PNP vs NNP

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If a nurse practitioner wants to specialize in caring for children, they usually opt to become either a pediatric nurse practitioner (PNP) or a neonatal nurse practitioner (NNP). The primary difference comes down to this: PNPs serve patients from birth to young adulthood, and NNPs serve patients up to age two. There is some overlap in educational requirements; however, there are many more nuanced differences in scope of practice, setting, and certification.

A pediatric nurse practitioner is an advanced practice nurse who specializes in serving patients ranging in age, from newborns all the way into young adulthood. If a PNP chooses to work in primary care (PNP-PC), they will guide young patients and their families through the routine coughs and colds of childhood using a patient-focused approach. In an acute care setting, a PNP-AC will manage critical, chronic, and acute conditions by taking a treatment-focused approach. Either way, all PNPs will need at least a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree and gain professional certification as experts in their specialty.

A neonatal nurse practitioner is an advanced practice nurse who specializes in serving patients from newborns to the age of two. Although they often work in a neonatal intensive care unit (NICU), they are skilled in providing both primary care and acute care in the interest of stabilizing premature and sick babies and getting them back into the parents’ arms. NNPs deal with a smaller range of patients than most, and as such, they need to be experts on the neonatal condition. All NNPs will have either an MSN or DNP degree, as well as professional certification.

Both PNPs and NNPs serve children, but they do so in different ways. To find out the details on who does what and how, read on for a full side-by-side comparison chart below.

PNP NNP
Definition A PNP is an advanced practice nurse who specializes in the treatment of patients ranging in age from newborn to young adulthood. While the majority of PNPs work in primary care, some work in acute care as well. An NNP is an advanced practice nurse who specializes in the treatment of newborns, infants, and toddlers up to the age of two. Most NNPs work in a neonatal intensive care unit (NICU) setting.
Education PNPs will hold either a master of science in nursing (MSN) or a doctor of nursing practice (DNP). They may have a subspecialization in acute care or primary care. NNPs will hold either a master of science in nursing (MSN) or a doctor of nursing practice (DNP).
Featured Programs
Typical Courses

Curriculum varies from program to program and subspecialization (acute care or primary care), but common courses include:

  • Advanced pediatric health assessment
  • Children with chronic illnesses and special needs
  • Theory of advanced pediatric nursing practice
  • Infant, child, and adolescent health
  • Pediatric clinical pharmacology
  • Health promotion of the pediatric population
  • Advanced physiology and pathophysiology across the lifespan

Curriculums vary from program to program, but common courses may include:

  • Advanced neonatal pharmacology
  • Advanced neonatal pathophysiology
  • Translating research evidence into practice
  • Advanced health assessment of the neonate
  • Population health in a global society
  • Advanced neonatal management
  • Essentials of patient- and family-centered care
  • Embryology and developmental physiology
Program Accreditation PNP programs should be accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). NNP programs should be accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
Clinical Hours Most MSN programs require at least 500 clinical hours, while DNP programs often require at least 1,000 clinical hours. Most MSN programs require at least 500 clinical hours, while DNP programs often require at least 1,000 clinical hours.
Licensing & Certification

Both acute care and primary care PNPs are professionally certified through the Pediatric Nursing Certification Board (PNCB).

Following national certification, PNPs generally must seek state licensure as well.

NNPs are typically professionally certified through the National Certification Corporation (NCC).

Following national certification, NNPs generally must seek state licensure as well.

Percentage of NPs in Specialization According to the AANP (2018), 4.6 percent of nurse practitioners specialize in pediatric primary care, while only 0.3 specialize in pediatric acute care. According to the AANP, only 1.3 percent of nurse practitioners specialize in neonatal care.
Competencies

PNPs in both primary care and acute care have many of the same core competencies:

  • Performing routine checkups
  • Ordering, performing, and interpreting laboratory tests
  • Counseling children and their families
  • Diagnosing illnesses
  • Prescribing medicine
  • Designing non-pharmacological interventions

Please note that the scope of these responsibilities varies by state of practice.

Core competencies of NNPs can include:

  • Administering medication
  • Monitoring vital signs
  • Providing critical nutrients to newborns
  • Coordinating with medical staff to develop treatment plans
  • Educating parents on day-to-day operations as well as home care

Please note that the scope of these responsibilities varies by state of practice.

Professional Associations & Resources
The Bottom Line PNPs shepherd patients ranging in age from birth to young adulthood. In a primary care role, they guide patients and their families through the typical bumps and transitions of growth. In an acute care role, they manage chronic and critical conditions over their duration. In either role, they are vanguards of a child’s health, keeping them healthy as they mature and prepare to enter adulthood. NNPs provide critical care to sick and premature newborns. They often work in a NICU setting, where the stakes are highest. They must provide life-sustaining care to their patients, while also navigating the extremely sensitive landscape of the parents’ emotional needs. Often working around the clock, NNPs are always there to step in and get children back into their parents’ arms, where they belong.