true, all the specialties exist. but they may not be considered a 'specialty' in the facility. obvious;y, in a children's hospital you have a better chance of getting that. where i work, the only 'specialties are heme/onc, and picu and nicu. some places have specialized cardiac icus, neuro, gi, resp, etc.
harder- some days i feel like yes. different is the better way to describe it. that 'taking care of the whole family' is so cliche, but sooooo true. often times the parents are more draining than the kids. generally speaking, everything takes longer, because you have to get the kid to 'agree' to the procedure, then you have to convince the parent that the kid needs it (the med, treatment, whatever). then the parent has to lay down the law (or not, in some cases). situations like this are all too common, and time consuming.