BECOMING A PEDIATRIC NURSE

Pediatric nurses are Registered Nurses (RNs) who care for children of all ages in a variety of healthcare settings. They graduate from a nursing school within a college or a university and then take a credentialing examination known as NCLEX. All nursing students learn to care for children through formal classes and guided clinical experiences. Undergraduate nursing programs do not offer a specifically program for pediatric nurses.

To specialize in pediatrics, a nurse typically applies to work in a site that serves pediatric patients. Most of these sites offer classroom and/or clinical experience directed to the unique characteristics of children. These orientation programs, also known as internships or residency programs, may last weeks or months. The salary of the pediatric nurse depends on the education and experience of the nurse, the location of the facility, and the acuity of the patient population.

Pediatric nurses are very knowledgeable about growth and development as they adapt their interactions and care to the individual child’s developmental level. In addition, they acknowledge the expertise of the family and collaborate with them to provide care for the child. Diseases, equipment, and treatments for pediatric patients are either different or vary in presentation from those of adults because children are unique, not miniature adults.

The general pediatric unit provides nursing care to children with a wide range of acute and chronic medical and surgical conditions. Children who require more frequent and invasive monitoring such as those with severe, critical, or life-threatening conditions are cared for in a neonatal intensive care unit (NICU) or in the pediatric intensive care unit (PICU) where the staff has advanced knowledge and training in the care of critically ill infants and children. Intermediate care is provided to patients who are acutely ill and require more frequent assessment and monitoring than provided on a general unit but less than standard in the PICU. For many, intermediate care facilitates transition between the critical and general pediatric units. The staff is specially trained to recognize early signs of problems and how and when to intervene.

Nurses working in pediatric rehabilitation units provide combined rehabilitation and nursing care to prepare the child and family for the child’s return home and re-entry into the community and school with any remaining disability.

After gaining experience, the pediatric nurse can take an exam to become a certified pediatric nurse. Pediatric nurses continually add to their knowledge base by reading professional journals, participating in continuing education classes, and attending conferences such as those offered annually by the Society of Pediatric Nurses.

Certification

Certification recognizes an individual as having attained a level of expertise as demonstrated by passing a valid and reliable standardized exam. Certification identifies the nurse as having a recognized degree of proficiency in the stated area of clinical practice. The Society of Pediatric Nurses strongly supports and encourages certification for nurses at both basic and advanced practice levels.

There are two organizations, Pediatric Nursing Certification Board (PNCB), and American Nurses Credentialing Center (ANCC), that support certification programs. Each one has an initial exam and subsequent requirements for continued certification (and SPN members are offered a discount on both of these initial exams!). If you choose to work in a pediatric subspecialty, many of the subspecialties also provide specialized certification. 

Maintaining certification is based on demonstration of continued knowledge acquisition. SPN encourages you to explore the information available on the website to learn more about this valuable opportunity to promote excellence in pediatric nursing.

Becoming a Pediatric Advanced Practice Nurse

After obtaining a BSN from a college or university, a nurse can pursue advanced education to earn a master’s or doctorate degree in nursing. Advanced degrees are required for many leadership positions as well as clinical and faculty positions.

A master's degree is required if you wish to become a Pediatric Nurse Practitioner (PNP) or Clinical Nurse Specialist (CNS). Masters in nursing (MSN) programs usually are two years in length for full time study or longer for part time study. After completion of the master’s degree, PNPs and CNSs apply to the state board of nursing for recognition as an advanced practice nurse and take their respective national exam for certification. Certification is required in many states and recommended in others.

Pediatric advanced practice nurses serve as pediatric healthcare providers in primary or acute care settings for well and ill children from birth to 21 years of age. Examples of primary care sites include physician offices, school health, ambulatory, or outpatient clinics, surgical centers, and health departments. The acute care environment encompasses the pediatric inpatient, intensive care, and intermediate care units, the pediatric emergency room, same day surgery center, and pediatric rehabilitation facility.

Primary care PNPs have the additional knowledge and skill to diagnose and treat episodic illnesses; manage ongoing care of children with chronic conditions; and provide for the child’s on-going health maintenance needs including well child examinations, developmental assessment, and anticipatory guidance. Acute care PNPs manage the medical, surgical, and nursing care for children during hospitalization in acute or intensive care settings. All PNPs practice in collaboration with physicians who provide protocols and are available for consultation or referral as needed. Nurse practitioners in the United States have prescriptive authority.

Clinical Nurse Specialists function in a variety of settings. They model expert direct family-centered patient care, and they influence nursing care outcomes by providing education, expert consultation, and leadership in defining and implementing evidence-based practice for the staff. The Pediatric CNS may be identified in terms of a setting, a subspecialty, a type of care or a type of patient problem (e.g. skin, pain). They also work cooperatively with other disciplines to implement improvements in health care delivery systems.

The opportunities pediatric nurses have to care for varying types of patients in a variety of settings and at different levels are vast. Each individual will find their niche in pediatric nursing and excel!