Guide to Advanced Practice Pediatric Primary Care Nursing (PPCNP)

Pediatric primary care nurse practitioners (PPCNPs) care for patients during some of the most important years of their development, from infancy up through 18 years of age. They provide ongoing primary care services such as wellness visits, immunizations, and treatments for mild to moderate conditions. PPCNPs also educate pediatric patients and their families on preventative care measures and make referrals to external health care providers when patients are in need of more intensive or specialized care. PPCNPs typically work in collaboration with and under the supervision of a physician; however, in 21 states and the District of Columbia, nurse practitioners including PPCNPs have the ability to practice independently and to even set up their own private practices.

Advanced pediatric primary care nursing can be a rewarding field for nurses who enjoy interacting with children and helping to ensure they develop into physically and emotionally healthy adults. Pediatric primary care nurse practitioners help their patients address physical, behavioral, and emotional health challenges early on so that they can build a solid foundation of health and wellness. Pediatric nursing is also unique in that patients’ families are often just as involved in the health care process as the patients themselves, and thus PPCNPs can work closely and develop strong relationships with families as an entire unit.

To become pediatric primary care nurse practitioners, registered nurses must complete a Master’s of Science in Nursing program, Doctor of Nursing Practice program, or post-Master’s certificate program in pediatric primary care nursing that is accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). Registered nurses must also fulfill a certain number of clinical hours and pass an examination administered by the American Nurses Credentialing Center (ANCC) or the Pediatric Nursing Certification Board (PNCB) to receive board certification as PPCNPs.

Where Pediatric Primary Care Nurse Practitioners Work

where-do-ppcnps-work-810x300Pediatric primary care nurse practitioners work in settings that provide primary care services to children from infancy up through 18 (and sometimes 21) years of age. Such settings include outpatient pediatric clinics within medical centers and hospitals, health departments, community health centers, schools, private practices, and specialized clinics.

PPCNPs’ general role and responsibilities tend to remain consistent regardless of their work environment, in that they provide direct primary care services and coordinate the medical care of their patients. However, depending on their work setting, pediatric primary care nurse practitioners may work with different patient populations and encounter different types of medical challenges. For example, while PPCNPs at large hospitals may encounter a wide variety of pediatric patients who come from various social, cultural, and financial backgrounds, and who experience a wide range of ailments. Depending on the region in which they work, PPCNPs who are employed at private practices serving one or a few communities may encounter less diversity among their patient population, and encounter certain health conditions much more frequently than others.

Children are very vulnerable to health changes as a result of their environment and lifestyle–for example, poor diet, lack of physical activity, environmental pollution, and other factors may dramatically affect their physical, emotional, and cognitive development. As a result, PPCNPs should be attuned to the social, cultural, environmental, financial, and familial contexts in which their pediatric patients live to better understand why their health challenges develop, and how they progress.

Below is a description of several common settings in which pediatric primary care nurse practitioners work.

Medical Centers and Hospitals

Pediatric primary care nurse practitioners are integral members of health care teams within hospitals and medical centers. Pediatric departments in large medical facilities are typically divided into smaller groups such as General Pediatrics, Pediatric Cardiology, Developmental and Behavioral Pediatrics, and Pediatric Infectious Disease. PPCNPs may work within one or more primary care-focused pediatric divisions, in collaboration with pediatricians, registered nurses, and medical assistants. They may also work alongside other types of nurse practitioners, such as family nurse practitioners. While pediatric primary care nurse practitioners often work under the supervision of physicians, they nevertheless operate largely independently of doctors, carrying their own patient load, developing plans of care, and directing registered nurses and medical assistants in the appropriate treatment of patients.

Ginny Angert, MSN, who worked for over four years at La Porte Hospital within their Pediatric Department, noted in an interview with OnlineFNPPrograms.com, “The nurse practitioners and physicians work collaboratively to provide primary care to our patients from birth to about age 21. We do regular check-ups and diagnose and treat common (and sometimes not so common) childhood illnesses and injuries. The nurse practitioners have their own schedules and generally work independently but collaborate with the other providers when necessary.”

PPCNPs who work at hospitals and medical centers may encounter a wider range of health issues than do PPCNPs at smaller clinics, due to the higher volume of patients and the fact that large hospitals and medical centers tend to serve larger communities, relative to smaller private practices.

Another way in which hospitals and medical centers are distinct from other types of medical settings is that some hospitals are affiliated with medical and nursing schools (these types of hospitals are called teaching hospitals). These settings may provide nurse practitioners with additional opportunities to instruct medical residents on certain medical skills, conduct research, and precept nursing students.

Private Practices and Group Medical Practices

Pediatric primary care nurse practitioners can also work in physicians’ solo offices or in group medical practices that serve pediatric patients and their families. PPCNPs who work in these settings alongside physicians typically have the same responsibilities that PPCNPs in hospitals have, in that they conduct health assessments and address mild to moderate health conditions. Kelly Ruemmele, CPNP is a pediatric nurse practitioner who works for two private practices in Pasadena, Texas. In an interview with OnlineFNPPrograms.com, she explained how pediatric private practices and group practices operate very similarly, with the main differences being the number of staff available for patient care, the patient populations served, and the number of resources available to practitioners to evaluate and treat patients.

“Most offices, whether private or large, are more alike than different; the basic care administered is the same,” Ms. Ruemmele said, “Larger offices tend to have multiple providers available for consultation for difficult cases, and may offer their employees more extensive benefit packages. It’s fair to say that staff turnover is often higher at larger offices as well.”

Patricia Jamo, MSN, PPCNP-BC also elaborated on the differences between private practices and larger group practices, citing her different experiences while working at Pediatric Associates at Argyle, Acute Care Pediatrics, and Southwest Medical Associates. “My responsibilities and role were the same at these practices, but the way I could practice was much different,” she said, “Pediatric Associates at Argyle, a private practice, was located in a large city. Therefore, I had better access to pediatric specialties and hospitals and could receive lab results rather quickly. The structure here [Pediatric Associates at Argyle] was similar to Acute Care Pediatrics, where the pediatrician was the owner and had three pediatric nurse practitioners working for him. We all practiced independently and would consult with each other as needed.”

Specialized Pediatric Clinics

In addition to settings that provide general pediatric primary care services, such as hospitals and private practices, PPCNPs can also find employment in very specialized clinical settings that help patients address a particular medical issue, such as allergies, asthma, overweight and obesity, and diabetes. Unlike outpatient pediatric clinics that provide general primary pediatric care, these specialized clinics focus on the evaluation, monitoring, and treatment of certain types of conditions. Similarly to teaching hospitals, and unlike most private and group practices, these specialized clinics (which themselves are often affiliated with larger medical institutions) can also provide nurse practitioners the opportunity to conduct research on certain medical conditions and how they manifest and progress in pediatric patients.

Maria Crain, CPNP works at the Food Allergy Center at Children’s Health in Dallas and Plano, Texas. At the Food Allergy Center, Ms. Crain conducts physical assessments and diagnostic tests for specific food allergies. Prior to this position, she worked at the Jaffe Food Allergy Institute, which is an international center for food allergy care and research. In an interview with OnlineFNPPrograms.com, she explained how her role is comprised of a combination of health assessments, allergy screenings, treatments and patient education around the management of their condition, and research.

“My daily responsibilities as a PNP at Children’s Health are to provide outpatient care to all allergy patients, with a focus on food allergies. Most of my assessments include taking a detailed history, physical examination, and allergy skin and serum testing,” she said, “I am also managing patients that have asthma, allergic rhinitis, atopic dermatitis, as well as drug and insect allergies.”

Schools and Educational Settings

Pediatric primary care nurse practitioners can also find employment at school-based health centers (SBHCs) at the elementary, junior high, and high school levels. SBHCs vary in the types of care they provide their students, but they can offer primary heath care services, mental health care and substance abuse counseling, nutrition and wellness education, sexual health education, and/or dental health care to students. Pediatric primary care nurse practitioners who work at SBHCs and similar school-based health care settings may see students on an as-needed or routine basis for health evaluations and consultations, coordinate student immunizations, collaborate with school staff to develop health education programming, and implement other preventative care measures for their students.

What Pediatric Primary Care Nurse Practitioners Do

what-do-pediatric-primary-care-nurse-practitioners-do-810x300Primary care is the ongoing provision of medical care and advice in order to promote overall wellness, prevent the development of chronic and acute disease, and ensure patients’ healthy physical, mental, and emotional development. As mentioned previously, pediatric primary care nurse practitioners tend to have consistent core responsibilities regardless of their work setting, in that they complete health assessments, treat mild to moderate health conditions in children and adolescents, administer immunizations, educate patients and their families on leading a healthy lifestyle and preventing or managing chronic conditions, update parents on the health status of their children, and refer children and their families to health specialists if necessary.

Patricia Jamo, MSN, PPCNP-BC, summarized the role of the pediatric primary care nurse practitioner in her interview with OnlineFNPPrograms.com. “A primary care nurse practitioner works in an office where patients make appointments to be seen. The PNP is responsible for providing preventative health care education and screenings and managing uncomplicated acute and chronic conditions. It is also the PNP’s job to recognize emergent situations and know when to refer a patient to the emergency room, directly admit a patient to the hospital, or set up an urgent visit with a specialized provider,” she said. Due to their focus on understanding their patients’ medical histories and helping children build a strong foundation of health, pediatric primary care nurse practitioners may have the opportunity to develop long-term relationships with patients and their families.

Below is a more detailed description of some of the core responsibilities that pediatric primary care nurse practitioners complete on a daily basis.

Health Assessments and Screenings

Health assessments and screenings for specific health conditions are two very important elements of pediatric primary care. Health assessments, also known as physical checkups or wellness visits, involve conducting a physical exam and taking a patient’s health history in order to understand his or her current health status, the origins of any health issues he or she has, and any genetic, social, and/or environmental risk factors for future health problems. Regular health assessments help to ensure that a child develops normally by detecting potential health problems before they become too serious, so that health care providers and patients’ families can address them.

If a PPCNP has reason to believe that a child may have a disease or disorder, he or she may order more specialized diagnostic tests. Specialized screenings include tests for allergies including asthma, eczema, and food sensitivities, developmental disorders such as autism, behavioral issues such as attention deficit hyperactivity disorder (ADHD), and mental or emotional disorders such as OCD, depression, or severe anxiety. “PNPs screen for autism and speech delays, referring to available resources and coordinating the care with external specialist agencies,” Ms. Ruemmele said, “It’s imperative to intervene early with suspected delays, as the early intervention increases success in closing gaps.”

During their completion of health assessments, pediatric primary care nurse practitioners should aim to understand the social, environmental, and/or cultural issues underlying the medical challenges their patients face. Kelly Ruemmele, CPNP explained in her interview with OnlineFNPPrograms.com how financial constraints are a major challenge facing her patient population. “[One of the core challenges] facing my patients, which has also become a national concern, is the prevalence of obesity,” she told OnlineFNPPrograms.com, “Our patients often eat a high fat diet, fast foods, starches, sweetened beverages such as sweet tea, juices, and soda. They consume few fruits and vegetables. […] Financial resources are scarce; many are on public assistance, such as WIC and food stamps.”

Environmental issues are another contributor to the health issues that Ms. Ruemmele encounters in her clinical work. “We struggle as practitioners to combat circumstances which interfere with our pediatric patients’ health: public schools have cut back on physical education to 2-3 days/week, parents have concerns with allowing their children outside for safety reasons, and increased tablet time all contribute to the problem. School lunches are also high in fat, and parents rely on them due to financial resources,” she said. “Another issue, which is unique to Houston’s urban and suburban areas, is asthma. The climate has frequent fluctuations in temperature, high pollen and mold counts, and pollution from nearby chemical plants. Asthma also plays a part in hindering physical activity and school attendance, adding to the obesity crisis.” Due to the significant effect that children’s environment has on their health, pediatric primary care nurse practitioners must be attuned to the context in which their patients’ health problems manifest.

Immunizations and Other Preventative Care Treatments

Immunizations and vaccinations are another important part of the preventative care that is the foundation of pediatric primary care. Immunizations for conditions such as the flu, polio, tetanus, measles and hepatitis help prevent serious conditions in children. PPCNPs monitor the immunization schedules of their patients, and also educate patients and their families on the purpose of each immunization or vaccination.

As some vaccinations require multiple administrations over the course of several months or years in order to be effective, PPCNPs must work to keep patients compliant with coming in for repeated doses, which can be challenging for some practices due to controversy around the benefits and risks of vaccines. Some communities may be more compliant with vaccinations than are others. Ms. Ruemmele noted to OnlineFNPPrograms.com, “[M]y patient population is extremely compliant with vaccinations and scheduling well visits. While there is considerable vaccination controversy facing many practices, we claim a 100% vaccination rate.”

Patient Education

Patient education is crucial in effective pediatric primary care nursing. Ms. Ruemmele told OnlineFNPPrograms.com, “Education is the foundation of all primary pediatric care. NPs share information on developmental stages, common illnesses, and chronic conditions such as obesity, asthma, and even constipation with their patients, with the aim of empowering them with knowledge to prevent more serious ailments or conditions down the road.” Educating children and their caretakers empowers them to take control of their health and reduces health care costs associated with urgent care visits and expensive procedures to address severe health complications. In addition, educating patients and their parents on health problems and their treatment, developmental milestones and how to handle them, and other relevant topics helps to develop a stronger, more trusting, and ultimately more effective relationship between patient and health care provider.

Treatment of Mild, Moderate, and Chronic Health Conditions

In addition to preventing illness through a combination of regular health assessments, patient education, and immunizations, pediatric primary care nurse practitioners treat mild to moderate ailments and injuries that do not require surgery or intensive care. Such conditions include minor lacerations and infections, the common cold, mild cases of the flu, stomach pain and upset, migraines, and mild to moderate cases of asthma and other allergies.

PPCNPs may also be the first health care provider that pediatric patients see when they are suffering from a condition that needs more intensive treatment; in such cases, the PPCNP typically evaluates the patient’s condition and then makes referrals and recommendations for further and more specialized care.

Research

Some pediatric primary care nurse practitioners, and particularly those who work for medical centers affiliated with a university or research institution, may have the opportunity to engage in research that is relevant to their clinical work. According to the American Association of Nurse Practitioners, PPCNPs and other nurse practitioners can also find research opportunities outside of their work settings through networks such as the AANPs Network for Research (AANPNR). The incidence of certain health issues in different demographic groups, the effectiveness of particular medical treatments, and the impact that environment has on children’s health are just a few topics that nurse practitioners can potentially explore through research.

Maria Crain, CPNP, explained to OnlineFNPPrograms.com how she divides her time between clinical work with patients suffering from allergies, and research of the conditions that are prevalent among her patient population. “I am also co-investigator on most food allergy research studies that are conducted in our center, along with my supervising MD, Dr. John Andrew Bird,” she said.

Care Coordination and Leadership

Pediatric primary care nurse practitioners are not only providers of care, but also coordinators of care in that they may direct registered nurses and medical assistants, collaborate with physicians and other NPs to develop comprehensive plans of care for their patients, and even initiate or participate in the development of programs that improve patient care services.

In her interview with OnlineFNPPrograms.com, Ms. Crain explained how she supervises other staff members in both clinical and research settings at the Food Allergy Center. “My role is often a supervisory role, especially when the attending is not present. We often perform ingestion food challenges to high risk patients, meaning that it is likely the child will have an allergic reaction in our office,” she said, “I am there to provide direction to the research nurses and act as the provider. On a daily basis, most of my role includes training by organizations that provide our studies, as well as documentation in the chart on the patients we see that are in the study.”

Pediatric primary care nurse practitioners may find ways to engage in program development to improve health care services at medical facilities. Ms. Crain told OnlineFNPPrograms.com how her work at the Jaffe Food Allergy Institute helped her to contribute to the establishment of the Food Allergy Center at Children’s Health in Dallas, Texas. “[At the Jaffe Food Allergy Institute,] I was able to work directly with the experts in the field and Dr. Sampson and Dr. Sicherer taught me everything I know about food allergy. I worked with all the physicians in that center and the job was more intense because there were several allergists with whom I had to collaborate and see patients. It was complicated but it taught me time management skills, and improved my clinical skills,” she recalled, “Due to my experience in the Jaffe Food Allergy Institute, I was able to assist in the development of the food allergy center in Dallas with Dr. John Andrew Bird.”

Ginny Angert, MSN, PNP-BC also used her clinical experiences as motivation to found her company EHR Optimize, which works to streamline technology systems within medical facilities to improve patient care. “A few years ago, I developed an interest in health informatics and completed the Masters of Medical Informatics (MMI) program at Northwestern University. This led to consulting work; I have worked for hospitals to help them utilize their electronic health records and other technology more effectively,” she said, “I have also worked with technology companies to help them understand healthcare workflow and providers’ technology needs and I also founded a start-up company to work on patient engagement.”

Through clinical experiences, additional training, and collaborating with their colleagues, pediatric primary care nurse practitioners may find opportunities to lead staff and care improvement initiatives.

Why People Become Pediatric Primary Care Nurse Practitioners

why-pediatric-primary-care-nursing-810x300Advanced pediatric primary care nursing can be an incredibly rewarding field for registered nurses who enjoy working with children and who find gratification in developing strong relationships with pediatric patients and their families. “I would say in pediatric nursing, those who chose pediatrics want to be there,” Ms. Ruemmele told OnlineFNPPrograms.com, “The nurses are a little nicer, there is a sense of hope, one which is sometimes missing in adult medicine where chronic illnesses and end of life issues are apparent. There are some who will go to all measures to save a child.”

Ms. Jamo explained to OnlineFNPPrograms.com how her interest in pediatric nursing originated from an experience at a camp for children suffering from chronic illness. “When I was in my pediatric rotation in nursing school, I was given the option of spending a week volunteering at a place called Camp Boggy Creek or writing a research paper. I opted to go to camp and it changed my life forever,” she recalled, “Camp Boggy Creek is a camp for chronically ill children and depends heavily on volunteer camp counselors and medical professionals. […Shortly] after the campers arrived and we sat down together for our first meal in the dining hall, my self-centered world stopped and I found my purpose in life. There was such a positive energy there that I cannot explain and it exuded through the campers and staff. […] I returned several times to volunteer during my last year of nursing school and spent the summer after graduation working there as well. I do not think I would have ever entered pediatric nursing had it not been for this experience.”

Ginny Angert, MSN, PNP-BC described to OnlineFNPPrograms.com how the impact she has on the long-term health of her patients and the connections she makes with patients’ families have kept her engaged and motivated for over two decades of work in pediatric medicine. “During my early RN experience, I had the opportunity to observe various PNPs in their clinical work and this led to my decision to enroll in the pediatric nurse practitioner program at the University of Maryland. Over the past 20-plus years I have never doubted this decision!” she said, “Pediatrics is a unique specialty for a few reasons. First, you almost always have a parent or family member to include in your care. […] I have learned an incredible amount from the parents I have worked with. Second, longitudinal studies abound that support the connection between health in childhood with health in adulthood. In my opinion, many of the behaviorally-modified health problems that are seen in adults should be addressed in the pediatric population first.”

Both Ms. Angert and Ms. Jamo also noted how pediatric nursing in particular requires a special kind of emotional intelligence and creativity that can be engaging and rewarding. Ms. Jamo described the importance of finding innovative ways to connect with children, “Working in pediatrics requires one to be creative in how they engage a child in order to examine him or her with the least amount of struggle possible. This skill comes with lots of practice as well as trial and error.” Ms. Angert similarly noted, “[P]ediatric nursing requires creativity. I may need to be able to discuss super-heroes with one patient, professional athletics with another, and sing-along cartoon songs with another. I laugh at some point during every clinical day and that’s a great thing!”

The Challenges of Pediatric Primary Care Nursing

challenges-of-advanced-practice-pediatric-primary-care-nursing-810x300The rewards of pediatric primary care nursing can also be part of the challenges, in that the joys of connecting with pediatric patients and their families can also be the cause of stress and distress when pediatric patients experience serious health issues. “Losing a pediatric patient is by far the hardest part of the job,” Ruemmele said, “With adult patients, it’s an accepted and expected part of life (for the most part). Zipping up a body bag on an infant with an inoperable heart condition was unnatural and haunts me to this day.”

Ms. Angert similarly described how the ups and downs of pediatric patients’ health and the communication challenges that can arise between provider and family may pose challenges in the workday. “Pediatrics is not all fun and games,” she said to OnlineFNPPrograms.com, “Pediatric patients do get serious life-threatening illnesses and injuries. Family dynamics and parenting skills are not always healthy. While those instances can be challenging, they also require a PNP with strong clinical knowledge and the ability to advocate for the health of the child.” Ms. Jamo also emphasized the need for strong communication skills, diplomacy, flexibility, and patience when working with children and their families. “Working with the parents can often be challenging as well. Patience is key! Listening and acknowledging their concerns help parents feel validated and more willing to trust your medical opinion.”

The hours for pediatric nurse practitioners can also be challenging, depending on one’s work setting. “Twelve hour shifts are brutal for all hospital nursing staff, which is unlikely to change. Holidays, weekends, and ongoing staffing remain challenges to the field of nursing as a whole. Facing these challenges is not unique to pediatric nursing, but rather is present across all fields of nursing,” Ms. Ruemmele said.

To manage the demanding schedules of pediatric nursing, PPCNPs should work to maintain work life balance and seek the support of colleagues and friends. “Clinicians definitely need to develop strong coping skills and strategies to avoid burn-out in these difficult situations,” Ms. Angert advised, “My favorite way is to simply talk with my co-workers and debrief the situation.”

Advice for Registered Nurses Interested in Becoming PPCNPs

advice-for-students-interested-in-pediatric-primary-care-nursing-810x300Becoming a PPCNP is challenging from an academic and a professional perspective, and requires considerable preparation, maintenance of relevant certifications, and consistent efforts to stay up to date on developments in pediatric health and medicine. In her interview with OnlineFNPPrograms.com, Ms. Ruemmele said that one of the most important steps that registered nurses should take before enrolling in a graduate pediatric primary care nursing program is to determine whether working with both well and ill children is for them, through a combination of relevant experiences and careful self-evaluation.

“For nursing students contemplating a pediatric nursing career, volunteering at a children’s hospital, a clinic, daycares, schools, or as a nanny can provide useful information about whether working with children suits them,” she advised, “Spend in-depth and quality time with children. Child development courses are available in high schools and college.”

Once registered nurses decide to become pediatric primary care nurse practitioners, they must be prepared to face the numerous challenges of gaining admission into and successfully completing an accredited graduate nursing school program. “Graduate school for NPs has become incredibly competitive,” Ms. Ruemmele said, “Securing clinical placements is also a challenge; our Houston area has been saturated with both on-line and on-campus university students seeking clinical placement sites and preceptors.” Networking can be one way in which students can tackle the challenge of finding preceptors. “Networking at local and state NP Continuing Education Unit programs is one way to find preceptors and mentors,” Ms. Ruemmele added. Creating and maintaining strong connections with colleagues, fellow students, and mentors in the field throughout one’s nursing career is essential, as these friendships can provide emotional support, professional opportunities, and advice to pediatric nurse practitioners as they progress through their careers.

Ms. Angert recommends that graduate nursing students interested in advanced pediatric nursing try to gain a wide variety of clinical experiences to supplement their core training in pediatric nursing. “Current PNP students should really seek out as varied a clinical experience as possible,” she advised, “They should be honest about their knowledge and experience gaps and seek out experiences to help mitigate those gaps.”

Much of pediatric primary care involves carefully evaluating patients’ health status, diagnosing conditions, and making appropriate referrals to specialists as necessary. As a result, it can be helpful for pediatric primary care nurse practitioners to familiarize themselves with the role of various specialists, and to proactively connect with the specialists in their medical office. “Spend some time with the specialists in your area. In the primary-care setting, you want to reach out to the specialists your office refers patients to frequently. Establish that relationship and learn what they want (and don’t want) from you in terms of a patient referral,” Ms. Angert advised.

Working before and throughout one’s graduate nursing education can also be a way to apply and thus solidify clinical skills that one learns in the classroom and through clinical practicums. “For prospective students, I personally recommend working as a pediatric registered nurse for 1-2 years before enrolling in the MSN program. Then once you have entered the MSN program, continue to work at least part-time,” Ms. Jamo told OnlineFNPPrograms.com, “Working in a pediatric hospital allows you to become familiar with the common childhood illnesses that tend to put kids in the hospital as well as how to treat them. It helps hone your assessment, critical thinking, and communication skills. Continuing to work while going to school allows you to immediately apply new knowledge and enhances the learning process.”

After completing their accredited program in advanced pediatric nursing, students must study for the certification exam administered by either the Pediatric Nursing Certification Board (PNCB) or the American Nurses Credentialing Center (ANCC). These certification exams have eligibility requirements, including an active license as an RN in one’s state of residence, completion of a CCNE or ACEN-accredited graduate nursing program in pediatric nursing, and the completion of at least 500 hours of clinical practicum. After they pass the examination and receive certification, PPCNPs must maintain their certification by fulfilling annual requirements outlined by either PNCB or the ANCC.

By establishing a strong support system of colleagues and mentors, honing their clinical skills through volunteer and professional work, working to understand and meet the needs of each pediatric patient and his or her family, and staying abreast of developments in the field of pediatric primary care, PPCNPs can enjoy a rewarding career that allows them to help children develop into physically, mentally, and emotionally healthy adults.


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About the Author: Kaitlin Louie is the Managing Editor of OnlineFNPPrograms.com, and creates informational content that aims to assist students in making informed decisions about graduate programs. She earned her BA & MA in English from Stanford University.