Academy Policy in Relation to the Pediatric Nurse Associate

The Academy has been involved with the concept of the pediatric nurse associate (PNA) since its evolution in the early 1960's. At that time it was recognized that there were children in this country who were receiving inadequate or no health care. In addition, predictions were being made of an impending physician shortage. It was also becoming increasingly apparent that there was a reservoir of health professionals who were not being utilized to their fullest potential within the health care system. This reservoir was nursing; thus, the concept of the PNA was conceived, developed, and has continued to grow over the past ten years. The education of the PNA has many unique aspects, for in this endeavor medicine and nursing assume joint responsibility in the development and administration of the educational programs. The PNA is a professional nurse with additional education in the field of child health care. In addition to his/her nursing role, she/he assumes certain functions and responsibilities which traditionally have been the domain of medicine. In the provision of these medical services the PNA functions under the supervision, direction, and review of the physician. Thus, it is imperative that medicine be actively involved, not only in the educational process, but also in the development of the role of the PNA within the health care system. There have been many changes not only within the specialty of pediatrics, but also within the health care system in general in recent years. To mention a few: a decline in the birth rate; the development of national health programs; rapid expansion of medical schools and classes; an increased emphasis on primary care and avoidance of fragmentation of care; the emergence of the family physician; and a crisis in the medical profession regarding professional liability coverage.