A child's emergent admission to the pediatric intensive care unit (PICU) can strike fear and feelings of helplessness into the hearts of parents who only hours earlier had been in control of their lives. Acute critical illness seriously threatens the parents' ability to fulfill their familiar and important roles of protecting and providing for their child. The PICU setting can rapidly undermine the sense of competence, control, and stability of even the most dedicated parents. Parental stress is primarily caused by their displacement from familiar roles, the child's appearance and behavior, and difficulties in communicating with staff members. In planning interventions, these issues should be considered as well as the specific needs that parents have emphasized: accurate information, ready access to their children, and meaningful participation in their children's care. Advanced practice nurses are in an excellent position to improve delivery of psychosocial services to parents of critically ill children through direct care, acting as models of care practices and mentoring staff, staff education, policy development, and clinical research.