PNP vs. NNP

[joeb1, ASN, BSN, RN]

Ok, I know this is probably a decision that will need to be more about what I want more than anything. I have as an RN a couple years in Pediatrics and a couple years in Labor/delivery/nursery. NNP's, most of you probably work in hospitals, am I correct? Where do the PNP's here work? Another question is the competitiveness of the programs as far as which has more schools, potential for employment, etc.? I also am curious about the autonomy of one versus the other. Lastly, and this is probably my least concerning question as job satisfaction far outweighs monetary satisfaction, what is generally the difference between NNP's and PNP's? Obviously this varies greatly but I was wanting just a very generic outlook. Thank you very much.

[SarasotaRN2b]

Hi joeb1,

I'm still on my journey towards my RN, but I'm looking into being a NNP with some post masters certificates in Acute and Chronic Pediatric care (Rush University has this) which is based both in hospital (in PICUs) and outside.

Kris

[zahryia, LPN]

You might want to PM SteveRN21. He is working on his NNP

[SteveNNP, MSN, NP]

Hey....

Basically the PNP cares for a full scope of pediatric patients, usualy ages 0-18. They can work in both outpatient and inpatient, acute and chronic areas.

NNP's scope is limited to 0-2 yrs of age, but focuses specifically on neonates. Most, if not all NNPs work either in a hospital, followup clinic, or flight team. You become skilled in taking a full caseload of patients, performing tasks such as intubation, vent management, chest tube and umbilical line placement, arterial lines, central line placement, critical care transport, etc....

Autonomy wise, I can only speak to the NNPs, and it seems to differ according to facility. Some places use NNPs in a resident-like role, others rely on them to manage their own patients and practice pretty independently.

With a PNP you have a much broader scope of practice. You would feel VERY out of touch in NICU however. I rarely see PNPs hired in a NICU. It's just too specialized to NOT have focused your entire grad education on it ....Some PNPs I know have amazing jobs on the peds cardiology service, managing open hearts, transplants, etc... however the NNPs manage neonatal pre/postop open hearts where I work ...

I hope this helps a little. PM me if you need any more help.

[scribblerpnp]

Hi!

As you can see, I am a PNP. Please feel free to IM me with questions! I work in private practice in primary care. My hours are pretty solid Monday through Friday 9-5. No holidays, and I don't see pts in the hospital, (though I certainly did at one time and certainly could again- I just don't like to).

Job opportunities can vary according to where you live. But for the most part, if you live in an area where there is a pediatric hospital (not a peds unit inside a reg hospital) or are willing to move to an area where there is a peds hospital, the job opportunities are excellent. Some rural areas may be difficult because clinics will want an FNP to cover more population ages.

As a PNP I can manage the care of children from 0 to 21 yrs (NOT 18 yrs as previously stated by another poster). I can go higher in age, but only in certain cases. Think CP or CF adults that may still go to a children's hospital for care. NNPs go from birth to 2 years, though there may be extended ages as well.

NAPNAP or National Association of Pediatric Nurse Practitioners has a great website that may answer a lot of your questions: http://www.napnap.org

I am able to manage the care of preemies, and theoretically could work in a NICU, but I would never do that. I have no NICU experience, and I think it would be difficult to get hired in that position if NNPs were also applying. If you want to work in a NICU, NNP is the best.

I can and do care for preemies AFTER they get out of the NICU!

I'm sorry that I probably didn't answer all your questions, but I can't remember all of them. I am happy to answer any questions you may have via IM.

[scribblerpnp]

Forgot to mention, that some of my PNP friends work in children's hospitals. One is on the surgical team and her job is rounding on all of the assigned surgical pts, and basically managing the in-pt care, providing education, etc , so the doc can run by and spend less time writing up orders and notes.

Another friend works at the health dept and is head of the vaccine program, writes protocols, policies, etc and doesn't really see pts any more.

Just as in being an RN, PNP's have a very wide range of job opportunities.

[bayouchick02]

I am interested in going that route as well. I have nicu experience, but do you reccommend that I obtain pediatric experience prior to becoming a PNP, or does it really matter? I was told by one school, that NICU experience would be fine, another school suggested that I volunteer at a pediatric clinic or shadow a school nurse or something like that to gain SOME of that pediatric experience.

Hmm... M-F 9-5, no holidays, and no patient visits in hospitals. I would LOVE, LOVE, LOVE that schedule as a PNP. Is that typical or PNP's? Is it realistic to want a schedule like yours for those who would just be starting out as a new PNP or would u recommend that I take whatever I can get for my first job?

One last question: do PNP's cap-out after so many years of experience the way RN's do?

Thank you so much for your help, anything would be greatly appreciated!!

[scribblerpnp]

Hmm... M-F 9-5, no holidays, and no patient visits in hospitals. I would LOVE, LOVE, LOVE that schedule as a PNP. Is that typical or PNP's? Is it realistic to want a schedule like yours for those who would just be starting out as a new PNP or would u recommend that I take whatever I can get for my first job?

One last question: do PNP's cap-out after so many years of experience the way RN's do?

Thank you so much for your help, anything would be greatly appreciated!!

I went straight into PNP school after finishing nursing school and worked at a peds hospital during my two years of graduate school. If you want to be a PNP, getting peds experience during school would probably be a good idea. Maybe PRN?

The job I have now is in the same office where I got my first PNP job. Different management though. The doctor who now owns the practice (and used to be a co-worker- she bought out the first owner), is very laid back and let me make the deicision about the hospital thing.

I did take what I could for my first job, and I shouldn't have- though maybe now I would have the great job that I do! My first job (under the previous owner) was awful. I felt that I was just out of school and would have done anything to get that first job. Add that to looking for a PNP job in an area that 1) Does not have a peds hospital, 2) Doesn't have any other PNP's in the area (closest one is at least 1 hour away by car). 3) No one new anything about NP's other than the FNP type!

I made a lot of mistakes with my first contract because I was willing to take crap since I was a new grad and wanted to move back to my rural hometown. Under the current owner, I knew what I wanted to be different, asked for it, and got it. I had the crap job for a year, so maybe it was worth it in the end, if that means it was the way to get where I am now.

As far as capping out, I don't know. I am still under 5 years experience. I do know of some RN's who have been RN's so long that the starting wages of an NP is actually a pay cut, but that wasn't the case for me, since I had been an RN two years prior to being a PNP.

I also know of an RN/PNP (with little PNP experince) who has been one for a very long time. She is working per diem at a local hospital as an RN and making about 5.00 more per hour than I do working per diem as a PNP.

As far as that schedule, depends. Most of the PNP's I shadowed as a PNP student had similar schedules. So it can be found.