Pediatric Nurse

Lindsay Smith
Last updated at August 12, 2021

Becoming a pediatric nurse is no easy task. It requires years of study and continual dedication to providing medical care to those who need it. But more importantly, a pediatric nursing job requires empathy and steadfast focus in the face of crises.

To become a pediatric nurse, though, a nurse must be prepared to overcome a big set of challenges. In addition to being headstrong and having a calm demeanor while providing patient care, a pediatric nurse must remain positive to keep the child and the parents at ease. 

Furthermore, a pediatric nurse must be attuned to babies and children who may not have the ability to explain how they're feeling.

Providing nursing care to infants and children can prove challenging. However, pediatric nurses are compensated generously, have great job prospects, and enjoy excellent benefits.

But what are the duties of a pediatric nurse? Where do pediatric nurses work? And how does one become a pediatric nurse?

We discuss all that and more in this post to give you better insight into this career path.

What is a Pediatric Nurse?

An Advanced Practice Registered Nurse (APRN) specializing in providing primary care (and acute care) to children is a pediatric nurse practitioner (PNP). These qualified nursing professionals are involved with the recovery of infants, tweens, and teens on a daily basis.

But before you can become a PNP, you must become a Registered Nurse with an Associate Degree in Nursing at the minimum. You will then be able to work as a pediatric nurse.

If you wish to grow in the career, you could aim to become a Pediatric Nursing Practitioner (PNP). PNPs have a master's degree in pediatric nursing and often also hold other certifications. 

The added training they receive enables them to take on additional responsibilities like prescribing and administering medication and performing developmental screenings.

While pediatric nurses can only practice under a physician's supervision, PNPs have greater autonomy, and supervision is not mandatory.

What does a Pediatric Nurse Do?

As a pediatric nurse, you can expect to take on the following responsibilities on a daily basis:

  • Asking children questions to diagnose the problem.
  • Drawing blood for diagnostic tests if required.
  • Documenting symptoms and learning the medical history of the child.
  • Differentiating between normal and abnormal physical findings.
  • Assessing immediate needs and providing primary care.
  • Monitoring symptoms, identifying changes, and intervening if required.
  • Working with other healthcare professionals to execute pain management plans.
  • Evaluating children for signs of abuse.
  • Maintaining confidentiality in nurse/child relationships.
  • Serving as a child advocate if the circumstances call for it.
  • Providing critical care to dying children.
  • Monitoring and keeping accurate records of patient's vital signs.
  • Administering medication in accordance with age-appropriate guidelines. 
  • Calming parents' anxiety and helping families deal with their child's condition or injury.

Furthermore, a pediatric nurse is required to stay in the loop on the latest treatments for conditions, new drug therapies, improved equipment, and updated treatment procedures.

Pediatric nurses must operate within the bounds of the newest rules and regulations set by the authorities.

Where does a Pediatric Nurse Work?

PNPs work with patients aged 18 and younger and must also provide acute care for infants. While you will need to work under physician management initially, you could operate a private practice after earning your Master's Degree.

Work environments pediatric nurses work at include:

Emergency Rooms

A hospital can employ a registered nurse that specializes in pediatrics to work in the emergency room to tackle various aspects of patient care. RNs in this position must assess the condition of children in the ER, order tests, and prescribe medication. They may also be responsible for admitting and discharging patients.

Surgical Theaters

If you choose to become a Pediatric Nurse Practitioner, you could work in an operating room, serving as the first assistant to the surgeon. You may need to help with implant placement, graft harvests, and incisional closures.

Pediatric Intensive Care Units (PICU)

Pediatric Nurse Practitioners in Pediatric Intensive Care Units must provide acute care to patients. Your duties will include stabilizing young patient's health and working to minimize complications. 

Pediatric Oncology Units

A Pediatric Nurse Practitioner in a pediatric oncology unit must provide critical care to patients with cancer. A nurse in this role will need to provide clinical attention to patients up to 21 years of age.

Evaluating patient health, updating charts, and monitoring and updating treatment plans if treatment isn't effective are part of an Advanced Practice Registered Nurses' daily responsibilities in this environment.

Other Work Environments

Pediatric Nurse Practitioners may choose to work in an academic facility, providing medical attention to the students on campus. PNPs can also work with organizations that facilitate the medical care of the youth in various locations.

As mentioned earlier, you could also choose to start your own practice after getting your pediatric nursing certification.

The problem-solving skills, knowledge of evidence-based treatments, and superior communication and teaching skills that a PNP possesses make them the perfect candidates for unique work opportunities. 

A PNP could get a job in a legal consulting firm or an information technology enterprise.

A Quick Note on Working Conditions

A survey by the Institute of Pediatric Nursing revealed that almost 60% of registered nurses specializing in pediatrics work in children's hospitals.

Much fewer (a little over 10%) of the surveyed pediatric nurses work at outpatient health care centers, and only 2.4% of the participants reported working in an academic setting.

You may find the idea of working in a specific environment (like at a school or a patient's home) appealing. However, since there aren't as many jobs available in those work environments, you must be open to any opportunity that comes your way. 

You must also remember to keep your own health in check. Working with ill children can be emotionally draining, and burnouts are inevitable if you choose to work in this profession. 

Burnout is common among pediatric nurse practitioners, so if you think you need some time off, don't be afraid to ask for it.

Pediatric Nurse Salary

According to the Bureau of Labor Statistics, the median annual salary for a nurse practitioner was $117,670. 

While the lowest 10% in the occupation made $84,120 annually, the salary of the top 10% in the profession was $190,900 and above.

Bear in mind that your salary will depend on your qualifications, nursing experience, and job location.

If you want to make the highest salary, you could consider moving to a state where pediatric nursing specialists are paid more.

The states that offer the best pay for this role include:

  • California
  • New Jersey
  • Washington
  • New York
  • Massachusetts
  • Hawaii
  • Minnesota

If you want to make the best salary possible and also gain nursing experience working with the best medical teams in the country (and abroad), you could consider becoming a pediatric travel nurse.

How Much do Pediatric Travel Nurses Make?

Getting into travel nursing will allow you to make a lot more money than you would as a permanent staff nurse. The medical industry is currently facing a shortage of qualified nurses, and travel nurses are brought in for periods of 13 weeks to counter the shortage.

In addition to being compensated generously (with salaries ranging from $2,000 to $3,000 per week, sometimes a lot more), you will also get some great perks.

Your staffing agency will cover your travel, housing, and state licensing costs. Also, you will receive health, life, dental, and vision insurance free of charge.

Some of the money you make will be tax-free, which is another excellent benefit of becoming a travel nurse.

Demand for Pediatric Nurses

The Bureau of Labor Statistics reports that the demand for NPs practicing in all specialties is expected to grow by 45% in the coming decade. The growth rate of jobs and opportunities is exponentially higher than the average growth rate of 4%.

A report by The National Association of Pediatric Nurse Practitioners (NAPNAP) revealed that out of the 270,000 nurse practitioners in the country, less than 8% specialize in pediatrics.

Around the time the report was published in 2019, there were 73 million children in the United States. The healthcare industry doesn't have the human resources it needs to ensure the country's population of minors remains in good health.

The number of children in the country is expected to increase to 75.7 million by the end of this decade, which means nurses specializing in pediatrics will be in high demand for the foreseeable future.

Pediatric Nursing Sub-Specialties

Two primary specialties come under the umbrella of pediatric nursing: pediatric oncology and pediatric intensive care unit (PICU) nursing.

Here's a closer look at the roles and the duties that entail the roles.

Pediatric Oncology Nurse

Nursing in this specialization involves treating patients struggling with complications of cancer. However, the role may also involve working with patients facing complications with malignant tumors. 

Adult oncology is a lot different from pediatric oncology. Treatment protocols are vastly different for children since the medication has a stronger effect on a child's body. Also, the side effects of the treatments pose the risk of stunting the development of the child.

Furthermore, some types of cancer only affect children. Treatment of these varieties of the disease requires specialized knowledge.

The unique duties of a pediatric oncology nurse include:

  • Assessing children and ensuring they are well enough to tolerate chemotherapy treatment.
  • Administering chemotherapy per doctor's orders.
  • Monitoring patients post-chemotherapy for life-threatening side effects.
  • Educating families and potential caregivers about the condition and the treatments. Teaching them how to manage the side effects of chemotherapy at home.

Pediatric Intensive Care Unit Nurse

Like ICU nurses provide critical care to adults, PICU nurses provide medical care to children and teenagers suffering from life-threatening conditions.

PICU nurses share a lot of their duties with ICU nurses. A professional in this role must monitor and assess patient needs and administer medication accordingly. PICU nurses must be prepared to think on their feet and work quickly to stabilize a patient if their condition worsens.

The main difference between ICU and PICU nurses is that PICU nurses typically have fewer patients to care for. However, a lower number of patients does not translate to an easier job. 

Treatments for patients in the PICU vary hugely because children in the PICU are often in different stages of development.

How Do I Become a Pediatric Nurse Practitioner?

You will need to study for years to become a certified PNP. However, you can find jobs at care facilities and begin working with children well before earning your MSN degree.

Step #1: Earn a Bachelor's Degree of Science in Nursing (BSN) Degree

Before you can start working as a nurse, you will need to earn a bachelor's degree in nursing. While you can start working as a nurse with an associate's degree, most employers now only hire nurses with a BSN.

A BSN program will take you between three and four years to complete. Some nursing programs allow students to complete some of the coursework online. However, you will need to complete the physical training requirements at an approved medical center or health care facility in your ZIP code.

If you already have an associate's degree, you can enroll in an RN-to-BSN nursing program to advance your education. There are programs that allow working professionals to study online and complete the required practical work at a medical center in their ZIP code. You could get your bachelor of science nursing degree in as little as 20 months with these programs.

If you want to begin working in health care quicker, you could enroll in an accelerated nursing program. These are available to licensed vocational nurses with an Associate's Degree in Vocational Nursing (ASVN).

Taking the LVN to BSN path and enrolling in the right nursing programs will accelerate your education, allowing you to skip the first three semesters of a BSN program.

Step #2: Pass the NCLEX-RN 

After you earn your degree, you will be eligible to apply for the NCLEX-RN exam. Passing this exam is a requirement before you can begin your career in nursing.

When you pass the National Council Licensure Examination for Registered Nurses, you can apply for a license and start your career as a nurse.

Step #3: Gain Experience 

Having an education is not enough to become a PNP. Gaining nursing experience will teach you how to operate in different work environments and help you understand what is expected from you.

You can work as an RN anywhere, but most RNs looking to become PNPs prepare for the role by applying for positions in children's hospitals. Some apply for roles in the pediatric or neonatal departments of community hospitals. 

A few even begin working in a pediatrician's clinic after getting their bachelor's degree to gain experience and get a solid recommendation.

Registered Nurses must complete 1,800 clinical hours in two years if they want to enroll in advanced nursing education programs.

Step #4: Pursue an MSN Degree

Enrolling in an MSN program is a necessity for RNs that want to become PNPs. Several MSN programs combine online and offline coursework to give you the skills students need to provide clinical and acute care to children.

Pursing an advanced degree such as a master's degree to specialize in pediatrics will take you between 18 and 24 months. You must apply to a school or a university that offers a two-year Master of Science in Nursing degree program.

Step #5: Become an APRN

In addition to earning your Master of Science in Nursing (MSN) degree, you will need to be recognized by your state's board as an Advanced Practice Nurse.

Just like students must pass the NCLEX-RN to get licensed as an RN after completing their BSN, students are required to pass another test after completing their master's program.

Several institutes offer certification exams for MSN holders, testing their education and practice to ensure they are fit to work. 

You can choose your certification exam depending on what area you want to specialize in and get licensed in your state before becoming an advanced practice registered nurse.

Step #6: Get Certified in Pediatric Nursing

While the formal education requirements are complete, getting more certifications will give you the specialized knowledge you need to improve job prospects. 

The Pediatric Nursing Certification Board administers the Certified Pediatric Nurse (CPN) exam, and taking the test is one of the best ways to prove your commitment to your field. 

Besides looking great on your resume and making you an excellent candidate for working in magnet status hospitals, becoming a certified PNP will indubitably increase your annual salary.

Other Specialties to Consider

You may have a different vision as to what kind of healthcare professional you want to become. If becoming a pediatric nurse doesn't seem like the right career path for you, you could consider getting certified in a related specialty.

Neonatal Nursing

Neonatal nursing involves providing medical support for newborns who are born prematurely or are suffering from health problems. A neonatal nurse will care for children suffering due to congenital disabilities, infections, or heart deformities.

Most neonatal nurses work in the Neonatal Intensive Care Unit. Some of the responsibilities of a neonatal nurse include:

  • Monitoring vital signs of babies.
  • Informing parents about their child's health and educating them about their status.
  • Ensuring that the equipment needed for the babies in the NICU is working correctly.

Completing an MSN degree program is not required to become a neonatal nurse. However, you will need to pursue some education and get certified before applying for a position.

Developmental Disability Nursing

Developmental Disability Nursing involves providing specialized care for young patients with mental and developmental disabilities. 

Nurses in this specialty work with children that have down syndrome, autism, Rett syndrome, and Asperger's syndrome. These conditions affect the children's ability to learn and carry out daily tasks.

A nurse in this position will:

  • Assist patients with feeding and bodily functions.
  • Educate parents and caregivers about the child's condition.
  • Help children learn to communicate.
  • Teach children and caregivers to use required medical equipment.
  • Aid children in achieving independent mobility.

Completing advanced education programs isn't needed to become a Developmental Disability Nurse. Nursing students must gain two years of experience in a relevant department to be eligible to get certified as a Developmental Disability Nurse.

Palliative Pediatric Nursing

Palliative Pediatric Nursing involves providing care for terminally ill children. A nurse in this role must do all they can to relieve the child's suffering. 

Furthermore, palliative pediatric nurses must provide the highest quality of care to the patient and the family through the tribulation.

Nurses in this specialty are trained to handle discussions of death, so they can compassionately communicate a child's condition to the family.

The responsibilities of a palliative pediatric nurse include:

  • Clearly communicating the child's current condition.
  • Working with other health care professionals to minimize suffering.
  • Staying at the child's bedside and determining if they need medical attention.
  • Giving the family all the information so that they can make informed decisions about their child's health.
  • Assisting children and caregivers with using medical equipment.

Conclusion: Is This The Right Career For You?

Becoming a pediatric nurse can take years, and while you're compensated well, working with sick children can be emotionally draining.

Regardless of what sub-specialty you choose to work in, you will experience some low moments. It's not hard to imagine the emotional impact of witnessing a child losing their life to a deadly disease and seeing the family heartbroken. 

In these moments, a nurse must remain headstrong, and not everyone can do that. If you're not gritty by nature and tend to lose your calm in a crisis, becoming a PNP may not be the right career choice.

However, being a pediatric nurse is not all bad. Moments, where a child recovers fully from their condition and goes back home healthier and happier, can be incredibly rewarding to witness.

If you can thrive in stressful situations and find the vision of seeing a child under your care recover fulfilling, then you have a bright pediatric nursing career ahead of you.