How to Become a Pediatric Home Care Nurse

Are you a registered nurse or aspiring nurse who would love to focus on children’s health in your career? Within this defined area of study and practice, there’s an even more specialized role to consider: becoming a pediatric home care nurse.

As a pediatric home care nurse (also known as a pediatric private duty nurse), your patients will be children and youth with special health care needs (CYSHCN), a designation indicating their “increased risk for chronic physical, developmental, behavioral, or emotional conditions” requiring special care.

A subset of these patients suffer from life-threatening, life-limiting, or chronic conditions that medical professionals describe as “medical complexities” (the term “complex chronic” is also frequently used to describe these conditions). This second group constitutes less than one percent of all children, but their numbers have “increased dramatically” in recent years, according to a Long Island University study.

Children who are candidates for home healthcare, according to the American Academy of Pediatrics (AAP), include:

• Premature infants (born at 24 to 32 weeks)
• Children with respiratory issues, such as those who are dependent on ventilators and those with bronchopulmonary dysplasia, traumatic brain injury complications, and more
• Children with cardiac issues, such as a congenital heart defect
• Children with neurological issues, such as cerebral palsy or seizure disorders
• Children with gastronomy issues, such as those who require a feeding tube

The AAP reports a shortage of home care nurses contributing to prolonged hospital stays for children with no other options. Often, there are also not enough home-care resources available to transition out of in-facility care. This adds up to millions of dollars of healthcare costs each year, money that could be saved if there were more pediatric home care nurses available.

You can become a pediatric home care nurse if you are a licensed practical nurse or a registered nurse.

Interested in learning how? In this article, we’ll cover:

• What does a pediatric home care nurse do?
• Education requirements to become a pediatric home care nurse
• Steps to become a pediatric home care nurse
• Reasons for becoming a pediatric home care nurse

What does a pediatric home care nurse do?

What are the duties and responsibilities of a pediatric home care nurse?

Pediatric home care nurses see young patients outside of a traditional hospital or clinical setting by conducting home visits. A pediatric home health care nurse’s duties, according to blogger Kathryn Sneed, include:

• Managing medications
• Organizing existing supplies
• Ordering new supplies
• Handling emergency interventions
• Coordinating therapies
• Managing tube feedings
• Tending to wounds
• Checking and recording vital signs
• Assessing patient’s overall health
• Sterilizing all medical equipment
• Maintaining medical paperwork
• Liaising with pediatrician
• Contacting insurer
• Documenting all treatments

Education requirements to become a pediatric home care nurse

What should you study to become a pediatric home care nurse?

Undergraduate nursing programs do not offer programs specifically in pediatric nursing. However, all accredited nursing programs should introduce you to caring for children through your coursework and clinical experiences, according to the Society for Pediatric Nursing (SPN).

To specialize in the field, the SPN recommends that nurses apply to work at clinical sites that serve pediatric patients. These types of internship programs may last weeks or months.

Steps to become a pediatric home care nurse

What is the highest level of education required to become a pediatric home care nurse?

There is no standard set of requirements for pediatric home care nursing. Some employers may require nurses to complete a one-year certificate program at a community college, trade, or vocational school. Others hire licensed practical nurses (LPNs) and licensed vocational nurses (LVNs).

Other employers, however, require applicants to be registered nurses (RNs). To become an RN requires either a two-year associate’s degree in nursing or a four-year bachelor’s degree in nursing. Either qualifies you to take the NCLEX-RN exam and earn your registered nursing certification.

With a master’s degree in nursing, you can become a pediatric nurse practitioner (PNP) or clinical nurse specialist (CNS) in pediatrics. With this degree, you will more likely work in a hospital or clinic than as a home care nurse. After earning your master’s, you’ll need to apply to your state board of nursing for recognition as an advanced practice nurse and pass a national licensing exam.

What is the certification process for becoming a pediatric home care nurse?

While certification in the pediatrics specialization is not always a requirement for landing a pediatric home care nursing job, getting certified can only help. It demonstrates experience and expertise, two qualities all employers value. The Pediatric Nursing Certification Board (PNCB) offers a Certified Pediatric Nurse (CPN) certification. To be eligible, nurses must:

• Pass the PNCB exam
• Hold a currently active RN license within the U.S., Canada, American Samoa, Guam, Northern Mariana Islands, or the U.S. Virgin Islands
• Have practiced two years full-time as an RN
• Have a minimum of 1,800 hours of pediatric clinical experience completed within the past 24 months, or
• Have five years (within the previous five) experience as an RN in pediatric nursing and 3,000 hours of clinical practice in the specialty area of pediatric nursing

According to PNCB:

• 90 percent of nurse managers prefer hiring certified nurses over non-certified nurses
• 88 percent of nurses agree that certification helps with confidence in one’s clinical abilities
• Certified RNs on average earn $7,000 per year, or nine percent, more than those without certifications

The American Nurses Credentialing Center (ANCC) offers a Pediatric Nursing Certification (RN-BC). To be eligible, nurses must:

• Pass the ANCC pediatric nursing board certification exam, accredited by the Accreditation Board for Specialty Nursing Certification
• Hold a currently active RN license within the U.S. or hold the equivalent in another country
• Have practiced two years full-time as an RN
• Have a minimum of 2,000 hours of clinical practice in the specialty area of pediatric nursing—all within the previous three years
• Have completed 30 hours of continuing education in the area of pediatric nursing—also within the previous three years

Within the field of critical care, the American Association of Critical-Care Nurses offers the CCRN (Pediatric) certification for nurses who provide critical care to pediatric patients regardless of their physical location. To be eligible nurses must:

• Hold a currently active RN license within the U.S.
• Have practiced as an RN or APRN for 1,750 hours in direct care of acutely/critically ill pediatric patients during the previous two years, or
• Have practiced as an RN or APRN for at least five years with a minimum of 2,000 hours in direct care of acutely/critically ill pediatric patients

Where are the most jobs for pediatric home care nurses?

Most employers for pediatric home care nursing professionals are health services companies, many specializing in-home healthcare, home nursing, pediatric home healthcare, or pediatric home nursing.

The U.S. has a bit of a nursing shortage in general, particularly in the western states, so there are many opportunities for registered nurses. Some of the top cities where home health nurses earn the most pay include the following locations, according to PayScale data:

• San Diego ($35.87/hour)
• Los Angeles ($33.08/hour)
• Denver ($32.00/hour)
• Tampa ($30.97/hour)
• Houston ($29.66/hour)

Reasons for becoming a pediatric home care nurse

What is it like to be a pediatric home care nurse?

Home Healthcare Now followed Greg Burns, Maine’s Home Care Nurse of the Year, for”A Day in the Life of a Pediatric Home Care Nurse.” In the piece, the writer describes one day on the job for a pediatric home care nurse, which can involve:

• Finalizing assessments and care plans from the day before
• Completing and submitting documentation for billing purposes
• Coordinating and scheduling patient visits
• Checking vital signs
• Offering education and guidance for caregivers
• Providing treatment instructions
• Coordinating services with physicians
• Performing safety checks and cleaning of equipment
• Conducting assessment and administering daily medications
• Removing the patient from the ventilator and engaging in playtime
• Bathing, tooth brushing, and hair combing of patient
• Updating charts
• Changing suction devices
• Feedings
• Preparing medications and treatment reports for the family

Who is best suited to pediatric home care nursing?

Some of the core competencies of pediatric nurses, as determined by the Society of Pediatric Nurses, include:

• Advocacy
• Assessment
• Collaboration
• Communication
• Critical thinking
• Cultural sensitivity
• Ethical practice
• Evaluations and outcomes
• Plan of care
• Professional development and leadership
• Research and evidenced-based practice
• Safety and quality improvement
• Technology and informatics

Researchers from the Long Island University School of Nursing note that the ability to support the family caretakers of chronically ill children is also critical to success in this role.

Finally, keep in mind that, as a home health provider, you’ll often be working independently. Pediatric home care nurses must be comfortable making decisions in the moment, even as emergencies arise.

As a pediatric home care nurse, you’ll help to improve the health and well-being of extremely vulnerable patients, children with critical care issues who need ongoing support and advocacy. You’ll also have the chance to work in a non-traditional setting—in a patient’s home or on-the-go with the whole family.

Establishing a bond with children and their families takes compassion, patience, and a balanced blend of patience and grit. Sound like you? Then the role of a pediatric home care nurse may be a perfect fit.

Questions or feedback? Email editor@noodle.com