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Being A Nurse For Children With Special Care Needs

Updated on April 7, 2016
This child is similar to the type of children I care for.
This child is similar to the type of children I care for. | Source
This is a diagram of a tracheotomy.
This is a diagram of a tracheotomy.

The Best Nursing Position Ever

As I walked up to the front door of a house I had never been to before, I was anticipating a new challenge, another assignment that I wanted. As the door opened, I was greeted not only by the lady who is the Mom, yet a little girl with glasses, double hearing aids and a tracheotomy greeted me with her arms wide open, ready to jump into mine. Was it my smile? Was it the pretty colors I was wearing? I find it amazing that a child who is deaf and only four years old could have the ability to sense that I was to be her new companion in whom she could trust. I instantly had gained a new friend on that day. The Mom was very receptive as well, and did not hesitate to let me know that I was hired for the job. I am to attend school with her newly adopted daughter to assure her respiratory ease, and to make sure her artificial airway stays intact.

I am a licensed practical nurse, and I prefer to take care of young children and young adults who were born with birth defects, birth injuries, after birth complications, and to assist their families. I either take care of them in their private home or in their schools. The conditions that these young people are born with could be cerebral palsy, respiratory deficiencies, chromosomal defects, dwarfism, brittle bones, seizures, muscular distrophy, or heart defects. They could also have behavioral disorders like ADHD, or autism.

I have heard the phrase, it takes a special person to take care of special needs. I believe that not every nurse is cut out for it. I used to joke to myself about it, and I called it "glorious babysitting". As a Christ centered person, I know that taking care of a child is the greatest opportunity to show God's kindness and bring good will to those I have the privilege to care for.. Each child is different and deserves a place in this world. The smiles and expression of love that comes from these special individuals lets me know I am doing a good job. And the feedback from the families can be very rewarding.

Continuity Of Care

I have been taking care my client for three and a half years now. She is now a young adult who is quite stable and because her caregivers schedules are constant, she is doing very well. She has multiple physical challenges and I have been guided well by her mom in providing the same care that she gives to her. Sometimes there are challenges to face, but they are only minor ones. It is so nice that I know I am employed for "life" to take care of this one. The support I give to her parents and brother is constant as well.

I have fun with my client. It is not all medical care or nursing procedures and providing nutritional needs by tube feeding. We read books, do art projects, watch all the latest and greatest movies, listen to the best music and socialize with the family. I even bring my laptop to her house once a week, when her mom allows, and I read to her from the hub pages. Around the holiday time we make decorations and greeting cards. She signs each card "hand over hand". My favorite time also is beauty spa treatment day. I become the beautician. Her mom is always impressed when she gets her pedicures, manicures, and hair braided.

School Nursing For Special Needs

I have a more limited assignment only during the school months. I am pretty competent with the manner of which I function in our local school system. It is more formal than that of private nursing in the home. I am still considered "private duty" whereas I have to go everywhere with the special needs student, including rides on the school bus. My most enjoyable and easiest school assignment was with a high school student with an artificial air way called a tracheotomy. He also had ADHD and a growth disorder making him almost 7 feet tall at the age seventeen. To assure that his tracheotomy stayed patent and intact was my only necessity there and to be ready for any emergency, including Cardio-Pulmonary-Resusitation or reinsert his trach if need be. Of course, I never had to do that but everywhere I went, so did his special suitcase with his supplies and equipment.

On this particular assignment, which I had for two school years with this teenager, I even got to go to his work study assignments, where he got a chance to work in the retail industry. I followed him around in the hardware and discount dollar stores where he was trained to stock shelves and count inventory. I even got to go on field trips with the young man. All at the same time, I rest assured that he continually kept an open airway.

When I go on the assignment with the new little girl who is hearing impaired, it will be to a special needs preschool. She will do all the normal things a preschooler will do in a school setting. Of course, I will make sure she continues to have a patent , intact airway and that there will be no complications. To communicate with a child in this age range is truly fun and challenging. I enjoy playing with preschoolers! And if the preschooler is not feeling well, it is important to show the nurturing kindness that shows acceptance and approval.


What makes my job as a nurse legitimate is documentation of my care to my client. What they said in nursing school is true, "If it was not documented, it was not done." How could any nurse prove their activity with the client except to document. I feel this is the best feature in my professional role. I feel that thorough documentation is necessary, not as a communication tool between caregivers, it helps plan for the future care of the client. What works best for one child is different for another. Each and everyone is unique in their own way.

First, based on my training, I do head to toe assessment. Being able to identify what's going on with each part of the body gives a clear picture to how the child is going to feel that day. Periodic reviews are expected throughout my shift. Then, noting all my expected tasks based on what is ordered my the Doctor is documented. Again, "If it wasn't documented, it wasn't done" applies. I really need to be on my toes on the time clock though; learning to find time to document while having fun with the child can be a challenge too.


Thank you, Mom and Dad! When I was starting the Senior year of high school, I really had the idea that I wanted to be a special education teacher. At that time, I was told by my parents that they were laying off teachers, and my parents did not want me to struggle to keep a steady job. So Daddy said, "Be a nurse. You'll always have a job."

I started out first, in the Rehabilitation Centers and Long Term Care Facilities for the elderly. I wasn't afraid to take care of old people. A few years later, after the birth of my children, I decided to work as a PRN staff nurse, so I could choose my own hours, and pick my desired assignments. That is when I discovered Private Duty for special needs children. Even when I chose to go back to the care of the elderly, I jumped right back to the care of the young.

I really feel that being a nurse was what the Lord called me to be. I couldn't do anything else. I really love what I profess to be- a Special Needs Nurse. And I think that the special needs children love me to be who I show them I am- JUST ME!


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    • CMCastro profile imageAUTHOR

      Christina M. Castro 

      2 years ago from Baltimore,MD USA

      For Licensed Nurses with experience in Pediatrics, the Pediatric Hospitals have provided Home Health opportunities, and there are also Nursing registries and agencies that specifically focus on the care of children and adults with special needs. I have been very fortunate in the last eleven years to be working for a nursing agency that provides nursing services in the home. It is very rewarding to be involved in a private duty case. I have been with my current client for almost ten years. Thanks, Susan for writing. I hope I was able to help.

    • profile image


      2 years ago

      Where do you find one on one Nurse jobs for special needs children/

    • Laurinzo Scott profile image

      LJ Scott 

      2 years ago from Phoenix, Az.

      A very beautiful and inspired article...

    • profile image

      Brandie Bramlett 

      5 years ago

      Very sweet, I would like to ask you a few questions on your job field im looking into nursing for special needs children I need a mentor for my senior project and would like your help or anyone who knows about the field im looking into going into. any information I should use would be very helpful 8646177250

    • Deborah Brooks profile image

      Deborah Brooks Langford 

      5 years ago from Brownsville,TX

      wow what a great hub Christina.. I am so proud of you my sweet friend.. You have the love of God is you.. My oldest Granddaughter.. Franchesca was born with Bina Spinafa (cant spell) anyway she has a hold in her back.. will never walk without braces and walker.. etc, she has the strongest arms I have ever seen.. she has to have 3 -4 operations a year just to stay alive. she is an amazing child.. she wasn't supposed to live pat 6 months and now she is 10.. I love that child..

      great hub.. I love it



    • anoocre8ion profile image


      5 years ago from Texas

      Thank you for sharing your story with us. As a nurse, I so understand the dedication it takes for you to do what you do day in and day out.

    • CMCastro profile imageAUTHOR

      Christina M. Castro 

      6 years ago from Baltimore,MD USA

      mdennis- your concerns are far beyond of what is constituted a comment. Comments refer to as like or dislike, agree or disagree, thumbs up or thumbs down. You have deep concerns which make your situation highly personal and I can not address your situation. If you really seek an opinion or guidance, you should present your case in a forum discussion, or in the question/answer segment in this website. Check with your local Care Coordinators which are local organizations of social workers and therapists who can give you guidance. I can not give you any guidance since I do not work in a social work capacity. Go to your local school system as well that caters to special needs. I wish you the best of luck in the care of your child.

    • profile image


      6 years ago

      I have a 18 years old girl with cerebal palse , mr and a seizure daughter has a VNS implant , part of her brain removed to help with her seizures and is in several meds , at this moment we are wating for the neurologist to get a drug program for a new drug for her seizure that was denied by her insurance. I had the opportuned to espend 1 month with my daughter wile out of work ; during that time she had only one seizure( normaly she has couple of seizure in one week , and sometimes require us to call 911 after we use all the home emergency meds .I made sure she got rest, fresh air and a health diet for the month I was off work. Her neurologist was impressed with the changes on her; she lost water wt due to the diet and her anxiety level was zero, and I really believe it helped her with the seizures .I am a single parent and need to work to provide for my child and my self.I am a LPN and I work long hrs , the state pays for nurses to take care of my child wile I am working ( they make almost double of wat I made) ,. They are good people and I am really glad that I have these nurses taking care of my girl , but I don't undestand why I could not work part time at my job and stay at least 2 days weekly with my child , and be paid for at least 8 hrs daily , so I can keep my health insurance and 401K . I was told that I need to be hired from an agency , but the local agencies doesn't hired parents. Tonight her nurse had to go home earlier, she dropped my daughter at the clinic where I work , and I had to room pt's and call prescriptions from 5:30 until 8 pm wile watching my child eating McD in my nurse station calling for me.I am glad my supervisor aloud me to do it, since I was the only night nurse , I couldn't live anyway , . I can no longer deal with all the agencies , IU classes and all the above.Does anyone knows how can I get help to stay at least 2 days home with my child without loose my home and break the bank? I WAS TOLD THAT TAKE CARE OF HER IS MY JOB, and I am a good mother , but, someone needs to pay the bills.If anyone has any info , please help

    • jamiesweeney profile image


      7 years ago from Philadelphia, PA

      Such a great help I found on this hub. God Bless you,CMCastro.

    • Kristine Manley profile image

      Donna Kristine 

      7 years ago from Atlanta, GA

      The Lord has blessed you with the gift of Helps. What precious children and the love you have for them. Thank you for sharing.

    • profile image

      Larry Glenn 

      7 years ago

      cerebral Palsy is extremely tough to exist with. Congratulations on constructing an effective site to spread the knowledge about this terrible disease.

    • profile image


      8 years ago

      It takes a special kind of person to do what you do, Christina!Awesome hub!

    • CMCastro profile imageAUTHOR

      Christina M. Castro 

      8 years ago from Baltimore,MD USA

      Thank you Spirit W.!

    • Spirit Whisperer profile image

      Xavier Nathan 

      8 years ago from Isle of Man

      My mother was the night sister of the National Maternity Hospital in Dublin. It meant that I didn't get to see her much but she too was very dedicated to her job. Nurses are angels God forgot to paint with wings. Thank you for this wonderful hub and may it stand as a model for all who do the kind of work you do. It is an honour to follow you.

    • onceuponatime66 profile image

      Jackie Paulson 

      8 years ago from USA IL

      I am so thankful to you for being a nurse for special needs children. I am not a nurse but I have compassion for anyone who "society" would categorize as "retarded" - I have a sister who has "fetal Alcohol syndrome" so I deal with special needs daily. I think God gives us each gifts, including special needs "anyone." In my current field of female Barber I do have tons of "retarded" and special needs children sit in my chair. As you know this is not an easy job to cut hair to them who have a disability or special needs, but it's as if God lets me communicate the calm and peace I send mentally and the blessings I say in my head as I cut their hair. I have been told more than once "Jackie, you sure have a way of calming children, to cut their hair." Either way you keep up the great "service" to God as you glorify him while you work. Bless you my new friend.

    • vocalcoach profile image

      Audrey Hunt 

      8 years ago from Idyllwild Ca.

      A beautiful hub which everyone should read. We have no complaints and should thank God each day for our healthy bodys and minds. You have such a gift. You offer yourself freely and lovingly. You are an example for us all.

    • kaltopsyd profile image


      8 years ago from Trinidad originally, but now in the USA

      You've definitely been blessed with a kind heart. I love working with special needs children too... but more in the mental defect arena. I enjoyed reading your Hub.

    • parrster profile image

      Richard Parr 

      8 years ago from Australia

      Thanks for sharing this, what a wonderful way to use your god-given gifts. I have also found there is a unique intuitiveness with special needs children. God bless


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