How to Become a Pediatric Nurse Practitioner

Pediatric Nurse Practitioners (PNPs) often work independently, or with pediatricians and other healthcare providers in settings that range from hospitals to physicians’ offices. Some even provide home care services. Primary care PNPs can serve as a child’s primary healthcare provider, providing services such as:pediatric nurse standing with mother and child

  • Health maintenance care, including well-child exams and childhood immunizations
  • Routine developmental screenings
  • Diagnosis and treatment of common childhood illnesses
  • Teaching and counseling of children and their families on issues related to health

Additionally, acute care and specialty PNPs can perform services such as:

  • Caring for children who have acute, chronic, and critical illnesses
  • Conducting advanced physical assessments
  • Interpreting lab and diagnostic test results

Pediatric nurse practitioners can also choose to work in a pediatric subspecialty, such as cardiology, neurology, dermatology, gastroenterology, orthopedics, or infectious disease, etc.

In states where laws grant nurse practitioners prescriptive privileges, PNPs routinely prescribe medications when acting as primary providers, and often use pharmaceuticals in pharmacotherapeutic applications in acute care settings.

For more information about what a pediatric nurse practitioner does, click here.

Education and Degree Program Options

To become a PNP, a Registered Nurse must first complete a master’s, post-master’s, or doctoral degree, often specific to the pediatric patient population. All programs include a combination of classroom and clinical training. Possible degrees include:

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  • Master of Science in Nursing with a major, track, specialty, or concentration as a pediatric nurse practitioner
  • Pediatric Nurse Practitioner Post-Master’s Certificate (Post-master’s programs are generally designed for nurses who already have a master’s degree and later decide they want to specialize as a PNP)
  • Doctor of Nursing Practice with a specialty as a Pediatric Nurse Practitioner

Some programs offer a track in primary care (maintaining and promoting health and managing diseases); some offer a track in acute care (complicated acute and chronic health conditions), while others offer a dual-track program. In addition, some programs also offer a specialty focus, such as Pulmonary Specialist or Specialist in Developmental Disabilities.

Classes vary by program, but typical courses would include:

  • Assessment (developmental, physical, family, environmental, community, and cultural)
  • Child growth and development
  • Diagnosing and managing behavioral problems and childhood illnesses
  • Ethics
  • Health promotion
  • Laboratory skills
  • Pathophysiology
  • Pharmacology

National PNP Certification

After completing a graduate or post-graduate degree program, most PNPs become nationally certified. Most state Boards of Nursing require national certification as a condition for licensure. Although national certification is available through either the American Nurses Credentialing Center or the Pediatric Nursing Certification Board, it is important that candidates for PNP licensure consult their state Board of Nursing to determine which one their state’s Board recognizes.

The American Nurses Credentialing Center (ANCC) offers a primary care certification that provides the credential PNP-BC. Applicants for the certification exam must have a degree from a school with accreditation from the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC). The program must have included:

  • At least 500 faculty-supervised clinical hours
  • Three different courses in advanced pharmacology, advanced pathophysiology, and advanced physical/health assessment
  • Subject matter relating to promoting health and preventing disease, and relating to differential diagnosis and managing disease

Applicants must have a current, active RN license in the US or its equivalent from another country. After submitting the application and fee, applicants have 90 days to take the computer-based exam at a Prometric Testing Center. Recertification is required every five years and requires professional development (a number of options are available).

The Pediatric Nurse Certification Board (PNCB) offers two PNP certifications:

  • Pediatric Nurse Practitioner – Primary Care (CPNP-PC)
  • Pediatric Nurse Practitioner – Acute Care (CPNP-AC)

Both certifications require a current, active RN license in the US or Canada and completion of a Pediatric Nurse Practitioner Program accredited by the CCNE or NLNAC. Nurses who completed a PNP program that included both primary and acute care clinical tracks can take both exams.

Both exams are computer-based, administered through Prometric Testing Centers, and contain 175 multiple-choice questions each. Annual renewal of certification requires completing 15 contact hours of an accepted activity, which may be academic credit or professional learning activities.

Specialty Certification

The PNCB also offers the Pediatric Primary Care Mental Health Specialist (PMHS) as a specialty certification open to primary care pediatric nurse practitioners (as well as to other types of nurse practitioners and clinical nurse specialists). The focus of this specialty certification is child and adolescent behavioral and mental health care.

Nurse practitioners who wish to hold this certification must also maintain their primary certification. The Board recommends, but does not require, that applicants for this exam have experience in clinical practice, and have completed continuing education or other preparation in pediatric behavioral mental health.

PNP Associations

The National Association of Pediatric Nurse Practitioners (NAPNAP), which has state chapters located throughout the country, promotes pediatric health by providing opportunities to PNPs through funding, education, and research. The organization also helps shape laws that affect child and maternal health care and creates educational materials for parents and families.

For nursing educators, the Association of Faculties of Pediatric Nurse Practitioners is a national organization that addresses the challenges faced by pediatric nurse practitioners involved in education.

Setting-Specific Credentialing and Privileging

Credentialing and privileging of PNPs provides the public with additional assurance that the practitioner has demonstrated competency within a particular setting, whether this be an independent clinic or hospital. This credentialing and privileging process includes the verification of current licensure, acquiring letters from colleagues that attest to competence, and obtaining proof of competency in performing the clinical activities the setting will demand.

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Hospitals and clinics may have their own credentialing processes; however, NAPNAP supports NPs becoming credentialed through The Joint Commission’s Medical Staff Credentialing process as Allied Health Professionals (AHP) or Licensed Independent Practitioners (LIP).

PNP Salaries

According to the National Salary Report 2011 published by Advance for NPs and PAs, the average full-time annual salary for nurse practitioners working in pediatrics was $82,101. The average hourly rate for those working part-time was $43.24.

NAPNAP also publishes a state-by-state salary report of its active members. The most recent report is for the 2009–2010 membership year and represents the full-time salaries of 4,335 association members.

Annual Salary
Number of PNPs

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