How to Become a Pediatric NurseEdited by Nancy Lynn Swezey, BSN, RN, CNOR
Pediatric nurses specialize in caring specifically for children. Some of their main responsibilities include providing developmental screenings for certain conditions, administering immunizations, performing routine checkups on children, and treating common childhood illnesses such as chicken pox and asthma.
There are a few levels of pediatric nursing that professionals can attain. The primary level is pediatric nurse with an RN, which requires students to receive an RN license from their state and to pass the National Council Licensure Examination for Registered Nurses, or NCLEX-RN exam. Pediatric RNs can also receive optional CPN certification from the Pediatric Nursing Certification Board (PNCB). This is an optional certification exam that experienced nurses in pediatric settings can take after 1800 hours of pediatric clinical nursing experience at minimum.
Pediatric registered nurses can also work their way toward becoming a pediatric nurse practitioner (PNP), which requires at least a master’s degree in nursing (MSN) and additional certification from the PNCB. This level of practice gives nurses more autonomy in their clinical career, greatly expanding scope of practice and professional autonomy.
What Is a Pediatric Nurse?
Pediatric nurses primarily provide services to patients under 18 years of age. Pediatric RNs work in both outpatient and inpatient settings, assessing young patients, administering medications, evaluating for developmental milestones, educating patients and parents, and addressing common childhood illnesses. 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 needs to have excellent critical thinking skills paired with the ability to communicate difficult or complicated information to young patients and inquiring parents. Quality pediatric nurses are to be open-minded, patient, and willing to listen, as children may have a more difficult time than adults staying focused and communicating needs.
What Does a Pediatric Nurse Do?
A pediatric nurse’s job description depends 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, adminstering medication via intravenous and other routes, and constantly communicating with patients and family members. A pediatric nurse in a doctor’s office or health clinic may primarily be responsible for administering vaccinations, managing chronic childhood diseases such as asthma and diabetes, and providing wellness visits for growing patients.
Working with children’s parents and families to make them feel comfortable is a critical part of a pediatric nurse’s job. Often, parents have many concerns about their child’s health, and the pediatric nurse often acts as liason between the child’s guardians and the provider directing their care.
Pediatric nurses can also choose to specialize in various fields. Most of these specializations do not require additional certification or licensure but allow a nurse to develop distinct expertise in one area of pediatric healthcare. These include pediatric intensive cardiac care, neonatal care, childhood respiratory disease, pediatric endocrinology, and even school nursing.
Where Can a Pediatric Nurse Work?
There are a number of settings where a pediatric nurse can work. They might choose to work in a hospital, especially on a specially designated pediatric floor. 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 settings, nurses are seldom faced medical emergencies, focusing instead on wellness visits, checkups, disease-management follow-ups, and acute - but not emergent - 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 also work in hospitals, clinics, and private care settings, but in many states they are independent practitioners and can establish their own practice, acting as primary care and specialty providers.
The work environment for pediatric nurse professionals all depends on what 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, 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.
Overall, pediatric nurses must be extremely compassionate, as they will need to provide empathy, sympathy, and support for children during difficult times in their lives. Even if the situation is dire, they’ll need to stay positive to provide motivation for both the child and their family. It is also important to have a clear head to keep from panicking if something goes wrong.
Career Outlook and Demand
The pediatric nurse job outlook is currently positive, making this a promising career for young nurses to enter. According to the Bureau of Labor Statistics, the job outlook for registered nurses between now and 2026 is much higher than average, with an anticipated growth of 15%. For professionals who work to earn their Master of Science in Nursing (MSN) to become a nurse practitioner, there is an expected 36% increase in the number of job opportunities by 2026.
The salary for pediatric nurses can vary depending on the state where the nurse practices, and in what type of setting. 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. Across the entire United States, the median pediatric nurse salary is $59,381 or $26.49 an hour for hourly workers, according to PayScale. For pediatric nurse practitioners, the salary jumps up to $87,265 or $46.84 for hourly workers.
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. Pediatric nursing is part of the core curriculum of most BSN programs, and includes both clinical and didactic training. Before graduation, many RN hopefuls do an intensive clinical, and schools may allow them to choose a specialty. Pediatric nurse hopefuls can request placement in a pediatric setting for this experience.
The education requirements for a pediatric nurse practitioner are more stringent. Pediatric nurse practitioners (PNPs) have a graduate level education, with either a master’s or doctoral degree. Further clinical training experience is required, and most PNP’s have previous extensive work experience as RNs.
Applying to Nursing School
Because most nursing schools don’t offer specific pediatric nursing programs for undergraduate programs, there aren’t many pediatric-specific requirements for students interested in pediatric nursing. All that is required is graduation from an accredited nursing school that prepares students to pass the NCLEX-RN exam, the nurse licensing boards, and to work clinically. Upon graduation from a BSN program, aspiring pediatric nurses can seek job placement that will provide them with the required experience for future pediatric nursing certification.
There are prerequisites for professionals pursuing a pediatric nurse practitioner career. They need to already hold a bachelor’s degree in nursing and a nursing license in good standing. Recently, more and more programs offer accelerated tracks to graduate level nursing and PNP qualifications, rendering previous RN experience unnecessary.
The PNCB does have stringent pediatric nursing continuing education requirements to ensure that all CPNs, CPNP-AC/CPNP-PC nurses, and PMHSs maintain a certain level of 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 choose to take academic classes (one semester equates to 10 contact hours), utilize clinical practice work (200 hours equates to five contact hours), or take a professional practice learning session (one professional practice learning session equates to five contact hours).
The first step in becoming a pediatric nurse is to earn RN certification by taking the NCLEX-RN exam after BSN graduation. This is required for all pediatric nurses.
The most common additional certification for pediatric nurses is the certified pediatric nurse (CPN). This certification 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 who wish to become advance practice registered nurses, there are several certifications they can work toward: the CPNP – Primary Care (PC) certification, the CPNP – Acute Care (AC) certification, or the Family NP certification. Primary care CPNPs 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 CPNPs 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. Family NPs provide care to the whole family, often following a patient from childhood into adulthood.
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.
Frequently Asked Questions
How Long Does It Take to Become a Pediatric Nurse?
To become a pediatric nurse, a student must first earn at least an associate degree in nursing, which usually takes around two years. However, it’s recommended to pursue a bachelor’s degree in nursing, which takes closer to four years. Students must then meet their state's requirements for licensure, including passing the NCLEX-RN exam. After achieving this, a pediatric nurse may also pursue CPN certification. To qualify, nurses need at least 1,800 hours of pediatric clinical experience during their last two years of work and need to pass an exam from the Pediatric Nursing Certification Board. However, students may be able to have and maintain a position as a pediatric nurse without a CPN certification.
Can a Nurse Practitioner Work in Pediatrics?
There are multitudes of master’s level nursing programs directed exclusively toward pediatric care. Licensure is required for pediatric nurse practitioners, either by passing the CPNP-PC or CPNP-AC boards from the PNCB. This will ensure they have the skills and education necessary to provide either primary or acute care for children of all ages. Pediatric nurse practitioners in many states can have a private practice and manage patients as independent providors in hospitals, home-based care or special clinics.