Advanced Practice Nurses (APN) are registered nurses who have advanced education and training to care for patients. APNs at St. Louis Children’s Hospital (SLCH) may be Pediatric Nurse Practitioners (PNP), Neonatal Nurse Practitioners (NNP) or Clinical Nurse Specialists (CNS). They may be board certified and are titled by the State Board of Nursing. All APNs are in a collaborative practice agreement with a physician and are credentialed by SLCH to work in their specific area. St. Louis Children’s Hospital is fortunate to have over 65 APNs working in a variety of roles, contributing to the excellent care of SLCH patients and families. You will find listed below the job description of many of the SLCH APNs. Contact names and numbers are listed if you are interested in more information about any of the roles.

Contact: Nancy Duncan

APN for Professional Practice & Systems
This APN role was created to provide centralized coordination of nursing practice throughout the hospital. The APN in this role is responsible for coordinating and communicating clinical practice changes as well as developing and implementing new practice guidelines that are based on the best available research and evidence. In this position, the APN coordinates the development and implementation of standards, policies and procedures to promote the mission of Family & Child Services at St. Louis Children’s Hospital.

Contact: Lisa Steurer

Asthma Pediatric Nurse Practitioner
The PNPs in the Asthma Intervention Model manage the care of children who are admitted to the hospital for treatment of asthma and other respiratory illnesses. The PNPs are in collaborative practice with pediatric pulmonologists and allergists and manage care by performing physical assessment, taking histories, developing a plan of care, rounding with the floor team, documenting care in daily notes, writing orders, planning discharge, and educating the patient and family. The PNPs communicate with the primary care physician as well as colleagues in other disciplines. Besides managing care, the PNPs can be consulted to help with clinical or education issues, and participate in research. The PNPs are involved in the education of staff, students and community.

Contacts:
Anne Borgmeyer MSN, RN, CPNP
Patti Gyr MSN, RN, CPNP 
Beth Roehm RN, CPNP

Child Protection Pediatric Nurse Practitioner
SLCH has had a PNP assigned to child maltreatment for 18 years. There are currently two PNPs on the service. The majority of work is in the outpatient area where the PNPs evaluate children with suspected sexual abuse. This includes conducting videotaped interview of children which can be used in court. Also for court purposes, the PNPs perform forensic physical examinations which include the use of a colposcope. The PNPs testify in court regarding these cases. We also offer consultation on the inpatient service, the emergency unit and to providers in the community.

Contact: Nancy Duncan

Cleft Palate & Craniofacial Deformities Institute Clinical Nurse Specialist
The Clinical Nurse Specialist (CNS) in this role interviews and educates families of infants and children with craniofacial conditions. The CNS provides assessment of feeding for infants who are born with craniofacial conditions such as cleft lip and palate and works with families to establish a feeding plan and obtain necessary special equipment. The CNS educates families whose children are scheduled to undergo surgical reconstruction for cleft conditions and for craniosynostosis. The CNS in this role is available for inpatient and referring nursery consultation regarding issues related to cleft lip and palate, including feeding. When an infant with a cleft has a complex feeding problem, the CNS works closely with our speech pathology colleagues to establish a feeding plan and follow-up program. The CNS provides service to community pediatricians and family practitioners to coordinate appointments and to provide information and follow-up for their patients.

Emergency Room Pediatric Nurse Practitioner
PNPs who work in the Emergency Department primarily care for urgent patients who need primary care. They also see select emergent level patients such as children with asthma, knee/ankle injuries and lacerations.

Epilepsy Center Pediatric Nurse Practitioner
The Epilepsy PNP works in the outpatient center to see new patients who have had a first time seizure or episode that might be a seizure. The goal is to get treatment quickly for children who have epilepsy and give appropriate education to all patients and families.

Contact: Tracy K Connell RN, MSN, CPCP

Healthy Kids Express Pediatric Nurse Practitioner
PNPs working on the SLCH Healthy Kids Express Van deliver care to children in the community. The van began operation in 1999 and serves as on-site care for hearing and vision screening, immunizations, physical examinations, asthma care and dentistry. The PNPs on the van are also involved in school community health education, research and program development.

Liver Transplant Pediatric Nurse Practitioner
The PNP in Liver Transplant is involved in the care of patients in the clinic and in the hospital. Their role includes: performing physical exams, writing prescriptions, diagnosing minor illnesses and prescribing treatment, performing procedures such as suture/staple removal and drainage tube removals, monitoring for the side effects of medications, educating children and families, and planning for admission and discharge. The PNP works to ensure a smooth transition between inpatient and outpatient care and works closely with all team members (social work, psychology, child life, dieticians, pharmacy, primary care provider, etc.)

Contact: Michelle Nadler

Lung Transplant Pediatric Nurse Practitioner – Acute Care
The PNP in this role is responsible for the coordination, assessment, evaluation and planning of care for the inpatient pre and post operative lung transplant patients.

Contact: Carole Branch APRN, BC

Lung Transplant Pediatric Nurse Practitioner - Outpatient
The PNP in outpatient Lung Transplant manages and coordinates the pre and post operative care of lung transplant patients in the outpatient setting. In the clinic, the PNP collaborates with physicians to see patients, take histories, perform physical exams, develop the plan of care, and dictate notes. The PNP also performs phone triage. Education of patients, staff and outside medical community is important in this role. The PNP also assists with research projects and coordinates actual transplants. The PNP is on call if a donor becomes available for a child waiting for heart or lung transplant.

Contact: Donna Manley

Neonatal Nurse Practitioner
The Neonatal Nurse Practitioner (NNP) at SLCH has a varied scope of practice which includes clinical management, education, research, program development and mentoring of staff. Clinical management responsibilities include providing night and weekend coverage for acutely ill neonates. Also, a team of NNPs manages infants who are more stable and progressing towards discharge. NNPs are also involved in lectures and in planning clinical education forums for the NICU staff. They are frequently involved in informal education at the bedside and mentoring the clinical skills of the NICU staff. NNPs have developed research studies that look at noise levels in the NICU, antenatal support programs, and enhancing breastfeeding the acutely ill infant. They have spearheaded programs designed to enhance family centered care, evaluate clinical practice, and develop new guidelines.

Contact: Ann Donze RNC, NNP

Neurosurgery Pediatric Nurse Practitioner
The PNP role in Neurosurgery includes scheduled and emergent clinic visits, teaching families, admitting patients, performing histories and physicals in the APC/Same Day Surgery departments, writing orders, discharging patients, and doing procedures such as shunt taps. The PNP sees patients independently, but consults with physicians when needed.

Oncology Acute Care Pediatric Nurse Practitioner
The PNP in Pediatric Oncology provides the daily acute management of children admitted for routine chemotherapy treatments, and for the management of the complications of chemotherapy. In addition, the PNP has one clinic day a week where the PNP sees their primary caseload of patients for outpatient visits. The PNP does extensive family education and discharge planning as part of the role. In addition, the PNP's are involved in mentoring staff, staff education, clinical research, and community outreach activities. The PNP's are instrumental in coordinating patient care between inpatient, outpatient, home health and community physicians.

Contact: Deborah Robinson MSNR, RN, BC, PNP, CPON

Orthopaedic Clinical Nurse Specialist
The CNS in this role has a collaborative practice agreement with an orthopedic surgeon and coordinated the care of the patients undergoing orthopaedic surgery. The CNS arranges equipment, and helps with paperwork like FMLA and letters of medical necessity. The Orthopaedic CNS is a problem solver for patients during admission and is the primary contact for patients after discharge who may have questions or issues. Education of staff, nursing students, patients and families is a key part of this role.

Contact: Madeleine Ortman

Pediatric Intensive Care Nurse Practitioner
There are presently 5 full time nurse practitioners who work in the Pediatric Intensive Care Unit at St. Louis Children’s Hospital. The practitioners collaborate with the attending physicians in the PICU to direct the care of the patients, and work alongside the fellows and residents in doing so. The practitioners cover a combination of days, nights, and weekends to ensure continuity of care for the patients in the PICU. The attending physician group, though small, switch every week, and the residents and fellows change every month. This leaves the nurse practitioners to keep everyone involved in the care of the patients up to date on the status of the patients.

Contact: Lara Smith

Same Day Surgery PNP
The Scope of practice for the PNP in the Pediatric Same Day Surgery unit includes preoperative and pre-procedural health assessment, diagnosis, intervention and evaluation in collaboration with anesthesiologists and/or surgeons and other practitioners to ensure safe and uneventful surgical procedures and post-op outcomes. The PNP provides pain management support to inpatient areas.

Contact: Bobi J. Toebe