Male PNP listening to stethoscope of little girl

In recent years, nurse practitioners have become significantly important to the healthcare system throughout the United States. Our country relies on the skills of nurse practitioners to bridge the gap in healthcare delivery. Despite this growing need, there is still a startlingly low number of nurse practitioners who specialize in pediatric care. This shortage offers high-demand career opportunities for nurses who are considering furthering their education with a Master's degree.

Read more about PNP programs.

Pediatric Nurse Practitioner Shortage

The U.S Bureau of Labor and Statistics states that the need for nurse practitioners is projected to grow 26 percent until 2028, with about 16,900 openings for nurse practitioners over the course of a decade. According to the American Association of Nurse Practitioners (AANP), there are more than 290,000 nurse practitioners currently licensed in the United States. Only approximately 3.7% of these nurse practitioners are certified in pediatrics. The U.S. is currently facing a severe nursing shortage in many states overall.

In 2017, the U.S. Census Bureau reported that approximately 23% of the United States population was under the age of 18. With the very small percentage of nurse practitioners specialized in pediatrics, many of these children are left without access to a pediatric care provider. Rural areas are even more greatly affected by this shortage.

Critical Factors That Could Explain the PNP Shortage

The demand for pediatric healthcare services continues to increase as a higher number of children are developing chronic health problems. Among other factors, fewer professionals are pursuing a specialty in pediatrics. "Not all universities have programs that are fully online, which may require students to relocate to a different state or travel each semester to obtain their education and this becomes a great barrier in obtaining a PNP degree," said Dr. Renee Flippo, Clinical Associate Professor and Pediatric Nurse Practitioner Track Coordinator at the Baylor University Louise Herrington School of Nursing (LHSON). Dr. Flippo went on to explain the dire need to fill the ranks of PNPs. "Also, the coronavirus is starting to impact children, which is a call to action for a lot of nurses. A multi-organ inflammatory disorder is now spreading through the country that is affecting children, placing them in the hospitals and ICUs. So, we need pediatric specialists on the front lines taking care of these kids."

Pediatric NP FAQs

Pediatric cardiac care nurses care for infants and children with cardiac and congenital heart disease. Their role involves collaborating with other members of the health care team to provide specialized care, from admission to discharge. This includes supporting the patient and family during all stages of diagnosis and treatment.

Pediatric cardiac care nurses are often employed in specialty pediatric clinics and children’s hospitals. In the hospital setting, they may work on inpatient cardiac units, in the cardiac catheterization lab, operating room, or on the cardiovascular intensive care unit. They receive continued education, training, and support to provide evidence-based care to the pediatric population.

Caring for children with cancer is extremely delicate. Parents and families are usually understandably in shock after a diagnosis is made. Pediatric oncology NPs can assist families in managing the diagnosis by offering resources such as support groups, social work referrals, financial planning, and even arrange care with a psychiatrist as needed. Stress, anxiety, and grief are common in families of children with cancer, so a pediatric oncology NP needs to be able to utilize the available resources to support a patient’s medical as well as psychosocial needs.

While pediatric oncology can be an emotional challenge for NPs, it is also extremely rewarding. The NP can help support families on their journey by acting as a lifeline. Having a “constant” in the chaos of cancer treatment is extremely necessary for parents. Moreover, assisting patients and families during the grief of a terminal diagnosis as well as during the joy of remission is invaluable.

Pediatrics is a specialized population.  There are differences in anatomy, disease processes, and treatments that are not the same as in the care of adults. Therefore, prior experience is critical to becoming a pediatric nurse practitioner.

When nurses enroll in an advanced degree nurse practitioner program, they must choose a specialty track to focus on. It could be adult-gerontology, pediatrics, acute care, or family medicine. Some programs require a year or two of previous staff nurse experience in pediatrics before enrollment, while others allow for concurrent experience. Students are encouraged to check the school website to determine specific admission criteria.

Staff nurses who have no pediatrics experience and who wish to become pediatric nurse practitioners should consider cross-training to pediatrics. The more experience attained, the smoother the transition to a pediatric nurse practitioner in the future.

Pediatric nurses differ from pediatric nurse practitioners in many ways. Pediatric nurses perform essential nursing functions to care for pediatric patients. This includes physical assessment, developing a nursing care plan, implementing nursing care and treatment, and evaluating response. They administer medications and vaccines as well as other procedures in the hospital or ambulatory care setting.

Pediatric nurse practitioners are advanced-practice nurses. This means they have earned a bachelor's degree and moved on to a master's or doctoral degree nurse practitioner program. Pediatric nurse practitioners have also completed a pediatric NP "track" within their advanced-degree program, which prepares them to care for the pediatric population. Additionally, they must obtain pediatric nurse certifications.

Pediatric nurse practitioners can perform the same functions as a pediatric nurse, but they mainly are responsible for the overall management of care of pediatric patients. They conduct physical exams, take a history, diagnose, and can prescribe medications. They can also act as a patient’s primary care provider.

Both pediatric staff nurses and pediatric NPs are highly specialized. Children are not just "small adults." They have anatomical differences and specific disease processes that require specially trained nurses and NPs to care for them.

SPOTLIGHT PNP PROGRAM - Baylor University Louise Herrington School of Nursing (LHSON)

Baylor University Louise Herrington School of Nursing Logo

Selected by U.S. News & World Report as one of the best graduate schools in 2019 and ranked 79th on their list of top national universities in 2020, Baylor University Louise Herrington School of Nursing (LHSON) is working to fulfill the growing need of pediatric nurse practitioners. Their new PNP program offers a unique "low-residency immersion format," allowing students to complete the majority of their classes online. Intensive two to three-day workshops take place on campus throughout the program, with a focus on lab activities and expanding clinical skills. Dr. Flippo explains, "This will allow students to obtain their degree at Baylor, while maintaining employment and caring for their families in their home state."

Baylor University has already seen a strong response to the new Doctor of Nursing Practice - Pediatric Nurse Practitioner program, drawing students from all over the country in states such as California and Virginia. When asked for her opinion on why the program has received such a positive response, Dr. Flippo explained that offering a low-residency format boosts marketability to people who live in other areas of the country. "Statistics show that children in rural and underserved communities lack access to a pediatric provider and having a low-residency status allows our program to reach and educate potential Pediatric Nurse Practitioners in those areas," said Dr. Flippo. "Students no longer have to live near or travel frequently to our Dallas campus."

"At Baylor, we have a dual-track program so that when nurses graduate, they will have the option of sitting for both the primary care and acute care pediatric nurse practitioner certification exams. They will also be earning a DNP or Doctor of Nursing Practice degree. The primary care pediatric nurse practitioner track will take three years to complete, with the acute care track taking an additional two semesters, or four years total. The distinction from a registered nurse who works at the bedside is that it allows for expansion of the scope of practice. Bedside nurses are critical to the care of our children, but becoming a Pediatric Nurse Practitioner provides an opportunity for nurses to broaden their impact."

Dr. Renee Flippo is a Clinical Associate Professor and Pediatric Nurse Practitioner Track Coordinator at the Baylor University - Louise Herrington School of Nursing (LHSON) which offers advanced degrees in nursing and executive leadership. Dr. Flippo holds expertise in clinical and professional lab practice and pediatric management.

Taking the Next Steps

This critical need for PNPs offers a bright future for nurses who are considering becoming a pediatric nurse practitioner. For those interested in pursuing this field, Dr. Flippo suggests exploring leadership and volunteer opportunities. "Look at ways to be involved locally, regionally, and nationally in policies that affect pediatric healthcare", says Dr. Flippo. "And consider how obtaining a DNP - PNP degree might impact you both professionally and personally."

Janine Kelbach, RNC-OB
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