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Pediatric Nurse Practitioner Education, Schools, and Career Overview

A pediatric nurse is a registered nurse who specializes in the care of children and teens. Serving as a pediatric nurse or pediatric nurse practitioner requires patience, compassion, and discipline. Treating young patients can be emotionally taxing and even frustrating at times. However, pediatric nurses and pediatric nurse practitioners know that there is no accomplishment greater than that of alleviating a child's pain and providing him or her with guidance and encouragement.

Children who are ill or injured depend upon pediatric nurses to provide and coordinate their diagnosis, care and treatment. Pediatricians and other physicians depend upon the work of pediatric nurses to ensure efficient case management and patient care. The parents and other family members of a child patient often rely upon the pediatric nurse to serve as a liaison with the treating physician and to assist in comforting the sick child.

Pediatric nurses and pediatric nurse practitioners fulfill many responsibilities. They serve as patient advocates and family counselors. They also ensure that certain ethical rules are followed, including the maintenance of confidentiality for the child and his or her family members. Above all, pediatric nurses and pediatric nurse practitioners are professionals who accept the responsibility of performing their very important duties in the face of great pressure. Knowledgeable pediatric nurses and pediatric nurse practitioners can serve as tremendous educational resources concerning issues of child and adolescent health and development.

What is the role of a pediatric nurse?

Individuals who work to become pediatric nurses may most often begin their careers as general registered nurses whose training consists of at least four years of nursing school at the bachelor's level. They may provide care to infants, children, and adolescents who are acutely, chronically, and critically ill. Their patients may range in age from newborns to as old as 21 years old, which is generally recognized as the official end of late adolescence from a medical and biological standpoint. They also provide preventative treatments and therapies and serve as educators and counselors on issues of infant, child, and adolescent health.

Generally, pediatric nurses provide assistance and work alongside and under the supervision of pediatricians, who are specially trained to tend to the health care needs of infants and children. Among the routine tasks handled by pediatric nurses are physical assessments of patients, which may include performing external head-to-toe physical examinations; obtaining vital signs such as temperature, heart rate, blood pressure, and respiration rate; and collecting samples of blood, urine, and stool. Other duties of a pediatric nurse include taking patient histories from parents or guardians, administering medications under a physician's orders, administering immunizations, performing routine developmental screenings, educating and counseling patients and their parents; dressing wounds and splinting bones, starting IVs and performing catheterizations, as well as performing child or infant CPR when necessary.

What is the role of a pediatric nurse practitioner?

Pediatric nurse practitioners obtain special education and training beyond what is required to become a pediatric nurse, may also prescribe medications and treatments, order diagnostic tests, and interpret the results of diagnostic and other laboratory tests. In addition to training as a nurse, pediatric nurse practitioners must also earn a master's degree. Unlike pediatric nurses, who work primarily under the supervision and direction of a physician, those who hold pediatric nurse practitioner jobs enjoy broader autonomy in diagnosing and treating illness and injury in their young patients. Both pediatric nurses and pediatric nurse practitioners address the psychological and psychosocial, as well as the physical, aspects of illness and injury when interacting with and treating their patients.

Some pediatric nurses and pediatric nurse practitioners specialize in psychiatry, which entails treating children who suffer from specific mental illnesses. Pediatric nurses and pediatric nurse practitioners may specialize in other practice areas as well, including cardiology, dermatology, oncology, gastroenterology, and emergency medicine. In many cases, they may collaborate or cooperate with physicians, nurses, and other health professionals from other specialty areas in order to coordinate patient care and provide the children they treat with the best possible diagnoses and therapeutic interventions.

How to Become a Pediatric Nurse

Can I start out as an LPN or LVN?

Those who wish to become pediatric nurses and want or need to get into the workforce as soon as possible can choose to train as licensed practical nurses (LPNs). The educational program that one must pursue to become a licensed practical nurse generally takes about a year to complete. However, licensed practical nurses generally get paid significantly less than their counterparts who obtain a bachelor's degree in nursing and become registered nurses.

In addition, the practice of licensed practical nursing is somewhat restricted and they cannot perform all the tasks that a registered nurse can. The allowable scope of a licensed practical nurse's duties varies from state to state. Some states allow licensed practical nurses to administer medication and start IVs. In some states, however, licensed practical nurses are not allowed to perform these routine and important tasks, which are reserved exclusively for registered nurses and pediatric nurse practitioners. In general, licensed practical nurses work primarily in school or clinic settings and rarely practice in emergency or acute-care departments in hospitals or other facilities.

What's the process for becoming an RN with a focus in pediatrics?

Becoming a registered nurse opens up many more career possibilities for those who wish to work in the challenging field of pediatric nursing. Comparatively, a pediatric nurse salary is often better than that of general RNs as well. Becoming a pediatric nurse through the RN route generally requires a bachelor's degree in nursing from an accredited four-year university. As an alternative, those who wish to train as registered nurses can obtain a bachelor's degree in another major subject, usually in the sciences, psychology, or another healthcare-related field, and then earn an additional degree in nursing or a nursing certificate. Post-graduate training to become a registered nurse generally takes about two years to complete. More and more, the bachelor's degree in nursing is becoming the preferred credential for registered nurses. Pediatric nurses who train as registered nurses have much more flexibility in the performance of their jobs, and a greater variety of workplace settings to choose from, than do licensed practical nurses. Pediatric RNs also have the option of obtaining additional training in an area of chosen specialty within the larger pediatrics field, such as psychiatry or oncology, and then becoming clinical nurse specialists.

How do I become a pediatric nurse practitioner?

Those interested in pediatric nursing and wish to take on more responsibility and authority can become pediatric nurse practitioners. Beyond the training necessary to become a registered nurse, a pediatric nurse practitioner generally requires aspirants to earn a Master of Science degree in nursing with a specialization in pediatrics, which takes about two years to complete.

Pediatric nurse practitioners must also meet the requirements to become advanced practice nurses set forth by the board of nursing in their state, and then apply for and obtain the appropriate credential denoting pediatric nurse certification. The Pediatric Nursing Certification Board is one of the national professional credentialing bodies that offer certification for both pediatric nurses and pediatric nurse practitioners.

What on-the-job training opportunities are available for pediatric nurses?

While some nursing students have the opportunity to take coursework in pediatric nursing, or specialize in this area during their academic career, most registered nurses who become pediatric nurses do so through on the job training. Nursing graduates who hope to work in the pediatrics field should obtain their license to practice as a registered nurse and then apply to work in a facility or office that serves the healthcare needs of infants, children, and adolescents.

Some hospitals offer internship programs for new graduates of nursing schools that train them specifically in the field of pediatrics through a combination of clinical training and classroom instruction. Such internships generally last about three months and teach the candidate all the specialized knowledge and skills required to work effectively and efficiently as a pediatric nurse.

How do pediatric nurse practitioners differ from pediatric nurses?

Candidates interested in pediatric nursing, and who want to experience some of the autonomy and responsibility that goes along with being a physician, should consider pediatric nurse practitioner programs. Just like general pediatric nurses, pediatric nurse practitioners may find career opportunities in a number of healthcare settings, from private practices to hospitals to schools. However, unlike general pediatric nurses, pediatric nurse practitioners function as primary medical providers who can diagnose illness and injury, direct a course of treatment or therapy, and write prescriptions.

Pediatric nurse practitioners are generally limited to serving as primary care providers for individuals who are infants, children, and adolescents. State boards of nursing often place limits on the age range of the patients that pediatric nurse practitioners are allowed to treat. The upper age limit may be 18 or 21 depending on the state in which the pediatric NP works. Some states may require pediatric nurse practitioners not only to become certified as advanced practice nurses but also to become certified in the specialty area of pediatrics. Pediatric nurse practitioners in these states may choose to become certified in family or adult health as well as pediatrics in order to provide continuity of care for their patients as they mature into late adolescence and beyond. It is important to check the individual rules and regulations of the state in which you plan to work in order to understand all that will be required of you in order to embark on this exciting career.

Pediatric nurse practitioners work more independently than general pediatric nurses and have more responsibility for administering the care of their patients. They work closely with pediatricians who provide informational rubrics and procedural protocols, and who also offer consultations about specific patients and accept referrals in especially complicated or demanding cases. In addition, pediatric nurse practitioners generally make more money with salaries up to 33% higher than those of their registered nurse counterparts.

What additional education is needed to become a pediatric nurse practitioner?

Pediatric nurse practitioner education requirements are more demanding than those for general practice pediatric nurses. To become a pediatric nurse practitioner, a candidate must pursue at least two additional years of education at the master's level after earning his or her bachelor's degree in nursing. In order to enjoy the full benefits of practicing as a pediatric nurse practitioner, candidates need to obtain certification from a national credentialing board and meet the requirements of by their state board of nursing for becoming an advanced practice nurse.

All students of nursing programs receive some training in the care and treatment of infants, children, and adolescents in their formal instructional classes and during clinical practicum and internships. Some nursing school curriculums offer elective courses in pediatrics for those students interested in learning how to become pediatric nurses. However, most nursing schools at the bachelor's level do not offer special programs for pediatric nurses or pediatric nurse practitioners.

To obtain specialized training in pediatrics, pediatric nurse practitioners generally obtain on-the-job training in a clinic or hospital department that provides direct care to children through on-site internship programs. Through these programs, pediatric nurse practitioners familiarize themselves with the unique demands of caring for children and the special characteristics and needs of this patient population. In addition, a master's degree in nursing is required to become a pediatric nurse practitioner. Some master's degree programs in nursing offer specialized programs, certificates, or concentrations in pediatrics. Pursuing one of these specialized graduate programs will offer the aspiring pediatric nurse practitioner a leg up when it is time to enter the job market.

Pediatric Nurse Practitioner Certification

How does one become a certified pediatric nurse or certified pediatric nurse practitioner?

Becoming a pediatric nurserequires first becoming licensed as a registered nurse under the regulations promulgated by the nursing board in the state in which you plan to practice, and then pursuing certification. Pediatric nurse practitioners must also meet their state's requirements for licensure as an advanced practice nurses. After licensure, you will need to meet the requirements for certification that are set forth by your state. Generally, these requirements include successfully completing the certification process offered by a national credentialing agency.

The most prominent national credentialing agency in the field of pediatric nursing is the Pediatric Nursing Certification Board (PNCB). The PNCB administers certification examinations that have been approved by a number of professional pediatric nursing bodies, including the American Academy of Pediatrics, the National Association of Pediatric Nurse Practitioners, the Association of Faculties of Pediatric Nurse Practitioner Programs, and the Society of Pediatric Nurses.

Pediatric nurse certification and pediatric NP certification provide many career benefits. Those who can demonstrate that they have been certified by a respected national credentialing organization tend to make more money than those who are not yet certified. They are more likely to be considered for open positions and get interviews for either the pediatric nurse or pediatric nurse practitioner jobs they are most interested in pursuing. Therefore, certified pediatric nurses and pediatric nurse practitioners enjoy enhanced career mobility in terms of the ability to move from job to job and to move up through the ranks into positions that demand more responsibility and provide more challenge and reward.

What is the Certified Pediatric Emergency Nurse certification exam?

Those who intend to pursue a career as general pediatric nurses may take the Certified Pediatric Nurse exam offered by the PCNB. The Certified Pediatric Nurse examination is designed for nurses with extensive experience treating pediatric patients and with knowledge of the field beyond that of a typical registered nurse. However, those who aspire to work in acute care settings, such as emergency rooms and intensive care units, may also take the Certified Pediatric Emergency Nurse certification examination which was developed in collaboration with the Board of Certification for Emergency Nursing.

What other specialized certification options exist for pediatric NPs?

Graduates of pediatric nurse practitioner programs have the choice of taking examinations to become certified as either primary care providers or acute/emergency care pediatric nurse practitioners, depending on the content of the curriculum they pursued during their studies. In addition, beginning in 2011, the PCNB will also administer the Child and Adolescent Behavioral & Mental Health Specialty Certification Exam. This certification examination is designed especially for pediatric nurse practitioners who hope to work in psychiatric settings or with specific patient populations, such as developmentally challenged or disabled children, or even mentally ill or suicidal adolescents.

What is Pediatric Advanced Life Support (PALS)?

In addition to these general certifications, it is advisable for pediatric nurses and pediatric nurse practitioners to become certified in Pediatric Advanced Life Support (PALS) through the American Heart Association. Other available certifications include training in Basic Trauma Life Support and Pediatric Basic Trauma Life Support. Special certification courses that can be of particular value to pediatric nurses and pediatric nurse practitioners who work in acute care settings include the Emergency Nurse Pediatric Course offered by the Emergency Nurses Association. Employers will often pay for this additional professional training.

Pediatric Nursing Degree Programs

Choosing which degree to get and what pediatric nursing courses to take depends on one's career goals. Becoming a pediatric nurse requires achieving the educational requirements of a registered nurse (RN), which is a bachelor's degree in nursing or a bachelor's degree in a different discipline combined with post-graduate work in nursing. It is possible to work with children in a pediatric setting with only the licensed practical nurse (LPN) credential; however, career opportunities and salary growth potential are limited for LPNs.

In addition, pediatric nurse practitioners require a master's degree on top of their basic nursing training, as do pediatric nurses who intend to enter the fields of management and administration or nursing education. Nursing degrees and advanced nursing courses are offered by a wide variety of academic institutions, from medical schools to four-year universities to online educational programs.

What courses should I take if I want to be a pediatric nurse or pediatric NP?

Undergraduates planning to major in nursing or pursue nursing at the graduate level should construct a course schedule that resembles that of pre-med students. In other words, they should take science courses including biology, chemistry, and physics and advanced mathematics courses including calculus.  Those planning to specialize in pediatric nursing should also consider taking courses in psychology and human or child development.

The nursing school curriculum covers the basics of anatomy and physiology, pharmacology, pathology, and patient evaluation. Pediatric nursing courses cover these topics with special emphasis on their implications for infants, children, and adolescents. Pediatric nurses learn much of their specialty through on-the-job training at a healthcare facility where they provide direct care to infants, children, and adolescents, although they can also choose to take advanced nursing classes in pediatric nursing as part of a degree program in pursuit of pediatric nurse certification. Moreover, pediatric nurse practitioners must pursue a master's degree in pediatric nursing. A number of nursing schools in the United States offer pediatric nurse practitioner programs at the master's-level, which qualifies students to seek certification as pediatric nurse practitioners.

There are a variety of pediatric nurse jobs and pediatric nurse practitioner jobs. Most pediatric nurses choose one of two academic tracks; they become either general pediatric nurses or pursue more advanced training through pediatric nurse practitioner programs. General pediatric nurses assist physicians and serve as educational resources and counselors. They work closely with children in performing physical examinations and assessments, taking samples for diagnostic tests, and administering treatment under a doctor's orders and supervision. They also help to maintain detailed records on patient progress.

Because general pediatric nurses are registered nurses, they generally have a four-year degree in nursing and on-the-job training in the pediatric specialty. Like most other registered nurses, general pediatric nurses generally obtain certification as an RN by taking a nursing board examination administered by the state in which they plan to practice. Pediatric nurses may also choose to become clinical nurse specialists. Clinical nurse specialists generally concentrate on specific areas of medicine, medical treatment, or patient populations. For instance, some clinical nurse specialists in pediatrics focus on oncology or cardiology. Others concentrate on emergency medicine. Still others work exclusively, or almost exclusively, with autistic children, mentally ill children, or other developmentally disabled or special-needs patients.

Like general pediatric nurses, clinical nurse specialists in pediatrics are registered nurses. However, they usually go beyond the basic requirement of four years of nursing school to obtain a master's or other advanced degree in their chosen area of specialization.

How do I pursue a certification in a specialized clinical field of pediatric nursing?

Nationally recognized nursing associations, including the American Nurses Credentialing Center, are responsible for certifying pediatric nurses as clinical nurse specialists. Those interested in pediatric nursing can also chose to become pediatric nurse practitioners.

Pediatric nurse practitioners do everything a general pediatric nurse does and more. They may perform school physicals and administer routine screenings and immunizations just as a general pediatric nurse would. However, pediatric nurse practitioners act as primary care providers for the infants, children, and adolescents who are their patients. They work in pediatric medical offices, clinics, hospitals, rehabilitation centers, and a range of other healthcare institutions. They often specialize in specific conditions or patient populations, for instance by working in pediatric intensive care units or focusing on neonatal or adolescent healthcare practice.

Not only do pediatric nurse practitioners make decisions about patient diagnosis and treatment much as a physician does, but they also have the authority to write prescriptions and order diagnostic tests. Pediatric nurse practitioners must meet considerably more educational requirements than registered nurses. They must pursue pediatric nurse practitioner programs at the master's level. This will involve graduate level study of advanced coursework in pathophysiology, pharmacology, and diagnostic techniques.

Is there room for advancement as a pediatric nurse?

Pediatric nurses can move on to positions of increased responsibility as they gain experience and prove their skills through strong job performance. Some pediatric nurses choose to continue their nursing education to the graduate level and train for careers in advanced practice registered nursing (APRN) fields such as nurse anesthetist or nurse midwife.

Management is also an option for pediatric nurses looking to advance their careers. Some workplace environments may provide on-the-job paths to nursing management, while some prefer management candidates who have earned a graduate degree in nursing or health care administration.

Do pediatric nurses need to be licensed or certified?

All U.S. states and territories as well as the District of Columbia require pediatric nurses to be licensed. Each region is served by its own state board of nursing, which sets the list of requirements that pediatric nurses must meet in order to qualify for the National Council Licensure Examination, or NCLEX-RN.

Further voluntary certification in pediatrics may also be obtained. Special pediatric certification can demonstrate dedication to an elevated standard of care and can be required by individual employers for certain positions.

Skills and Qualities

A pediatric nurse needs to have the sensitivity and social skills required to forge relationships with patients while providing direct care and treatment for illness and injury. Above all, because they routinely work with children, pediatric nurses should enjoy working with and spending time with children of all ages. Pediatric nurses must also be excellent team players, as they must work with one another, as well as with supervising physicians, to ensure that their patients receive the best care possible. In addition, pediatric nurse need excellent communication skills so they are able to explain treatments and diagnostic procedures to their patients and to their patients' parents and guardians.

Because they interact so closely with children, pediatric nurses must develop a teacher-like ability to explain complex concepts in simple, understandable terms. Since pediatric nurses may treat children of different ages, they must keep in mind developmental and cognitive milestones and communicate with each patient in a way that is appropriate for his or her age and background. Pediatric nurses must also have good memories so as to maintain familiarity with the different equipment and procedures that are appropriate to use with children of different age levels and physical sizes.

Pediatric nurses must also have the ability to manage stress and work under pressure. Dealing with the competing demands of physicians, patients, and patients' families can be a challenge. A pediatric NP must also have the emotional fortitude to work with children who may be in pain or who are otherwise distressed. It is therefore important that pediatric nurses maintain a healthy perspective on their work.

Pediatric nurse practitioners, in particular, should have the ability to make decisions autonomously and work independently. They must be good critical thinkers and problem solvers. They should also be able to make swift and thoughtful judgments about patient diagnosis and care. Being flexible and adaptable can help a pediatric NP accommodate patients who present unique challenges and demand a unique course of treatment and method of case management. Pediatric nurse practitioners must be able to respond quickly to crises and changing circumstances and be able to think and respond on their toes.

Career Outlook and Salary Information

Pediatric nurses and pediatric nurse practitioners get to enjoy the satisfaction of helping children feel better and providing reassurance and comfort to the child patient and his or her parents or guardians. It can be difficult for health professionals who work with children see them struggle with critical injuries or serious illness. However, even in these situations, pediatric nurses and pediatric nurse practitioners can provide much-needed support and compassion to children and their families at a most difficult time.

Where do pediatric nurses and pediatric nurse practitioners work?

Pediatric nurses and pediatric nurse practitioners may work in a variety of environments, including:

  • Doctor's offices
  • Hospitals, including the Emergency Room and the Pediatric Intensive Care Unit
  • Regional clinics
  • Primary or secondary school campuses

They may choose to work in routine settings, performing developmental evaluations and delivering immunizations, or in acute care settings, such as emergency rooms or operating rooms, where they may be called upon to interpret the results of diagnostic tests or provide direct assistance to doctors.

A pediatric nurse salary is often better than that of general RNs. The pediatric nurse salary range can be affected by factors such as job experience, occupational setting and regional demand for pediatric care.

Sources:

  • Registered Nurses, Occupational Employment and Wages, Bureau of Labor Statistics, 2012
  • http://www.bls.gov/oes/current/oes291141.htm
  • Registered Nurses, Occupational Outlook Handbook, Bureau of Labor Statistics, 2012,
    www.bls.gov/ooh/Healthcare/Registered-nurses.htm
  • National Occupational Employment and Wage Estimates, Bureau of Labor Statistics, 2012
    http://www.bls.gov/oes/current/oes_nat.htm

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