BackgroundNeonatal nurse practitioners are often the front line providers in discussing unexpected news with parents. This study seeks to evaluate whether a simulation based Difficult Conversations Workshop for neonatal nurse practitioners leads to improved skills in conducting difficult conversations.

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Hospital "boarding" of pediatric psychiatric patients awaiting inpatient placement is a growing problem. To address this need, a dedicated inpatient pediatric medical-psychiatric unit was opened at an urban university-affiliated pediatric hospital. An educational program for pediatric medical-surgical nurses who were expected to staff the pediatric medical-psychiatric unit was developed and implemented prior to the opening of the new unit. The rationale for the establishment of the new inpatient unit, educational program development, goals and objectives for the education, implementation, and evaluation of the program are described. Challenges, lessons learned, limitations, resource allocation, and staff attitudes are discussed. Implications for the future of this and similar hospitals are considered.