What Does a Pediatric Nurse Do?
Pediatric nurses primarily provide services to patients under 18 years of age. In general, they assess young patients, administer medications, verify that children have reached specific developmental milestones, address common childhood illnesses, and educate patients and parents. A pediatric nurse practitioner will do many of these same things, and can also establish treatment plans, order lab and diagnostic tests, perform procedures, and prescribe medications for children.
A pediatric nurse’s job responsibilities vary depending on the setting in which the nurse is working. In a hospital or other critical care setting, the pediatric nurse may spend more time doing critical assessments, monitoring responses to treatments, administering medication via intravenous and other routes, and constantly communicating with patients and family members regarding care plans. A pediatric nurse in a doctor’s office or health clinic may focus on administering vaccinations, managing chronic childhood diseases such as asthma and diabetes, and providing wellness visits for growing patients.
What Is a Pediatric Nurse?
Professionals at all levels of nursing can train to work with babies, children, and young adults. Graduates with certificates, associate degrees, or bachelor's degrees in nursing may qualify for licensure to practice as registered nurses (RNs). In some states, RNs who want to enter this specialized field may need to pursue certified pediatric nurse (CPN) certification, which involves accumulating additional clinical experience and passing an exam from the Pediatric Nursing Certification Board
Those with more advanced pediatric nurse education, such as a master's degree or a doctorate in nursing, may qualify to become advanced practice registered nurses (APRNs). Clinical nurse specialists (CNSs) and pediatric nurse practitioners (PNPs) are two types of APRNs who may earn the requisite credentialing to work with children.
How to Become a Pediatric Nurse
While it is possible to become a pediatric nurse with an associate degree, many employers and some states are requiring professionals to have at least a Bachelor of Science in Nursing. Although most nursing schools don’t offer specific pediatric nursing curriculum for undergraduate students, pediatric nursing is part of the core curriculum of most nursing programs. This may include didactic training, which involves learning primarily through lectures and reading, and clinical training, which involves hands-on demonstration and practice of skills.
Before graduation, many RN students must complete an intensive clinical experience, and schools may allow them to choose a specialty. Pediatric nurse hopefuls can request placement in a pediatric setting for this experience. Similarly, after becoming licensed RNs, aspiring pediatric nurses can seek job placement that will provide them with the required experience for future pediatric nursing certification.
The education requirements for a pediatric nurse practitioner are more stringent. Pediatric nurse practitioners have a graduate-level education, with either a master’s or doctoral degree. Further clinical training experience is required, and most PNPs have previous extensive work experience as RNs.
Licensure and Certification
The first step in meeting the pediatric nurse requirements is to earn a college degree in nursing and become an RN. Depending on the state's requirements for licensure to practice as a pediatric nurse, this may be an associate degree or more likely a bachelor's degree. Graduates can then complete the remaining RN requirements mandated by their state's licensing board, which includes passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam and fulfilling a certain number of clinical practice hours. In some states, candidates may be required to meet additional criteria as well.
Some states allow RNs to work as pediatric nurses, while other states require RNs to earn additional certification before obtaining one of these specialized nursing positions. The following are four types or levels of certification offered by the Pediatric Nursing Certification Board:
To qualify as Certified Pediatric Nurses (CPNs), RNs need to accumulate at least 1,800 hours of pediatric clinical experience during their most recent two years of work, and they need to pass an exam. This certification exam requires pediatric nurses to prove their mastery in four different areas: Professional Role, Management of Illness/Clinical Problems, Health Promotion, and Physical and Psychosocial/Family Assessment.
For nurses with advanced degrees who wish to become certified pediatric nurse practitioners, two types of certifications are available. Primary Care Certified Pediatric Nurse Practitioners can provide ongoing outpatient care for children as they grow from babies to young adults, managing acute and chronic diseases and monitoring milestones. The focus is on maximizing a child’s health within the context of their family, social and personal lives. Acute Care Certified Pediatric Nurse Practitioners are focused on patient-care needs and less concerned with context than CPNP-PCs. CPNP-ACs are more likely to be found in acute care settings, such as hospitals.
Another certification pediatric nurses can earn is Pediatric Primary Care Mental Health Specialist (PMHS) , which authorizes pediatric nurses to identify, intervene, and collaborate on care for children with behavioral and mental health issues. This certification is primarily for clinical nurse specialists or nurse practitioners.
The PNCB has imposed stringent pediatric nursing continuing education requirements to ensure that all CPNs, CPNP-AC/CPNP-PC nurses, and PMHSs maintain a certain level of current knowledge and professionalism in their careers. The organization calls these "contact hours," and professionals are required to earn at least 15 every year. One contact hour is equivalent to one 60-minute educational program, which can be taken online or in person.
Nurses can also accumulate contact hours by taking academic classes (one semester equates to 10 contact hours), utilizing clinical practice work (200 hours equates to five contact hours), or engaging in professional practice learning sessions (one professional practice learning session equates to five contact hours).
What Are Some Pediatric Nursing Specialties?
Pediatric nurses can choose to specialize in various fields by developing distinct expertise in one area of pediatric healthcare. Expertise may be obtained through a combination of additional college coursework, continuing education programs, and on-the-job training and experience. Most of these specializations do not require additional certification or licensure. These include pediatric intensive care unit nursing, pediatric cardiac care, pediatric oncology, childhood respiratory disease, pediatric endocrinology, and even school nursing.
Where Do Pediatric Nurses Work?
Pediatric nurse jobs can be found in a number of settings. Peds nurses might choose to work in a hospital or medical center, especially on a specially designated pediatric floor, or in a children's hospital. Many pediatric nurses also work in critical care units that are specifically dedicated to addressing life-threatening conditions.
Doctor’s offices or health clinics tend to be less intense settings that still allow pediatric nurses to use their training and education to work with children. In these facilities, nurses are seldom faced with medical emergencies, focusing instead on wellness visits, check-ups, disease management, and acute — but not necessarily emergency — illness visits.
Many clinics and outpatient sites are specialized as well, focusing in areas such as endocrinology, respiratory disease, and orthopedics. Pediatric nurses can also work in private care for individual patients. For example, they might visit a patient’s home to provide skilled nursing care for children with chronic diseases or disabilities.
Pediatric nurse practitioners can work in hospitals, clinics, and private care settings, but in many states they are independent practitioners and can establish their own practices, acting as primary care and specialty providers.
The work environment for pediatric registered nurses depends on the type of position. For example, nurses who work in a hospital may find the environment more stressful than an outpatient setting or doctor’s office. Hospital nursing involves exposure to patients in acute conditions and emergencies. In addition, full-time pediatric nurses in hospitals generally work longer shifts and fewer days. Some prefer this type of scheduling while others prefer shorter, more frequent shifts.
In any setting, pediatric nurses should be prepared for arduous work and need to be trained to handle a medical emergency, although this will be a more rare occurrence outside of the hospital setting. Another common facet of treating pediatric patients is responding to injuries like bone fractures, skull fractures, and brain injuries. Many pediatric nurses also deal with psychosocial issues of children and parents.
Furthermore, some pediatric nurses consider their patient load to include the parents of their patients, because treating children seldom happens without parent input and feedback. Every pediatric nurse is considered a mandated reporter for child abuse and must be trained to recognize the signs of maltreatment.
In any setting, pediatric nurses should be prepared for arduous work and need to be trained to handle a medical emergency.
Career and Salary Outlook
The pediatric nurse salary can vary depending on the setting and the state where the nurse practices. Nurses in urban settings tend to have higher salaries, as well as those in hospitals or private practice. Furthermore, salaries generally increase with experience, and most employers compensate accordingly as nurses gain more education and certification. The U.S. Bureau of Labor Statistics states that the median annual salary for all nurses is $77,600 and for all nurse practitioners $120,680. Through 2030, the projected growth rate for all nurses is 9%, which is on par with the average for all occupations, but demand for nurse practitioners is expected to grow at a much higher rate of 45%.
What You Should Know Before Becoming a Pediatric Nurse
There are several important factors to consider before deciding to become a pediatric nurse. First, nursing is a career path that requires ongoing education. Once you've earned your degree and obtained state licensure to practice, you may need to complete a certain number of continuing education hours each year to maintain your license or certification.
Second, nursing requires the right temperament and mindset. Nurses are on their feet throughout their workday so it's a physically demanding job, and some nurses find the weight of the responsibilities involved in nursing to be somewhat stressful. When working with young patients, nurses must also be sympathetic, patient, and willing to listen, as children may have a more difficult time than adults staying focused and communicating symptoms and needs. Pediatric nurses must also be able to convey difficult or complicated information to both young patients and inquiring parents, and they must remain calm, level-headed, and positive, even in emergencies or dire situations.