Maureen A Madden, MSN, RN, CPNP-AC, CCRN, FCCM

New Jersey

Member: Acute Care PNP SIG

The Acute Care PNP SIG is NAPNAP’s largest SIG. Maureen has been a member for more than five years and currently serves as chair. She is president of Pediatric Nursing Certification Board (PNCB), strives to continually recruit PNPs and encourages them to seek certification.

Nursing was a second degree for me. I was a mature student when I went back to graduate school. I knew I wanted a master’s, but my original intent with was to obtain my master’s degree as a CNS. I was investigating the various programs that would be accessible to me and learned about the University Of Pennsylvania School Of Nursing’s pediatric critical care program that was a new dual-degree program to prepare individuals for a career as a nurse practitioner and clinical nurse specialist. Upon completing the master’s program, I took my time in deciding on a direction, but I eventually decided to obtain work as a NP in pediatric critical care.  I was fortunate to find a position in the PICU at Methodist Children’s Hospital, in Lubbock, Texas. At that time, it was one of only six pediatric critical care PNP settings in the nation.

Accepting the position was one of the most challenging moves in my career. I left my personal and professional support system and was entirely singled out by being the only PICU NP in the state. Right when I walked in the door I was told, “You’re the expert!” I did my best and accepted the challenge.

I now have about twenty years’ experience as a NP, and today I work in an academic setting at a university medical center. I’m in a 20-bed combined PICU and intermediate care. The facility is a level-1 trauma center and does not have a congenital heart program. There, we train residents and nursing students alike. Only one thing is constant in my work, which is that every day is a challenge and every day I learn something new. Our team is always coordinating and preparing to receive the next critically ill patient. We work closely with the pediatric transport team and the emergency department staff.

I’m very proud to work with this team. I’m the only full-time NP, and we have a per-diem PNP. Our ICU is staffed 24/7 and includes board-certified intensivists, residents and nurses. We have a ratio of 1-2 patients per nurse. We also have pharmacists, social work, physical therapy, occupational therapy, child life and most recently a librarian, who all participate in our daily rounds. The addition of a librarian is a new initiative, and they help to immediately access research and information and disseminate that knowledge with the interdisciplinary team in real time. This way, we can more effectively implement standardized care and make more informed decisions, using evidence-based practice, guidelines, and the most up-to-date information in conjunction with the patient’s clinical condition.

Team dynamics are important to me, and I try to be a role model for trust, respect and open communication. I’m driven to help empower the people around me, especially the nurses I work with to speak up for themselves and our patients and families. This goes both ways, however, and I’m equally passionate about ensuring that the family has a voice, so that they and their child receive the best care possible. I’ve been acknowledged as a leader, sometimes “trailblazer,” in the acute care PNP role. I also feel strongly about educating PICU providers to provide the best possible care possible. I’ve invested considerable time in helping to develop an educational program that is focused on providing the fundamentals of pediatric critical care to individuals who do not routinely care for acute or critically ill children.  I am proud to say that I have had a part in educating and training over 3,500 persons and counting with this program! 

Access to health care for all children is also important to me. I’ve done international work, where children and families did not have the most basic needs of clean water, shelter and nutrition. In the US, we have our own challenges with access to health care. My vision is that all children would have better access to PNPs and providers of their choice from well care to acute care, and that all children would have a PNP coordinate their care. Here in the US, we have challenges to providing children access to mental health, rehabilitation and transitional care services after acute and critical illness as well as appropriate local community resources. We have a long road ahead, but together we can make this vision a reality.


Learn more about our Acute Care PNP SIG.