When deciding to dedicate your education towards a career path as a pediatric nurse practitioner, one must realize how much it involves to successfully achieve this goal. Prior to beginning this journey, one needs to self-analyze their drive and their reasons for wanting to invest the time and effort to go into this career as a lifelong profession. PNPs are one of the many specialty paths of nurse practitioners and is a slightly different atmosphere due to working with children only.
If an individual decides to take the course of becoming a PNP it requires multiple acceptances to school programs, examinations for licenses, and years of clinical experience. The research of this paper is to provide an accurate path to becoming a pediatric nurse practitioner and to give a clear guide to the challenges and duties one may face while pursuing this career.
When pursuing a career as a PNP, the student must realize that after their undergraduate degree they still are required to take two years of school.
The majority of Master of Science in Nursing programs require applicants to obtain a Bachelor of Science in nursing prior to applying to the program. There are also programs for students that only have associate degrees in nursing and can take the alternate route, bridge program, to achieve the degree of MSN (BLS, para 4). Students that desire to pursue this career through the BSN route must take two years of undergraduate before being allowed to apply to the nursing program. At East Carolina University, intended nursing majors must complete 58 credit hours of prerequisites, maintain a minimum of a 3.
0 GPA, and pass the HESI exam before applying to the nursing program.
When accepted, students will then take two additional years of schooling as a nursing major and complete 67 credit hours through in class lectures and clinical settings in order to graduate and receive a BSN (East Carolina University). If a student is successful upon graduating from the nursing school, they must then become a licensed nurse in the state of North Carolina by taking the National Council Licensure Examination-Registered Nursing exam. Nursing graduates from ECU “consistently earn a 95-percent—or higher—first-time pass rate on the National Council Licensure Examination for Registered Nurses” (East Carolina University). When students are licensed, they can begin to work as Registered Nurses in the state of North Carolina and start building their clinical experiences.
The Master of Science in Nursing program at University of North Carolina at Chapel Hill is selective when it comes to considering who gets accepted into their master’s program. Students who are interested in applying to this specific school must have completed 51 pre-nursing credit hours, that include: Statistics, Social Sciences, Biological Sciences, and English Composition (University of Chapel Hill, 2018). Students that have these specific requirements can then begin the process of applying to both Chapel Hill’s graduate program and Nursing Master’s program.
The application into the program also requires three letters of recommendation, at least one year of clinical experience as an RN, and students that are interested in PNP-Primary Care are required to take an additional six months of clinical work in a pediatric setting (University of Chapel Hill, 2018). Obtaining the additional six months of pediatric clinical experience is a good strategy, Nadine Aktan confirms, for students to use their experience to make it easier for them to choose their specialty (2010). If the student is accepted into the master’s program they will begin classes and clinicals the next fall semester.
As a student goes through the nursing program and the MSN program they will have to go through multiple writing intensive classes to prepare themselves for adequate documentation in the professional field of a PNP. At ECU, before entering into the nursing school, students must take a basic writing about the disciplines course. When the student is attending the School of Nursing they will have to take a summer course in another writing intensive class that focuses on trends and issues in professional nursing (East Carolina University, 2018).
Upon going into the MSN program at Chapel Hill graduate students will take their last two writing intensive classes, interpreting research reports and synthesis and transition of evidence, to strengthen their ability to document and evaluate research reports (University of Chapel Hill, 2018). All of the writing courses that a student will take from undergraduate to the master’s program will be documented through the writing style of American Psychological Association, also known as APA formatting. In a nurse practitioner’s career, they are responsible for documenting detailed notes about the patients when they provide care to the individual. Clear documentation is how NP’s protect the health of their clients on a daily basis (Aktan, 2010). The writing courses that a NP will take through their education process will help strengthen their approach on patient documentation and their individual approach of care delivery.
The resources provided by ECU for nursing students can be beneficial to their academics but also their practices as a future nurse. Laupus Library offers multiple databases like: Exam Master, Nurse Education in Video, UpToDate, and Health and Society in Video and they allow students to check out anatomical models to help deepen their knowledge on mapping out the human body (East Carolina University, 2018). As graduate students are working through their program, UNC-Chapel Hill provides the same databases as ECU offers for their nursing students. Students that are in the MSN program are now eligible to be members of the National Association of Pediatric Nurse Practitioners and can begin to attend conferences and collect research through the association (NAPNAP). NAPNAP can be a good tool to use for graduate students wanting to broaden their knowledge on current events happening in the NP work force. All of these sources are building blocks that a student will need to be successful in their career.
Upon completion of the MSN program and certification of pediatric nurse practitioner, the nurse practitioner can begin to look for a career opportunity. Upon graduation, NP’s have an advantage finding jobs because of the growing need for them. Especially in areas that lack medical attention and need NP’s that earnestly care for patients that do not have the proper medical care in their cities. Employment for nurse practitioners in all practices is increasing by each year, the Bureau of Labor Statistics is projecting that employment rate for NP’s will increase 31% by 2026, which is more than any other job average (2018). The two main reasons for the need for more NP’s are that nurse practitioners are becoming responsible for tasks that are similar to physicians and the increasing need of preventative care.
The health care system is benefiting from this change of job responsibilities and research by Stanik-Hutt addresses “partnership with MDs have a very significant role in promoting health and providing care to diverse populations in numerous settings” (2013). Due to the increasing roles of NP’s, their salary has also increased to an average of $103,880 annually. Income can also increase or decrease based on what industry the nurse practitioner wants to pursue.
With the majority of PNP’s working in hospitals or outpatient care centers, the individuals that work in low income areas that lack proper medical attention are overlooked. PNP’s that do work in “medically underserved areas” hold the same responsibilities as other PNP’s in stable rural areas (BLS, para. 5). As pediatric nurse practitioners expose themselves to the lower income areas they have to begin to educate themselves on different cultural diversities, drug exposures, and how impoverished lifestyles are affecting children and their health. In low income areas there is an increase of children that are put into child welfare systems due to the parent’s substance abuse. In these cases, a PNP’s responsibilities become more of a critical nature due to children being more at risk for diseases and being underdevelopment mentally, physically, and socially (Katz, 2007, p. 124-125).
The responsibilities of the pediatric nurse practitioner that are most vital, in effect of the children, would be comprehensive assessment skills and decision-making individually and with the medical team. To those who want to thrive in this specific field, one needs to have a good foundation in “nursing knowledge, science, and patient population” (NAPNAP, p. 19). When nurse practitioners choose this type of social class to work with it can come with more stressors than in a normal setting for a PNP. Individuals that have the compassion to help the less fortunate gain the knowledge and adaptability to the different atmosphere, they can find themselves being successful in this career path.
The daily schedule for a PNP can vary depending on the location that they are looking to work in, locations can include: offices of physicians, hospitals, outpatient care centers, and educational services (BLS, para. 2). Pediatric nurse practitioners, working alongside medical doctors, normally “record patients’ medical histories, perform physical exams, create patient care plans, perform diagnostic tests, and give patients medicines and treatments” (BLS, para. 1). According to Rankin, PNP’s will have the responsibility to implement documentation and care to well and sick children, infancy to eighteen years of age, and also have to mentor NP students during their clinical experiences. This indicates that PNP’s are on the go constantly through their work hours. Even though there are different atmospheres that PNP’s can work in, they all have the same goal to provide quality care for all children.
A pediatric nurse practitioner can be faced with multiple challenges throughout their years in practice. Working in the medical field can test your ethical, individual and professional, points of views when working with patients. When PNP’s are surrounded by emotional parents due to their children being sick, it can initially conflict how the nurse practitioner’s ethical views on what care plan they should implement for the child. This is a challenge for PNP’s that have the tendency to allow their personal emotions to spill over into their work. To remove this challenge in an PNP’s career NAPNAP encourages them to “identify ethical issues, discuss them with colleagues, and take action to resolve or ameliorate ethical conflict” (NAPNAP, p. 37).
Another challenge that PNP’s have to deal with is the stress of caring for severely ill children. PNP’s are more vulnerable to this challenge in their career if they work in underdeveloped areas, hospice care centers, and palliative care centers. In palliative and hospice care centers, most of the children are there due to chronic illness and have only months to live. When a child’s death is upon the care team they have the responsibility of being the support for the family while they mourn over their child’s death (Jennings, 2005). When events like this come up, PNP’s and their care team need to take a “holistic approach” to the care for the child and when they achieve this, the stressor of supporting the family will decrease (NAPNAP, p.27). As PNP’s enter into this occupation, they should be aware of the concerns and challenges that are surrounding their environment, so they can strengthen themselves before the conflicts get too difficult to handle.
New innovations are never a surprise when it comes to the medical field. The most important innovation that has been developed for a couple of years, but has not fully reached all PNP practices, is electronic documentation. With this new technique, Dr. Posey argues, “We can read previous assessments, orders and communicate with less difficulty. It is better for patient safety as well” (2018). Even though electronic documentation has its benefits, it also comes with some downfalls that include: less eye contact with patients and families, time consuming when you are new to the technology, and being dependent on the weather if the internet is out (Posey, 2018). Another innovation that has increased the availability in pediatrics is the use of smartphones for diabetic patients.
The patients are able to communicate with their parents through their cellphones to notify their need for medication even when the parents are not there at the moment. The new innovations help PNP’s focus on “the values, preferences, expressed needs, and knowledge of the child and family related to the healthcare situation” and when they strengthen this aspect in their career, then PNP’s benefit from this too (NAPNAP, p. 45). It is pertinent for one to be aware and educated of the present and future innovations that are in the medical field, so their patients and the professional can benefit from them.
The pediatric path has positive impacts but there are also negatives that come with having a career in this field. Since the PNP is responsible for creating and forgoing the plan of care for the patient, it can create a stressful situation for the nurse practitioner because they have to make decisions that will further affect the child’s health (BLS, 2018). In dealing with this, Posey suggests to “enjoy and learn from every experience in pediatrics and other areas […] Listen to parents all the time” (2018). Another negative impact on the lives of PNP’s is the physical demands that are placed on them. Working on their feet for eight hours a day, five to six days a week can lead to back injuries (BLS, 2018). Before a pediatric nurse practitioner begins their career, they must be aware of the labor that it requires daily. PNP’s can help prevent back injuries by getting appropriate shoes and using appropriate techniques when handling patients.
As a student decides to choose the career path of a pediatric nurse practitioner, they should question themselves first on if their passion is to work with pediatrics. It takes a special desire to want to work with children, well and sick, on a daily basis. With this specific specialty as a nurse practitioner, everyone needs to be aware of the educational requirements and the time that needs to be devoted into developing this career. A successful PNP is someone that puts aside their own individual beliefs and focuses on the best way to help care for their patients. When PNPs are successful in exercising this technique and continuously educating themselves on the latest technology and skills in the medical field they will benefit more in their future endeavors.