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Career Spotlight: Pediatric Nurse Practitioner

Date: January 9, 2018

Hospital pediatrics departments across the country handled more than 13 million outpatient visits in 2014, according to research from the Centers for Disease Control and Prevention. Private pediatricians saw even more patients, handling over 97 million office visits over the same span. While many of the children who attended these appointments saw doctors, a significant portion most likely encountered pediatric nurse practitioners. In fact, more than 20 percent of the young patients who pass through U.S. pediatric wards receive help from these nursing professionals, the Association of American Medical Colleges found. Why? Pediatricians are in short supply, according to research from the American Academy of Pediatrics. This state of affairs has required clinics and hospitals to rely on highly-educated Family Nurse Practitioners (FNPs) and Pediatric Practitioners (PNPs), most of whom have the experience and clinical faculty needed to treat children with varying health needs.

Registered nurses interested in new roles should consider pursuing this fulfilling specialty. What exactly does the job of PNP entail? Here is a brief outline of the position:

Roots of the role
PNPs materialized during the late 1960s in response to growing industry fears over developing primary care physician shortages, according to research from Dr. Bernard Schachtel published in the journal Medical Care. The AAP was responsible for promoting early PNP education programs, which empowered registered nurses to take on more advanced responsibilities. These nursing professionals were characterized as “new health practitioners” — medical specialists who could occupy untrodden territory between “physician’s assistant” and “clinician.”

There were more than 65 formalized nurse practitioner programs in the U.S. by the early 1970s, with many providing pediatric specialty education, according to the American Association of Nurse Practitioners. This building enthusiasm for the PNP role led to the creation of the National Association of Pediatric Nurse Practitioners in 1973 and the Association of Faculties and Pediatric Nurse Practitioners in 1978.

Today, roughly 234,000 licensed NPs work in American health care facilities, a little over 11,000 of whom specialize in pediatric treatment, the AANP found.

Education
According to the AANP, PNPs must have the following five credentials to practice legally: an undergraduate degree in nursing, a graduate degree, a nursing license, state NP certification and national board certification.

Aspiring PNPs often come from traditional nursing backgrounds and gain upward professional mobility by enrolling in graduate degree programs such as the Online Master of Science in Nursing – Family Nurse Practitioner Program at Bradley University. These educational tracks equip RNs with the specialized medical knowledge they need to excel in their expanded roles and include courses covering everything from nursing leadership to pediatric practice. While not all institutions require master’s degrees, a majority of PNPs — 97 percent, according to the AANP — possess them.

State certification requirements vary. However, the national provisions are more standardized. The American Academy of Nurse Practitioners offers an exam-based certification program through its Certification Board, which awarded more than 81,000 credentials in 2016. The Pediatric Nursing Certification Board also offers a PNP program and boasts over 25,000 members who work at esteemed health care organizations such as Boston Children’s Hospital — the top pediatric facility in the country.

Ultimately, most PNPs enter the profession with six years’ classroom and clinical education, according to the AANP.

Nurse meets with child and parent

The job
According to the AFPNP, PNPs perform duties centered on seven core competencies:

  • Health promotion, protection and disease prevention and treatment: The first competency encompasses three key tasks, the first of which is health assessment. Here, PNPs perform routine tests to determine the overall health of their patients. They also analyze family medical history to pinpoint any genetic conditions that might need extra preventive attention or monitoring. Of course, this task alone requires an immense amount of skill, as PNPs must not only assess their patients but also dig into documentation and search for health outcome predictors.

    With the proper data in hand, PNPs can make initial diagnoses and recommend various courses of treatment, should they be required. Care plan implementation is the third and final task associated with the health promotion and protection competency. This involves installing actionable disease prevention or mitigation strategies and monitoring them to ensure progress.

  • Care quality assurance: The care quality assurance competency encapsulates not only personal clinical practices but also the overarching policies of entire institutions. PNPs who master this capability can help optimize the effectiveness of their respective organizations.
  • Cultural functionality: This competency feeds into its predecessor, as PNPs who cultivate service-oriented, positive cultures often achieve better care outcomes.
  • Patient support: Patient support is, of course, one of the primary duties of all medical professionals. For PNPs, this responsibility comes with additional difficulties, as they work with adolescents who change physically and mentally at breakneck pace.
  • Professional progression: In addition to performing clinical tasks, PNPs must track their own development and evolve with medical and technological transformation so as to best serve their patients.
  • Health care delivery management: As frontline care providers, PNPs play an essential role in shaping and maintaining delivery processes, from billing to treatment scheduling.
  • Teaching and coaching: While most parents seek out PNPs for their medical expertise, they also come to them for more general advice concerning ancillary topics, including childrearing. These nursing professionals should be able to offer valuable guidance and coach parents on all manners of child development.

Next steps
The AANP projects there will be more than 12,000 practicing PNPs by 2025, performing essential duties such as the one mentioned above in an effort to protect and support the generations to come. RNs interested in joining their ranks within the next eight years can gain the skills and knowledge they need by enrolling in the Online Master of Science in Nursing – Family Nurse Practitioner Program from Bradley University. Here, RNs can expand their knowledge on a wide range of topics, ranging from advanced health assessment techniques to health care policy, all from their own computer. The 67-credit-degree track ends with a capstone research project and five preceptor-supervised clinical practicums, which can be administered locally.

The online MSN-FNP program at Bradley is the ideal choice for registered nurses hoping to move up to better serve their patients. Prospective students can find more information on the program at the Bradley University website.

Recommended Readings:
The HPV vaccine: What FNPs need to know”
Counseling for loved-ones with terminal illness

Sources:

http://onlinedegrees.bradley.edu/nursing/msn-fnp/

https://www.cdc.gov/nchs/data/ahcd/nhamcs_outpatient/2011_opd_web_tables.pdf

https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2014_namcs_web_tables.pdf

https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Shortage-of-Pediatric-Specialists-Rising-number-of-Chronically-Ill-Kids-Prompts-AAP-Call-to-Revamp-Training-Funds.aspx

https://www.bls.gov/oes/current/oes291171.htm

https://www.aamc.org/download/458082/data/2016_complexities_of_supply_and_demand_projections.pdf

https://www.jstor.org/stable/3763320?seq=1#page_scan_tab_contents

http://www.afpnp.org/afpnp/resource/documents/PC_Core_Comp_2002.pdf

https://www.aanp.org/all-about-nps/np-fact-sheet

https://www.aanp.org/images/about-nps/npgraphic.pdf

https://www.aanpcert.org/resource/documents/AANPCB%202016%20Pass%20Rate%20Report.pdf

https://www.pncb.org/cpns-numbers

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