Pediatric nurse practitioners (PNPs) are advanced practice registered nurses (APRNs) who specialize in children’s health. According to the National Association of Pediatric Nurse Practitioners (NAPNAP), PNPs provide a wide range of medical services, including:
Although there are some generalist PNPs, this group is increasingly being divided into two subspecialties: acute care (PNP-AC) and primary care (PNP-PC). Please note that the scope of practice for both fields varies by region. The American Association of Nurse Practitioners (AANP 2015) recognizes that some states—mainly concentrated in the midwest—give NPs relative autonomy of practice to perform medical evaluations, diagnose conditions, and manage treatments. By contrast, many states in the south require the supervision of physicians or other healthcare professionals to provide some healthcare services. To learn more about the state-based privileges of practice, prospective PNPs are encouraged to contact their local state board of nursing, a list of which is provided by the National Council of State Boards of Nursing (NCSBN).
The American Association of Nurse Practitioners (AANP 2015) reports that 95.1 percent of all NPs hold graduate degrees. PNPs typically hold at least a master of science in nursing (MSN) degree specializing in pediatrics. Some aspiring PNPs choose to pursue the terminal degree of the discipline—the doctor of nursing practice (DNP)—especially those interested in leadership roles. In fact, the American Association of Colleges of Nursing (AACN 2015) recommends the DNP as the new standard of training for all APRNs since nursing remains one of the few healthcare professions where practitioners are generally master’s-prepared as opposed to being trained at the doctoral level.
Read on to learn about how to become a PNP (acute or primary care), in addition to discovering what to expect from a PNP program (distance- or campus-based), professional certification, and program accreditation.
For those looking to become PNPs in acute or primary care, there is a diversity of educational and experiential paths. Here is a summary of one possible route to joining this career on the rise:
After graduating from high school, many prospective PNPs choose to enroll in a four-year bachelor of science in nursing (BSN) program. These programs feature courses such as biochemistry, structure & function of the human body, health promotion & risk reduction, pathophysiology, mental health & illness across the lifespan, and community health nursing. Also, students are encouraged to seek out BSN programs accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN) to qualify for the National Council Licensure Examination for Registered Nurses (NCLEX-RN), the test to become a registered nurse (RN).
After successfully passing the NCLEX-RN, candidates typically garner one-to three-years of experience working as an RN in settings relevant to their intended specialty (e.g., generalist PNP, acute care, primary care) such as pediatric intensive care units (PICUs), hospitals, emergency rooms, private practice clinics, and other healthcare environments.
Following the completion of at least of year of clinical work, students may be prepared to apply to graduate PNP programs. The Pediatric Nursing Certification Board (PNCB) provides lists of recognized graduate programs in PNP-AC and PNP-PC.
Please note that while a BSN is a typical prerequisite for graduate PNP programs—especially for online PNP programs—there are exceptions. Referred to as direct entry, alternate entry, bridge, or accelerated programs, some PNP graduate schools may accept candidates with associate degrees (i.e., ADN-prepared) or those with non-nursing bachelor’s degrees. The American Association of Colleges of Nursing (AACN) offers a list of “accelerated” BSN and MSN programs for non-nursing bachelor’s graduates.
In any case, aspiring PNPs should expect to complete at least a master’s degree. According to CareerOneStop (2015)—a data group sponsored by the U.S. Department of Labor—77.8 percent of all NPs have master’s degrees, and 12.7 hold doctoral or professional degrees. For both MSN and DNP degree options, admissions committees for PNP graduate programs typically call for the following:
As part of any PNP graduate program, students need to complete didactic coursework and supervised clinical hours—a minimum of 500 for MSN programs—which are hosted at healthcare preceptors close to a student’s home. Preceptorships are mentoring experiences in which advanced practicing nurses give supervised instruction and training to pediatric nursing students, allowing them to gain specialized experience in a clinical setting. Students may be able to select their own preceptor sites, or locations may be assigned with the assistance of program coordinators. For a more detailed discussion on becoming a PNP, please visit the how to become a nurse practitioner page.
Read on to discover what to expect from PNP programs (both acute and primary care) at the MSN or DNP levels.
In addition to the abundance of online PNP programs, here are five hybrid or on-campus PNP programs across both subfields:
The University of Florida (UF) in Gainesville hosts a DNP program for PNPs in the acute care specialty. This interdisciplinary program gives students over 1,000 clinical hours at local preceptors and 76 credits of didactic courses, including work in advanced acute & chronic child health nursing, nursing informatics & information management, and professional issues in advanced practice nursing. With a world-class health center and experienced faculty, UF’s program is open to both BSN- and MSN-prepared candidates. Please note that this school also has a DNP program in the primary care subfield.
Rush University of Chicago—tied for #5 among U.S. News & World Report’s (2016) top PNP programs—offers a unique DNP in the PNP-AC subfield. Available as a distance-based program, Rush’s renowned faculty gives 70-72 credits of instruction in areas such as palliative care, advanced pharmacology, and leadership in evolving healthcare environments. Students garner hands-on experience through clinical rotations in pediatric intensive care units (PICUs), nephrology, oncology, radiology, and various surgical hospitals. Please note that Rush also offers a DNP in PNP-PC.
The University of Michigan (UM) hosts a unique MSN program with a dual specialty: PNP-PC and nurse midwifery. This rigorous 69-credit curricula has classes such as promoting optimal models & systems for healthcare delivery; intrapartum, postpartum, & newborn care; and antepartum care of essentially normal women. A majority of the courses are on-campus, although some may be web-blended. Finally, UM’s interdisciplinary approach sets up graduates for employment in a variety of settings, including universities, clinical research facilities, hospitals, and public policy centers.
Yale University’s top-ranked MSN program specializes in family-centered primary care for children and adolescents. Featuring courses such as the management of common pediatric problems, health promotion in children, and pediatric pharmacology, Yale’s two-year program is tied for #3 among U.S. News & World Report’s(2016) best PNP schools. With over 1,300 distinct preceptors, Yale’s School of Nursing exposes its students to a wide range of clinical environments such as community-based hospitals, private practice clinics, and school healthcare centers.
The University of Virginia (UVA) provides a 21-month MSN program for aspiring PNP-PCs. With more than 600 hours of supervised clinical work and 48 credits of courses such as advanced pathophysiology, theoretical foundations in nursing, and research processes & biostatistics, students are prepared to become community-based practitioners, particularly for rural and other underserved populations. This program is available to BSN-prepared applicants. Please note that UVA also offers a 33-month DNP in this subspecialty.
Following graduation from a graduate PNP program, candidates are expected to seek national certification.
The American Nurses Credentialing Center (ANCC) offers a five-year PNP-PC certification, and the Pediatric Nursing Certification Board (PNCB) provides PNP-PC and PNP-AC certifications which must be renewed annually. Prerequisites for these certifications include earning a graduate NP degree (MSN or DNP) from a program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN); completing specific coursework; being an RN; providing proof of at least 500 faculty-supervised clinical hours; paying a registration fee; and passing an exam.
Also, PNPs will need to apply for licensure in the state in which they want to work. Licensure requirements vary, but typically require that applicants have an RN license, a graduate degree, and proof of clinical experience. Students can find links to the state boards of licensing through the American Association of Nurse Practitioners (AANP).
Aspiring PNPs are advised to ensure that their nursing programs have received accreditation through a reputable organization. There are two common accrediting organizations recognized by the U.S. Department of Education: the Accreditation Commission for Education in Nursing, Inc. (ACEN) and the Commission on Collegiate Nursing Education (CCNE). The accreditation process indicates that a school has been evaluated for quality, taking into consideration criteria such as program facilities, faculty, students outcomes, and comprehensiveness of curricula.
Finally, for graduate PNP programs, students may be advised to seek out schools recognized by the Pediatric Nursing Certification Board (PNCB)—one of the main national certification organizations in pediatrics—which offers lists of graduate programs in the PNP-AC and PNP-PC subspecialties.