A Day in the Life of a Nurse Practitioner: Primary Care Pediatrics

by Jacklyn DelPrete, EdD, CRNP, FNP-c
Nov 15, 2023
Articles

Have you ever thought about what it would be like to work with children as a primary care nurse practitioner? Maybe you aren’t sure about working with kids, and you’re wondering if it’s for you. If so, this post may help you decide!

I’ll walk you through how I became a family nurse practitioner (FNP) and wound up working with children, and describe a typical day at the office taking care of kids with acute and chronic issues from birth through early adulthood, so you can see if it sounds like a fit for you.

Of course, working with kids isn’t for everyone. I certainly didn’t think it was for me! But it’s turned out to be such a rewarding experience, I wouldn’t trade it for the world!

My Journey to Becoming a Nurse Practitioner

As I mentioned before, my certification is as an FNP, which means that I can care for children and adults, from birth through death (or “cradle to grave,” as they say). But, I must admit, that’s not why I got into it. I chose the FNP specialty because that’s what was offered at the program I applied to, not because I had some great passion for family medicine.

To be completely honest, I originally wanted to work with older adults in nursing homes and assisted living facilities. I didn’t really have any plans beyond that. While in NP school, I told myself I just needed to get through my pediatrics course and keep moving forward. I didn’t struggle with the material, and I had a fabulous preceptor in my clinical rotation, but it still just wasn’t my passion at the time.

My First Nurse Practitioner Job

When I graduated, I was having a hard time finding an NP position in a long-term care facility, and I decided to apply for a job at an internal medicine office, where the youngest patients I’d care for were in late adolescence. I interviewed, got along well with the physician and the staff, and ended up taking the job!

I was told the organization wanted to expand their patient reach to include pediatrics and general women’s health. So, the two main specialties I thought I was never going to use were going to become my main focus!

I ended up working in family medicine for two years at the practice, seeing patients from newborns through late adulthood. I cared for babies just released from the hospital, and my oldest patient was well into her nineties. I loved it! It was so fulfilling to build rapport and relationships with patients and their families.

After two years, I left full-time practice to teach at a university, and my clinical practice changed to a per-diem role in a long-term care facility. In those four years, I had the honor of caring for older adults, managing their chronic illnesses, and helping them at the end of life.

During this time, the COVID-19 pandemic happened. It was devastating to that vulnerable population, and I was starting to feel like I needed a change.

An Unexpected Email

In March 2022, I received an email from a local pediatrician who was looking for any potential leads on an NP student who might be looking for a part-time role. By that time, I had been an NP professor for about five years and the pediatrician got my contact information from the university I worked for. I decided to call him back, but without any particular students in mind who might be interested in a part-time role.

After speaking with him and the office manager, I decided this could be a great opportunity for me! It was for one to two days a week, which worked perfectly with my teaching schedule. I ended up having an interview with him, and took the job!

My story goes to show that you never know when a new opportunity will present itself. This was just the kind of change I was looking for!

So…What Does It Mean to Be a Pediatric Nurse Practitioner?

In my position, I have a primary care focus. There are some pediatric nurse practitioners that specialize in things like cardiology or endocrinology, and there is also an acute care pediatric NP specialty where you can care for children in the hospital.

I, however, focus on health promotion, disease prevention, and the treatment of common illnesses. This means that I conduct well-child examinations, order vaccinations, oversee referrals to specialists, review lab work and imaging studies, and see patients for acute injuries and illnesses.

For me, there are several benefits to this type of role. First, I work during normal business hours. I’m scheduled to work one to two days a week from about 8:30 am to 5 pm. This works so well with my family schedule.

Second, I get to care for kids! My time in family medicine really allowed me to improve my communication skills, and I learned how to work with kids and their parents. Children of any age bring such joy, and it’s a true privilege to be able to care for them.

And third, I’ve found a very supportive group of people to work with. I can’t emphasize enough how important it is to find a job where you can see yourself fitting into the culture of the office. The people I work with make the day so enjoyable, I really feel supported, and I can use the full extent of my NP expertise.

A Day in the Life Of a Pediatric Nurse Practitioner

So, let’s walk through a typical day at the office! On the days that I work, I’m the only provider seeing patients. For support staff, I have two secretaries managing patient check-in and checkout, general phone calls, chart audits, and scheduling.

I also have two nurses with me. One works with me side-by-side to room patients (for height, weight, and vital signs), administer vaccines, and assist me with tests and treatments. Another nurse triages phone calls for sick kids, manages referrals, organizes lab results, and anything else I need to review. I have a great team with me!

Morning

I start seeing patients around 8:30 am. We try to have most of the well-child examinations in the morning and early afternoon. These visits are about 20-25 minutes long, and I review developmental milestones in infants and younger children, and school performance in older children. I cover topics related to their diet, activity, social relationships, and overall growth.

Next, I complete a thorough physical exam and address any concerns. A lot of what I do during these well exams is anticipatory guidance, or teaching parents and children what is normal for the child’s age, and what they can expect in the next few months or a year.

Afternoon

Throughout the morning and for most of the afternoon, there are open time slots for sick visits, which are typically 10-15 minutes long. The sick visits can be for abdominal pain, an orthopedic injury, rashes, and (at this time of year!) any combination of cough, cold symptoms, sore throat, or ear pain.

During the summer months, there are less sick visits, so we fill those slots with sports physical clearances, and then during the fall, winter, and spring months, we leave more room for sick visits.

On most days, I also have two or three medication follow-ups. Along with the pediatrician, I help to manage children with ADHD or mild depression. We conduct frequent follow-ups to check in and make sure the patient is doing well with their medications.

Ending the Day

A typical day ends for me around 5 pm. I do participate in the call schedule, which means that every few weeks, I’m available for patient telephone calls after office hours. A lot of the phone calls involve educating parents on how to treat symptoms, when the patient needs to be seen in the office, or when they should go to the emergency department.

I Love Being a Pediatric NP!

As I said at the beginning, my FNP certification has allowed me to work in family medicine, long-term care, and now pediatrics. The possibilities are endless! If you’re undecided about what your long-term NP career goals are, the flexibility that comes with being an FNP might be a great option for you!

As a NP currently working in primary care pediatrics, I go to work excited about the patients I’m going to see. I understand how pediatrics may be intimidating, or just something you don’t think you’re interested in, but I urge you to keep an open mind. Like me, you never know what opportunity might come your way!

A Day in the Life of a Nurse Practitioner: Primary Care Pediatrics