Pediatric Nurse Practitioner Salary and Practice: Results of a Midwest Metropolitan Survey

Deborah G. Loman, PhD, RN, CPNP; Shu-Ling Hung, MA, RN


J Pediatr Health Care. 2007;21(5):299-306. 

In This Article


Of the 199 surveys, 120 were returned, which represented 60% of the PNPs recognized by Missouri in this geographic area. The respondents varied widely by age, years as a PNP, type of PNP practice, and employment status (see Table 1 , Table 2 ). The median age category was 45 to 49 years, average length of time as a PNP was 10 years, and average length of current employment was 6.8 years. A total of 68% reported being a member of SLA-PNP.

The majority of the sample reported having a master's degree in nursing, and 54% reported working full time. A total of 45% reported working full time as a PNP, another 9% reported as full time but part time as a PNP, and 32% reported working part time as a PNP (see Table 2 ). Those who worked part time as a PNP averaged 24 hours per week. Those who worked full time but part time as a PNP also had other responsibilities such as administration, case management, or educator or they worked as a registered nurse.

Slightly less than half of the PNPs in practice worked in primary care (47%), while slightly more than half (53%) worked in specialty-based care. When the data from only the full time PNPs in practice were examined, the percentage in specialty practice increased dramatically (see Table 3 ). A total of 70% of the St. Louis area full time PNPs in practice reported working in a specialty area. Interestingly, 65% of the part time PNPs indicated primary care as their practice area. Of the 24 PNPs with less than 3 years of experience (including those full time and part time), 50% reported primary care and 50% reported specialty care. The most frequently listed specialties included emergency/urgent care, asthma/allergy/pulmonary, same-day surgery, hematology/oncology, critical care, and sexual abuse (see Table 4 ). A total of 3 PNPs reported working in both primary care and a specialty area such as child sexual abuse.

In terms of types of certification, 97% reported being certified as a primary care PNP, 4% as an acute care PNP, and 2% also as a pediatric clinical nurse specialist. The majority of PNPs (74%) were certified through the Pediatric Nursing Certification Board and 29% by the American Nurses Credentialing Center, with 3 people who held certification by both organizations.

Salary was reported in increments of $5,000, which is the method used since the first survey. The midpoint for each category was used, and the adjusted mean was calculated. Respondents who were part time were asked to calculate what their full time salary would be based on their current part time salary. The mean salary for all reporting respondents in 2005 was $70,045, whereas the mean salary for full time PNPs in practice was $72,788 ( Table 5 ). The lowest salary category indicated by a full time PNP in practice was $50,000 to $54,999, and the highest was $90,000 or higher (Figure 1).

Figure 1.

2005 Salary for full-time PNPs (n = 52). This figure is in color online at

The data for the full time PNPs in practice were examined to determine if there were any variables associated with a higher salary, such as specialty practice, type of practice setting, or years of experience. Analysis of variance test revealed a significant difference in salary of full time PNPs based on years of experience, F (3, 48) = 11.15, p < .001 (see Figure 2). Post hoc comparisons demonstrated the following: a significant difference between those with less than 3 years of experience and those with 6 to 10.9 years (p = .004); a significant difference between those with less than 3 years of experience and those with 11 or more years of experience (p < .001); and a significant difference between those PNPs with 3 to 5.9 years of experience and those with 11 or more years (p = .002). However, there was no significant difference in salary between PNPs who worked full time in primary care versus specialty care, t (48) = .373, p = .710 or those who worked in office, clinic, hospital, or other settings, F (3, 48) = 2.04, p = .12.

Figure 2.

Full-time PNP salary based on years of experience (n = 52). This figure is in color online at

Several other items related to salary and benefits were noted. For the PNPs in practice, 83% of those who were full time indicated that they were salaried rather than paid an hourly wage. For the part time PNPs, 39% reported being salaried. With regard to continuing education expenses, 72% of PNPs in practice received employer reimbursement of continuing education expenses, and the mean of the actual amount reported was $1,355 (range $500-$4,000). A total of 33% of PNPs in practice reported receiving bonuses and these were based on unit/office productivity, individual productivity, or other factors.

In Missouri, a collaborative practice agreement (CPA) with a physician is required for an APN to have prescriptive privileges. A total of 97% of the PNPs in practice had a CPA, with the mean number of primary collaborating physicians given as 1.9 and the mean number of designated or alternate physicians as 3.5. Other practice areas of interest included receiving malpractice insurance from employer (76%), taking call as part of their work responsibilities (14%), having hospital privileges to make nursery rounds (15%), having hospital privileges that allow writing orders (48%), having a signed contract with their employer (30%), and being credentialed by insurance companies and/or Medicaid plans for reimbursement (37%). Only 1 person (1%) reported having an NP-related business. The most frequent barriers to advanced nursing practice that were cited included reimbursement issues (31%), prescriptive privilege issues (26%), and recognition of NPs by other professionals (20%).

The respondents also answered questions about various types of employment benefits. The most commonly offered benefits for all respondents included retirement savings plan (93%), dental insurance (80%), health insurance (89%), life insurance (77%), and tuition benefit (65%).

Types of educational offerings desired by the respondents were the following: primary care (73%), update on legislation and issues (70%), acute care topics (57%), and urgent care topics (55%). Specific educational offering requests included mental health problems, pharmacology, and a wide variety of other topics. Several respondents wrote that although they worked in specialty care, they needed to maintain and update knowledge in the primary care area.


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