The Pediatric Nurse provides specialized nursing care to patients from birth through adolescence across inpatient, outpatient, and emergency settings, reporting to the Pediatric Charge Nurse or Nurse Manager. What makes pediatric nursing structurally different from adult nursing is not simply smaller patients; it is the layered communication dynamic that always involves the child, the caregiver, and often siblings or extended family as part of the care unit. Success in this role means achieving clinical outcomes that meet or exceed unit benchmarks while maintaining family satisfaction scores above the 85th percentile. Pediatric nurses must be clinically precise and developmentally fluent, able to adjust their assessment approach and communication style for a six-month-old, a six-year-old, and a sixteen-year-old within the same shift.
Perform age-appropriate assessments across developmental stages, including infants, toddlers, school-age children, and adolescents, adjusting clinical techniques accordingly.
Calculate and verify weight-based medication doses independently, cross-referencing with pharmacy for high-alert pediatric medications.
Monitor for pediatric-specific deterioration signs using validated tools such as the Pediatric Early Warning Score (PEWS) and escalate per rapid response protocol.
Administer and monitor IV fluids, blood products, and medications through age-appropriate access routes, including peripheral IV, PICC, and central lines.
Communicate clinical information to caregivers in plain language, ensuring they understand the treatment plan, expected trajectory, and warning signs requiring immediate attention.
Provide developmentally appropriate pain and anxiety management using pharmacological and non-pharmacological techniques, including child life collaboration.
Maintain and troubleshoot enteral feeding devices, tracheostomies, and other medical equipment for medically complex pediatric patients.
Support family-centered care by involving caregivers in care planning, shift reporting at bedside, and daily goal setting.
Recognize and report suspected child abuse and neglect per mandatory reporting requirements, coordinating with social work and the appropriate authorities.
Complete transition planning documentation for patients with chronic conditions or complex care needs preparing for discharge.
Participate in pediatric code response and demonstrate competency in pediatric resuscitation algorithms quarterly.
Educate families on discharge care including wound management, medication administration, follow-up scheduling, and return-to-ED criteria.
CPN (Certified Pediatric Nurse) credential from the Pediatric Nursing Certification Board (PNCB).
Experience in pediatric subspecialty care: oncology, cardiology, neurology, or pulmonology.
Child life collaboration experience and trauma-informed care training.
Mandatory reporter training and experience working with CPS and social work teams.
Experience with medically complex children including tracheostomy, G-tube, and ventilator management.
Weight-based medication dosing and high-alert medication verification
Pediatric IV access, PICC management, and central line care
Age-appropriate assessment techniques across developmental stages
PALS algorithms and pediatric code response
PEWS scoring and rapid response escalation
Enteral tube and tracheostomy management
EHR documentation in pediatric platforms
Developmentally appropriate communication with children of all ages
Family-centered care and caregiver partnership
De-escalation skills with anxious or distressed families
Mandatory reporter judgment and documentation
Resilience and emotional regulation during pediatric adverse events
Pediatric nurses earn $78,000 to $100,000 annually in most U.S. markets, consistent with the national RN median of $86,070 (BLS, May 2023). CPN certification typically adds 6-10% to base compensation. Nurses in subspecialty pediatric units such as PICU or pediatric oncology command salaries toward the upper end. Children's hospitals in major metro markets often pay above the national median due to competition for specialized talent. Source: U.S. Bureau of Labor Statistics, May 2023; PayScale, 2025.
San Francisco Bay Area, CA ($108,000 - $130,000)
Seattle, WA ($100,000 - $122,000)
Boston, MA ($97,000 - $118,000)
New York, NY ($96,000 - $116,000)
Washington, DC metro ($94,000 - $114,000)
Pediatric nursing positions typically offer comprehensive medical, dental, and vision coverage, 401(k) with employer matching, 3-4 weeks PTO, PALS recertification support, and CPN exam reimbursement. Many children's hospitals offer expanded childcare benefits, tuition assistance, and staff wellness programs given the emotional demands of the specialty.
Cannot explain weight-based medication dose calculation confidently: Pediatric medication errors are disproportionately dangerous. Any candidate who cannot walk through the calculation process clearly represents an immediate safety concern.
Frames pediatric care as "basically the same as adults, just smaller": Pediatric physiology, pharmacokinetics, and communication requirements are meaningfully different. This framing reveals an inadequate understanding of the specialty.
Has no framework for working with distressed or uncooperative caregivers: Families under stress can become barriers to care. Candidates who cannot describe a strategy for this will struggle in family-centered environments.
Unfamiliar with mandatory reporting obligations: Every pediatric nurse is a mandatory reporter. Candidates who do not understand this responsibility or who express reluctance about reporting raise serious concerns.
No experience with PEWS or equivalent deterioration tools: Pediatric patients can deteriorate rapidly. Candidates unfamiliar with early warning scoring tools require significantly more orientation investment.
Q What does a pediatric nurse do?
A A pediatric nurse provides nursing care to children from birth through adolescence, adapting assessment and treatment approaches across developmental stages. Responsibilities include medication administration, family communication, deterioration monitoring, pain management, and discharge education for caregivers in inpatient and outpatient settings.
Q What qualifications do you need to be a pediatric nurse?
A You need an active RN license, PALS and BLS certification, and 2-4 years of pediatric nursing experience. BSN is preferred by most employers. The CPN credential from PNCB is the recognized specialty certification and is increasingly expected for senior staff positions at children's hospitals and subspecialty units.
Q How much does a pediatric nurse make?
A Pediatric nurses earn $78,000 to $100,000 annually in most U.S. markets, consistent with the national RN median of $86,070 (BLS, May 2023). CPN certification and subspecialty experience in units like PICU or pediatric oncology push compensation toward the upper end of this range.
Q What skills are required for a pediatric nurse?
A Pediatric nurses need weight-based medication calculation, age-appropriate assessment, PALS competency, PEWS scoring, and IV management for small patients. Soft skills are equally critical: developmentally appropriate communication, family-centered care, de-escalation with distressed caregivers, and mandatory reporter judgment.
Q What is the career path for a pediatric nurse?
A Pediatric nurses advance to charge nurse, pediatric clinical educator, or specialty unit roles such as PICU, NICU, or pediatric oncology. With an MSN, options include Pediatric Nurse Practitioner, Clinical Nurse Specialist, or Nurse Manager. Academic medical centers offer research and faculty pathways as well.
Q What are the biggest challenges facing pediatric nurses today?
A Pediatric nurses face rising rates of medically complex children with multiple chronic conditions, creating higher acuity across units once considered lower intensity. Caregiver mental health challenges are also increasingly affecting care dynamics. Staffing shortages at children's hospitals are acute, with few experienced pediatric nurses available in the pipeline to replace retiring staff.