Nursing program transforms pediatric care in emergency departments

Emergency department nurses across Nova Scotia Health are mastering critical skills to stabilize sick children under a unique program designed to eliminate geographic gaps in pediatric care. 

The Pediatric Emergency Nursing Program (PED-ENP) is among the first of its kind in Canada, specifically designed to train emergency department nurses across the province to recognize, assess and manage high-acuity pediatric emergencies across diverse healthcare settings. 

Developed through the Nova Scotia Health Learning Institute for Health Care Providers, the 24-week, part-time program recently graduated its inaugural cohort. The curriculum addresses a long-standing vulnerability in some rural and regional emergency departments, in which pediatric patients may represent a small percentage of overall visits but can provoke the highest levels of anxiety for staff. 

"Geography should never determine the quality of care a child receives," said Sandra Johnson, the provincial nurse educator for the pediatric emergency program. "Whether a child presents to Yarmouth, Amherst, Sydney, or Halifax, every family deserves to know the nurse at the bedside has the knowledge, confidence and clinical judgment to provide safe, evidence-informed care." 

That consistency is at the heart of what PED-ENP delivers. By training nurses from every corner of the province on the same evidence-based framework, the program ensures no matter which emergency department a family walks into, the care team is speaking the same clinical language. A nurse in Yarmouth and a nurse in Sydney is now assessing, communicating and escalating pediatric emergencies the same way a nurse at IWK Health would. 

Johnson and her colleague, nursing instructor Rene Boyd, took two years to develop and write the program. They received strong support from the entire learning institute. A core team of leaders from IWK Health and Nova Scotia Health also contributed. Trauma Nova Scotia, a provincial program involved in the care of severely injured patients, along with Translating Emergency Knowledge for Kids (TREKK), which helped convert pediatric research into practical, bedside-ready guidance, assumed key roles. 

Previously, Canadian emergency department nurses seeking specialized pediatric training had to choose between brief weekend certifications or a much longer specialty program offered in British Columbia. 

Treating a critically ill or injured child is an intense, high-stakes experience for frontline emergency personnel. After more than 20 years working in emergency departments, rural leadership, trauma care and simulation education, Boyd remembers exactly what it felt like when the words "We've got a sick kid coming in" echoed through the department. 

Those experiences became the foundation for the program.

Rather than focusing on memorizing tasks or algorithms, the concept-based curriculum teaches nurses how to think through pediatric emergencies. Learners develop clinical reasoning alongside technical skills, gaining a deeper understanding of pediatric physiology and why children respond differently to illness and injury than adults. 

Throughout the program, nurses participate in realistic simulations using advanced pediatric mannequins. The simulations mirror situations nurses encounter in emergency departments across Nova Scotia, allowing them to practise assessment, communication, teamwork and intervention before caring for real patients. 

"We wanted learners to leave saying, 'I've already managed this once,'" Boyd explains. "Not because they've seen it in real life, but because they've experienced it in simulation. That confidence changes how people respond when the real patient arrives." 

A core triumph of PED-ENP is the collaboration between Nova Scotia Health and IWK Health, bringing everyone together around one shared standard of pediatric emergency care. Nurses from the Annapolis Valley to Sydney now train side by side, learning to speak the same clinical language regardless of where they practise. 

The program was built using best practices from Nova Scotia Health, IWK Health, the Canadian Pediatric Society, National Emergency Nurses Association and TREKK. 

PED-ENP has already drawn interest from national pediatric bodies, with plans to present the framework at national conferences. As Johnson and Boyd analyze feedback from the first graduates to refine the next iteration, they reflect on the emotional weight the training carries for healthcare workers. 

"This program means that when it happens, you know you had the training and the team behind you to give that child everything; that's what lets you go home and still be a nurse tomorrow,” Johnson said. “That is the difference between carrying it and being crushed by it.” 

Photo by Canva.