I met Halley's parents when they came to my office during their pregnancy, looking for a provider for their baby. Three months later, I met Halley for the first time. I can still vividly remember her tiny hand gripping my finger. That was the start of a 25-year relationship. I remember comforting her when she was 3 years old and fearful of getting her blood pressure measured. I remember hearing about her soccer games when she was in grade school. I always looked forward to her appointments with me as I was eager to hear about the events of the past year. I will never forget the day Halley asked my advice on contraception. That was the day that I realized that this little girl was now all grown up. She may have been my patient, but the bond that we formed over the years made her feel more like family. Halley suffers from anxiety and depression. Visits during her high school years often revolved around medication management for her condition. I learned to listen more and type less. Bowels, bladder, sleep, and nutrition became less important while relationship issues and prom date decisions took precedence. During one visit, I tried to convince Halley that she would benefit from counseling. Her response to me was that she could not share her feelings with anyone. When I pointed out to her that she has been sharing her feelings with me, she responded with, “But you are Alycia, I can tell you anything.” That is a moment that will stay with me forever. Building trusting relationships is such an important part of being a PNP. That relationship is forged through a variety of ways, such as by spending time getting to know the family; examining the child in a nonthreatening way, perhaps in their parent's lap and always at their eye level; involving the whole family, including the child, in decisions; and taking time to explain procedures that may be scary to them. These steps can all let the child, as well as the family, know that they are important and that their opinion matters. Caring for children is unique in that our patient is not just the child, but rather the whole family. Parents trust us to teach them how to hold, feed, change, and bathe their newborn. They rely on our expertise to protect their child from illness and disease. They share their fears with us as their child navigates through the developmental stages. They look to us for advice on how to discipline. This relationship goes beyond clinical care—it builds lasting connections that transcend routine appointments. PNPs care for children from infancy through their transition into adulthood. The longitudinal care that we provide helps us to understand not only the medical histories of our patients but also the social and emotional context shaping the child. This knowledge helps us to serve as patient advocates, bridging gaps between the health care system and communities. Finally, the emotional dimension cannot be overlooked. Children and families often encounter PNPs during vulnerable moments—illness, developmental concerns, or transitions in care. The reassurance and compassion offered in these interactions create bonds that endure well beyond the exam room. In an era of evolving health care models, the PNP-patient relationship exemplifies the power of holistic, sustained, and empathetic care. It is a partnership that not only treats illness but nurtures growth, resilience, and trust—cornerstones of pediatric health.
Alycia Bischof (Tue,) studied this question.