Pediatric nurse practitioners (PNPs) specialize in delivering healthcare to all individuals younger than 18-years old. In many instances, these nursing professionals work while supervised by a pediatric physician, although as a certified PNP, physician oversight is not mandatory. PNPs provide affordable, quality healthcare for many patients and can work in any healthcare setting, including their own practice. While PNPs typically do not earn the most pay among nursing professions, they earn salaries well over the national average.
Pediatric nurse practitioners first earn accreditation and experience as RNs and then pursue training and experience in child healthcare service. Pediatric medicine advocates foresee a significant talent shortage in this field over the coming years. However, with improvements in several metrics, potential pediatric nurse practitioners can head off the anticipated talent shortage that’s currently causing concern among many pediatric healthcare watchdogs.
Pediatric Nursing as a Profession
PNPs work with patients 18 years old and younger, including newborns.  They typically deliver service under physician management. However, some PNPs operate private practices. While most PNPs practice in a physician’s office, others work in different settings, such as:
Pediatric Intensive Care Units (PICU)
Pediatric oncology units
Some pediatric nursing practitioners work in academic facilities, in private caregiving practice groups or with organizations providing services for children and youth. PNPs’ problem solving, guidance and teaching skills transfer well to many other occupations. Pediatric nurse practitioners also work in specialty caregiving facilities, Health Maintenance Organizations (HMOs) and legal and information technology consulting enterprises.
Pediatric nurse practitioners interact with family members more than any other caregiving discipline. These medical professionals diagnose sicknesses, prescribe medication and perform annual checkups, in addition to requisitioning patient testing and consulting with clients and their family members. PNPs also take patient vital sign measurements, as well as blood and urine samples when needed. Advanced practice pediatric nursing practitioners also interpret test results and develop treatment plans.
The Role PNPs Play in Caregiving
The medical community recognizes that pediatric nurse practitioners deliver high quality, cost-effective healthcare service and therefore supports employing PNPs to reduce barriers to caregiving. This support has increased now that new laws limit how many hours training physicians can deliver service.
As in other nursing disciplines, pediatric nursing practitioners combine science and empathy to deliver services, but parents feel more comfortable when a childcare specialist delivers caregiving service to their offspring. Children have different biological and mental reactions to illnesses and medicines. PNPs understand the physical and emotional needs of these young, growing patients.
Some children cannot communicate their symptoms effectively. Pediatric nursing practitioners train to pinpoint symptoms in children while providing a comfortable caregiving setting. They are experts at communicating with children while soliciting critical caregiving information.
Salary and Demand for PNPs
A report published on the professional nurse social networking web portal NursingJournal.org anticipates an increased need for pediatric nurses.  This is on par with a 26-percent overall nursing labor demand increase as forecast by labor analysts due to the population’s rising caregiving needs. Currently, pediatric nurse practitioners represent almost ten-percent of the entire United States nursing talent pool.
The Bureau of Labor statistics expects almost one million nursing positions to come available by 2020. According to the BLS, the average wage for pediatric nurses during the most recent census was almost $65,000 annually. The top ten-percent of salary earners took in around $95,000 for the year. The NursingJournal.org post states that PNPs earn slightly less than other nursing specialty practitioners in most regions. However, with additional education and work experience they can earn salaries commensurate with the higher end of the earnings scale. Pediatric nurse practitioner pay varies by region. The highest paying states are:
Work environment and experience typically influence this figure rather than discipline. However, most individuals choosing a pediatric career receive motivation from the desire to deliver medical service to the infant to juvenile age group more than from a promising income; these individuals forgo financial incentives for the reward of improving the wellbeing of United States children.
The Path to a PNP Career
New healthcare reform provides insurance access to all United States citizens, which contributes to the demand for PNPs. Most pediatric nurse practitioners spend approximately ten years as registered nurses before entering their specialty. During this time, the medical professionals receive exposure to many caregiving career paths before choosing to specialize in pediatrics.
Pediatric nurse practitioners begin their careers as RNs. Some earn associate degrees or diplomas, but most earn bachelor’s degrees. Nursing candidates must pass the National Council Licensing Examination for Registered Nurses (NCLEX-RN) before they practice healthcare delivery.
To gain experience, nursing professionals interested in pediatric work seek employment with a pediatrician. PNPs typically serve as RNs for approximately ten years before practicing independently. Pediatric nursing hopefuls earn Master of Science in Nursing (MSN) degrees in pediatrics, followed by certification via the American Nurses Credentialing Center (ANCC) or the American Association of Nurse Practitioners (AANP).
Pediatric Nurse Practitioner Certification
The National Association of Pediatric Nurse Practitioners (NAPNAP) advocates for specialized skill in child healthcare and supports a formalized standard for proving these skills.  The organization believes certified pediatric nurse practitioners deliver the best possible patient outcomes and improve the caregiving experience for patients and their families. The association supports this opinion with several related studies.
NAPNAP highlights how important it is that certifying boards remain independent and unbiased. They recognize PNPs requisite, extensive training to develop service delivery proficiency. To maintain service quality, they also support ongoing testing and continuing nursing education requirements.
The Pediatric Caregiving Talent Shortage in the United States
The Committee on Pediatric Workforce, sanctioned by the American Academy of Pediatrics, has conducted extensive research on the forecasted talent pool shortage.  The committee reports pediatric practice popularity waxes and wanes sporadically among medical students. The committee also notes that practitioners do not choose their specialty based on demand; many individuals choose the same popular disciplines despite public need. The committee predicts this selection characteristic will cause talent supply issues for pediatric caregiving organizations across the nation.
Among those who choose pediatrics, over two thirds of these individuals are females. Despite the recent sharp increase in individuals pursing pediatric medical practice, a significant portion of these individuals desire part-time employment. The committee views this desire as an additional threat to the supply of pediatric medical talent.
According to the Committee on Pediatric Workforce, around half of all children in the United States live in an area without child healthcare services provided by a physician, nurse or other provider. Additionally, ten-percent of this same group also lacks access to a family practitioner.
The committee recognizes pediatric specialists as the most capable candidates to deliver service to infant to juvenile patients in lieu of physicians. Several factors make physician service delivery a challenge. Pediatric patients with severe or complex conditions require extensive time and attention. Despite universal healthcare, many of these patients remain uninsured or underinsured. Additionally, medical services delivered at more convenient community health centers interfere with primary service delivery. The committee also warns that efficiency quotas enacted by the new healthcare reform result in increased patient visits – and in turn reduced service quality – while limiting the time available for care providers to learn about important caregiving innovations. Finally, new regulations limiting working hours for training pediatricians decrease the confidence these new practitioners display when collaborating with experienced PNPs. This reduced experience requires veteran physicians to spend more time helping new partners acclimate to the practice.
Due to these and other circumstances, some pediatricians limit their client base and hours. These individuals take on a tenth of the normal workload experienced by other physicians, with some billing patients directly rather than through insurance. The care providers do this because they have grown weary of heavy workloads and reporting responsibilities. They see this practice as a way to continue to deliver healthcare service while maintaining their quality of life. While this practice is minimal in the United States, the Committee on Pediatric Workforce fears an increase in this trend will further threaten pediatric healthcare talent supply.
Because demand for individuals to deliver this service is extremely high, practicing PNPs typically choose their desired work schedule and location. Many employers provide funding for registered nurses to pursue advanced pediatric education. A career as a PNP combines physician-level service delivery with nursing compassion. As a pediatric nurse practitioner, advanced nurses can improve the lives of individual children and entire communities.
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