PNP-AC (Acute Care) vs. PNP-PC (Primary Care) | Pediatric NP
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Registered nurses (RNs) who enjoy working with children can consider a career as a pediatric nurse practitioner. With a master’s of science in nursing (MSN), a post-master’s certificate, or a doctorate of nursing practice (DNP) degree, an RN can become a nurse practitioner specializing in pediatrics, providing healthcare for children and their families. Nurse practitioners pursuing a pediatric specialization can choose between acute and primary pediatric care or a dual specialization.
While both programs will prepare NPs to work as pediatric nurse practitioners, there are critical differences in deciding which program to enroll in. This guide explains the similarities and differences between acute and primary care pediatric nurse practitioner specialties to help current and future nurse practitioners decide which path is right for them.
A commonly asked question is: what is the age range for pediatric patients? According to the American Academy of Pediatrics, pediatric care spans from periconceptional through young adulthood. By this definition, pediatric NPs work with a wide range of children and families, including expectant mothers and parents, newborns, children, and teenagers. It’s important to note that pediatric nursing is not to be confused with neonatal nurse practitioners who work specifically with infants aged zero to four weeks.
Both pediatric nurse practitioner acute care (PNP-AC) and pediatric nurse practitioner primary care (PNP-PC) programs are designed to prepare students to become pediatric nurse practitioners. However, there are some critical differences between the two types of programs.
PNP-AC programs can be completed in slightly less time compared to PNP-PC programs since they focus less on overall health and more on health for specific situations. In addition, PNP-AC programs require students to complete clinical rotations in an acute care setting, such as a hospital or emergency room. As a result, the working hours in these positions may be more erratic, and NPs working in acute pediatric care can expect to be on-call during early morning, regular, and late-night hours.
On the other hand, PNP-PC programs typically have a stronger focus on primary care. Students in these programs complete clinical rotations in settings such as doctor’s offices, clinics, or community health centers. In addition, PNP-PC programs may require students to take courses in family health, child development, and chronic disease management. These healthcare facilities are typically open during business hours and have more predictable schedules.
How to decide which program is the right fit for you? The type of program you choose should be based on career goals. For example, a PNP-AC program may be the right fit if you are interested in working in an acute care setting, such as a hospital or emergency room. On the other hand, a PNP-PC program may be a better career choice for nurse practitioners interested in working in a primary care environment such as a clinic. Those who want to earn both specializations can attend a dual AC/PC nurse practitioner program and earn a dual certification.
Read on to learn more about pediatric NP specializations in acute (PNP-AC) and primary care (PNP-PC), including career outlook, salary data, accredited online programs, and licensure and certification.
Career Outlook: Acute Care and Primary Care Pediatric NPs
The job market looks good for both acute care and primary care pediatric nurse practitioners. The US Bureau of Labor Statistics (BLS) shows the demand for nurse practitioners, nurse anesthetists, and nurse-midwives will grow by 40 percent in the coming decade (BLS 2022). This growth is eight times faster than the national average (5 percent) and is estimated to create 118,600 new jobs between 2021 and 2031.
Acute and primary care PNPs are in high demand for many reasons, one of which is the increasing prevalence of chronic conditions among children and adolescents, according to the Centers for Disease Control and Prevention (CDC).
The BLS does not keep specific statistics on the career outlook for acute and primary care pediatric nurse practitioners. However, BLS data from May 2021 shows the top employing industries of nurse practitioners:
- Offices of physicians: 110,490 nurse practitioners employed
- General medical and surgical hospitals: 52,790
- Outpatient care centers: 22,630
- Offices of health other practitioners: 9,360
- Home health care services: 6,630
As previously stated, primary care PNPs typically work in clinics and physician’s offices. Given that nearly 60 percent of all nurse practitioners worked in physician offices, outpatient care centers, and health practitioner offices, it can be assumed that primary care PNPs are more in demand than acute care PNPs. By comparison, 22 percent of all nurse practitioners employed in May 2021 worked in medical and surgical hospitals, including emergency room and intensive care units, which is the most common work environment for acute care PNPs.
How Much Do Acute Care and Primary Care Pediatric NPs Make?
Salary depends on several factors, including experience, education, and the employment industry. In addition, the regional cost of living is an important factor influencing pay.
The BLS does not list specific salary data for PNPs with acute or primary specialization, but it does break down nurse practitioner salary data. According to the BLS (May 2021), nurse practitioners earned an average annual salary of $118,040.
PNP Salary: Experience & Education
In general, newer NPs with less education and experience are on the lower end of the salary spectrum and NPs with more education and experience earn higher salaries. Pediatric NPs have specialized education beyond general nurse practitioner curricula. Here are the salary percentiles for nurse practitioners (BLS May 2021):
- 10th percentile: $79,470
- 25th percentile: $99,540
- 50th percentile (median): $120,680
- 75th percentile: $129,680
- 90th percentile: $163,350
This data closely correlates to salary percentiles for pediatric nurse practitioners (specialty not specified) from Salary.com in February 2023, with higher amounts paid to those in the first two percentile categories:
- 10th percentile: $99,272
- 25th percentile: $106,100
- 50th percentile (median): $113,600
- 75th percentile: $119,200
- 90th percentile: $124,299
PNP Salary: Top-Paying Industries
Pediatric NPs working in specific industries can earn higher salaries compared to others. Here are the top-employing industries for nurse practitioners (BLS May 2021):
- Accounting and payroll services: $148,980 per year on average
- Business, professional, labor, and political organizations: $133,800
- Home health care services: $133,170
- Psychiatric and substance abuse hospitals: $131,830
- Outpatient care centers: $129,190
The BLS does not keep specific industry data for pediatric NPs. However, PNPs with acute and primary care specializations can work in the above industries.
PNP Salary: Cost of Living
Salary typically correlates with the cost of living in a particular area. Generally, the coastal states and states with large metropolitan areas pay higher salaries due to the higher cost of housing, utilities, transportation, and groceries in these areas compared to other areas of the United States.
Here are the top-paying states for nurse practitioners (BLS May 2021):
- California: $151,830 average per year
- New Jersey: $137,101
- New York: $133,940
- Washington: $130,840
- Massachusetts: $129,540
The Missouri Economic Research and Information Center (MERIC)’s cost of living data series ranks the 50 US states and Puerto Rico in terms of affordability. For context, nurse practitioners living and working in New Jersey and Washington are ranked #39 and #40 on the list, making them a more affordable place to live and work compared to New York, California, and Massachusetts, which rank in the top five most expensive states to live in February 2023.
In sum, PNPS may be often able to command higher salaries than other types of NPs due to their specialized skill sets, and certification training. Keep reading to learn more about PNP certification in the section below.
Accredited Acute Care and Primary Care Pediatric NP Programs
There are numerous accredited acute care and primary care pediatric NP programs to help RNs become qualified pediatric nurse practitioners. Many of these graduate and doctoral programs are offered in a hybrid format, a combination that includes online courses and in-person clinical experiences. Common degree and certificates conferred include the following:
- Master of science in nursing (MSN) with acute, general care, or primary care pediatric specialization
- Post-master’s certificate with acute, general care, or primary care pediatric specialization
- Doctorate of nursing practice (DNP) with acute, general care, or primary care pediatric specialization
Online NP programs offer the same high-quality education as traditional on-campus programs, but are delivered through an online learning platform. This allows students to complete coursework full-time or part-time at their own pace, with greater flexibility than traditional on-campus programs. Please see our Top Online Pediatric Nurse Practitioner Programs page for ranked, reputable, and accredited PNP programs.
Acute Care Pediatric NP Programs
The University of South Alabama (USA) is ranked #1 by NPSchools.com for offering multiple programs with a variety of degree entry points, NP specializations (including acute and primary pediatrics), affordable tuition rates, and minimal campus residencies. In addition, students in this program can choose between acute and primary pediatric specialties at the MSN, post-master’s, and DNP levels.
The acute care specialization at the DNP level is a 69-credit online program with one campus visit. The DNP program with an acute pediatric specialty requires more than 1,000 clinical hours. Applicants to this program should have a minimum 3.0 GPA, two years of nursing experience, and a bachelor of science in nursing. The GRE is not required for admission.
- Location: Mobile, AL
- Duration: Two to seven years (depending on program type)
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Tuition: $594 per credit
The University of Cincinnati’s online BSN-to-DNP program for acute care pediatric nurse practitioners is a 79-credit program that requires two campus visits. Applicants must have experience in pediatric nursing, as well as an unencumbered RN license.
Application materials include the application and application fee, resume or CV, three or more letters of recommendation, a goal statement, and official transcripts. There is no GRE required for this program. Upon completion of the program, students will be prepared to provide care for children with acute and chronic conditions in a variety of settings.
- Location: Cincinnati, OH
- Duration: 3-5 years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Tuition: $746 per credit (residents); $1,333 per credit (non-residents)
Primary Care Pediatric NP Programs
The University of Missouri offers a BSN-to-DNP program as well as an MSN-to-DNP program for those interested in becoming a primary care pediatric nurse practitioner. The graduate certificate in pediatrics clinical nurse specialist is also available for those acute care pediatric nurse practitioners who wish to expand their knowledge and skills. The program requires eight campus visits and 72.5 credits for completion.
Applicants must have a bachelor of science in nursing and a minimum 3.0 GPA. Those who are accepted into the program can complete the coursework in three to five years with full- or part-time study. After completing the program, students will be eligible to take the national certification exam.
- Location: Columbia, MO
- Duration: Three to five years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Tuition: $600.87 per credit
Texas Tech University offers a BSN-to-MSN program focusing on primary care pediatric nurse practitioners. The program is 49 credits and requires six campus visits. Applicants must have a bachelor of science in nursing with a 3.0 GPA or higher. The GRE is not required for admission. The program prepares nurses to provide primary care to children from birth to age 21.
Nurses in the program will learn how to diagnose and treat common childhood illnesses, as well as how to manage chronic conditions. They will also gain experience working with families and children in a primary care setting. Upon completion of the program, graduates will be eligible to take the national certification exam to become certified primary care pediatric nurse practitioners.
- Location: Lubbock, TX
- Duration: Three to five years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Tuition: $265 per credit (residents); $673 per credit (non-residents)
Licensure & Certification: Acute Care and Primary Care Pediatric NPs
Once graduating from a graduate or doctoral program, licensed registered nurses (RNs) must take and pass one or more certification exams in order to practice as licensed advanced practice nurse practitioners or APRNs legally. Nursing licensure requirements vary by state and are regulated by the National Council of State Boards of Nursing (NCSBN).
PNP Certification
There are several certifications to choose from, but here are the two most common ones conferred by the Pediatric Nursing Certification Board (PNCB) for pediatric nurse practitioners are:
- CPNP-PC: Primary Care Certified Pediatric Nurse Practitioner
- CPNP-AC: Acute Care Certified Pediatric Nurse Practitioner
- CPNP-AC/PC: Dually Certified Pediatric Nurse Practitioner
Eligibility requirements to sit for any of the PNP credential exams above include:
- A current and unencumbered registered nurse (RN) license
- A master’s (MSN) or doctoral (DNP) degree with a concentration in acute care or primary care in pediatric nursing from an ACEN- or CCNE-accredited program, or
- A post-master’s certificate from an accredited college or university
- A minimum of 500 supervised direct care clinical practice hours in acute care or primary care pediatrics (the PNCB strongly recommends a minimum o 600 hours)
- Completing three separate graduate-level courses in advanced physiology/pathophysiology; advanced health assessment; and advanced pharmacology
Once passing the specialization exam, PNPs will be eligible to practice as a pediatric nurse practitioner in most states.
PNP Recertification
Pediatric nurse practitioners must recertify with the PNCB every year between November 1 and January 31. CPNPs are also required to complete pediatric pharmacology hours and PNCB Pediatric Updates CE modules every seven years.
The recertification process helps to ensure that CPNPs are up-to-date on the latest advancements in pediatric care and medication management. This is done by earning continuing education credits through professional organizations such as the National Association of Pediatric Nurse Practitioners (NAPNAP) and others.
By keeping credentials current, CPNPs can maintain their national certification, which is essential for maintaining their state licensure. Recertifying on time ensures that CPNPs can continue to provide the highest quality of care to their patients.
Kimmy Gustafson
WriterAmong her many diverse writing endeavors, Kimmy Gustafson has also lent her expertise to NPSchools.com since 2020, providing insightful and engaging content about the significant role of education in shaping our future generations of nurse practitioners. Many of her pieces include interviewing experts on timely topics such as healthcare workplace violence and moral distress.
Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.