Neonatal nurse practitioner

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Neonatal nurse practitioner
Neonatal Nurse Practitioner.JPG
An NNP caring for a newborn at a high risk delivery
Occupation
Occupation type
 Professional
Activity sectors
 Healthcare, advanced practice registered nurse
Description
Education required
Master's degree or Doctorate degree
Related jobs
 nurse midwife, nurse anesthetist, clinical nurse specialist

A neonatal nurse practitioner (NNP) is an advanced practice registered nurse (APRN) with at least 2 years experience as a bedside registered nurse in a Level III NICU, who is prepared to practice across the continuum, providing primary, acute, chronic, and critical care to neonates, infants, and toddlers through age 2. Primarily working in neonatal intensive care unit (NICU) settings, NNPs select and perform clinically indicated advanced diagnostic and therapeutic invasive procedures. In the United States, a board certified neonatal nurse practitioner (NNP-BC) is an APRN who has acquired Graduate education at the master’s or doctoral level and has a board certification in neonatology. The National Association of Neonatal Nurse Practitioners (NANNP) is the national association that represents neonatal nurse practitioners in the United States. Certification is governed by the National Certification Corporation for Obstetrics, Gynecologic and Neonatal Nursing Specialties (NCC).

Contents

History

The first modern day NICU opened in 1960 at Yale-New Haven Hospital under the auspices of Louis Gluck, a pioneer in the emerging pediatric specialty, neonatology. [1] [2] Dr. Gluck’s NICU concept demonstrated improved outcomes of sick and preterm infants and led to the emergence of NICUs across the country by the late 1960s. [2] Most NICUs were located in large, university settings with patient management provided by medical interns and residents supervised by a neonatologist. To meet the needs of this vulnerable population, nursing roles expanded to include tasks previously relegated to physicians, such as initiating intravenous access and phlebotomy. [1]

In 1965, the first nurse practitioner program in the United States was developed at the University of Colorado to prepare pediatric nurse practitioners for primary care. [3] By the 1970s, neonatal intensive care was an integrated medical service in many large teaching hospitals across the country, providing successful management of the preterm and sick newborn and reducing the neonatal mortality rate. [1] [2] Neonatal transport services were established to move newborns from their birth facility to the nearest NICU, enabling expansion of the NICU nursing role as nurses filled these new positions. Guidelines published by the American Nurses Association (ANA) in 1975 set the NNP program standards until NANN published Education Standards and Guidelines for NNP Programs in 2002. [4] [5] These ANA standards led to the proliferation of hospital-based, certificate programs to train nurses as NNPs.

National certification for NNPs began in 1983 by the NAACOG Certification Corporation, now the National Certification Corporation (NCC) for Obstetrics, Gynecologic and Neonatal Nursing Specialties (NCC). [1] NANN was established in 1984, providing support to foster the neonatal advanced practice nursing movement. [2]

In the 1990s, states began requiring national certification or master's degree as entry into practice for the NNP. [2] In the early 2000s, nurse practitioners lobbied for prescribing privileges to make their provider status fully operational. In 2007,a division of the National Association of Neonatal Nurses (NANN), was founded as the only national association dedicated solely to NNPs. [6]

Today, neonatal APRNs are recognized as professional providers, and they have become an integral part of the neonatal health team at all levels of care. [7] Fifty-two states and jurisdictions already require advanced certification for APRNs. [8]

Education

To take the first step at becoming a neonatal nurse practitioner, a registered nurse (RN) must achieve a Bachelor of Science in Nursing degree (BSN). Before an application can be submitted for a Master's or Doctoral degree, at least two years of experience in a neonatal care unit is needed. [9] When applying for a Master’s and/or Doctoral degree, it needs to be from an accredited nursing school with a specialty in neonatology. These programs can take about two to three years. The classes that will be taken will be focused on neonatology, while there will also be a variety of core classes. After completing the program, it is required to apply to take the NNP exam through the National Certification Corporation (NCC) for national certification. Once passing this exam, there is another exam that must be passed for state certification. These certifications need to be renewed every few years for the continuing practice of being a NNP. [10]

Board Certification

Following educational preparation at the master's or doctoral level, most states require NNPs to be board certified by an approved certification body. Board certification must be maintained by obtaining continuing nursing education credits. In the US, board certification is provided through the National Certification Corporation (awards the NNP-BC credential). The exam for the certification consists of 175 questions and a three hour time limit. These questions cover topics related to pharmacology, general management, a general assessment, professional issues, and a majority of the content is on embryology, physiology, pathophysiology, and systems management. [11]

Scope of practice

The neonatal nurse practitioner provides specialized care for newborns with a wide range of acuity (level of illness) and conditions from prematurity, infections, genetic conditions, heart disease, surgical diagnoses, respiratory problems, and other disorders. NNPs primarily work in the hospital setting in well-baby nurseries, special care nurseries, neonatal intensive care units and the delivery room. Neonatal nurse practitioners can also work in office settings or private practices. Their specialized training allows them to provide individualized care to infants from the moment of delivery and from well babies to critically ill newborns . NNPs typically work in collaboration with Neonatologists and/or Pediatricians but (in most states) are licensed, independent providers who can diagnose and treat patients. NNPs have prescriptive authority and can prescribe medications as needed for the neonatal population (in most states). [10] Hours for neonatal nurse practitioners can vary a great deal. They typically work 40-hour weeks but might have to pick up overtime depending on the status of the patients and if there is another nurse to take over. The shifts can be five eight-hour shifts a week, four ten-hour shifts, or 3 twelve-hour shifts. Neonatal nurse practitioners can also have the possibility of working holidays. [12]

Day to day duties

Neonatal nurse practitioners will work with newborns daily. NNP take vital signs and monitor the newborns very closely since their conditions can deteriorate very fast. Neonatal nurse practitioners will perform, order, and analyze tests on the newborn. NNP will also create treatment plans and support the parents of the infant. Neonatal nurse practitioners will need to be physically in shape. NNP will stay on their feet for long hours constantly moving around and acting fast in emergencies. [13] Neonatal nurse practitioners will need to be able to stay calm and collected in stressful situations.  

Salary

Neonatal nurse practitioner's salary is dependent on where the location of the job is and the demand for it in the area. People with less experience make less than people with decades of experience. Education, skills, and certifications can also play a significant role in what salary is paid. As of 2022, the average salary ranges between $109,000 to $150,000 in the United States. [14]

Workforce

In this field of work, there is an estimated job growth of 26% to 28% from the years 2018 to 2028. This increase in job growth will be able to provide 26,000 jobs. [15] There is a very high demand for neonatal nurse practitioners. According to the data from 2020 from the National Certification Corporation (NCC), neonatal nurse practitioners make up about 2% of the 325,000 licensed nurse practitioners. [16] Most neonatal nurse practitioners in the workforce are female. Over the years, the majority of neonatal nurse practitioners' race and ethnicity were white then second to that was Asian ethnicity. The average age for NNP is forty years old. [17]

See also

Related Research Articles

<span class="mw-page-title-main">Neonatology</span> Medical care of newborns, especially the ill or premature

Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practised in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction, congenital malformations, sepsis, pulmonary hypoplasia or birth asphyxia.

<span class="mw-page-title-main">Neonatal intensive care unit</span> Intensive care unit specializing in the care of ill or premature newborn infants

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. Neonatal refers to the first 28 days of life. Neonatal care, as known as specialized nurseries or intensive care, has been around since the 1960's.

Pediatric nursing is part of the nursing profession, specifically revolving around the care of neonates and children up to adolescence. The word, pediatrics, comes from the Greek words 'paedia' (child) and 'iatrike' (physician). 'Paediatrics' is the British/Australian spelling, while 'pediatrics' is the American spelling.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion, but does not provide the depth of expertise needed to recognize more complex conditions.

An Advanced Practice Nurse (APN) is a generalist or specialized nurse who has acquired, through additional graduate education, the expert knowledge base, complex decision-making skills and clinical competencies for Advanced Nursing Practice, the characteristics of which are shaped by the context in which they are credentialed to practice. The two most commonly identified APN roles are Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).

<span class="mw-page-title-main">Certified Nurse-Midwife</span> Advanced practice nurse who provides mid-level nursing and midwifery care

In the United States, a Certified Nurse-Midwife (CNM) is a nurse midwife who exceeds the International Confederation of Midwives essential competencies for a midwife and is also an advanced practice registered nurse, having completed registered nursing and midwifery education leading to practice as a nurse midwife and credentialing as a Certified Nurse-Midwife. CNMs provide care of women across their lifespan, including pregnancy and the postpartum period, and well woman care and birth control. Certified Nurse-Midwives are exceptionally recognized by the International Confederation of Midwives as a type of midwife in the U.S.

Nursing credentials and certifications are the various credentials and certifications that a person must have to practice nursing legally. Nurses' postnominal letters reflect their credentials—that is, their achievements in nursing education, licensure, certification, and fellowship. The letters usually appear in the following order:

<span class="mw-page-title-main">Critical care nursing</span>

Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients following extensive injury, surgery or life threatening diseases. Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit, paediatrics and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications.

<span class="mw-page-title-main">Emergency nursing</span>

Emergency nursing is a specialty within the field of professional nursing focusing on the care of patients who require prompt medical attention to avoid long-term disability or death. In addition to addressing "true emergencies," emergency nurses increasingly care for people who are unwilling or unable to get primary medical care elsewhere and come to emergency departments for help. In fact, only a small percentage of emergency department (ED) patients have emergency conditions such as a stroke, heart attack or major trauma. Emergency nurses also tend to patients with acute alcohol and/or drug intoxication, psychiatric and behavioral problems and those who have been raped.

In the United States, a psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

<span class="mw-page-title-main">Neonatal nursing</span>

Neonatal nursing is a sub-specialty of nursing care for newborn infants up to 28 days after birth. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin". Neonatal nursing requires a high degree of skill, dedication and emotional strength as they care for newborn infants with a range of problems. These problems vary between prematurity, birth defects, infection, cardiac malformations and surgical issues. Neonatal nurses are a vital part of the neonatal care team and are required to know basic newborn resuscitation, be able to control the newborn's temperature and know how to initiate cardiopulmonary and pulse oximetry monitoring. Most neonatal nurses care for infants from the time of birth until they are discharged from the hospital.

The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States, as of 2011 certifying over 75,000 APRNs, including nurse practitioners and clinical nurse specialists.

Obstetrical nursing, also called perinatal nursing, is a nursing specialty that works with patients who are attempting to become pregnant, are currently pregnant, or have recently delivered. Obstetrical nurses help provide prenatal care and testing, care of patients experiencing pregnancy complications, care during labor and delivery, and care of patients following delivery. Obstetrical nurses work closely with obstetricians, midwives, and nurse practitioners. They also provide supervision of patient care technicians and surgical technologists.

In the United States, a registered nurse certified in neonatal intensive care (RNC-NIC) is a neonatal intensive care nurse who has earned nursing board certification. The certification is established by an exam that is one of the core certification exams offered by the National Certification Corporation (NCC).

The National Certification Corporation (NCC) was established for the development, administration, and evaluation of a program for certification in obstetric, gynecologic and neo-natal nursing specialties in the United States. Incorporated in 1975 and governed by a board of directors, NCC's certification program is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the Institute for Credentialing Excellence. By 2009, NCC had awarded over 95,000 certifications and certificates of added qualification.

Certified in Neonatal Pediatric Transport (C-NPT) is the designation in the USA for a paramedic, physician, respiratory therapist, neonatal nurse, nurse practitioner, nurse or physician assistant who has earned certification from the National Certification Corporation in neonatal and pediatric transport. This certificate of added qualification was rolled out in 2009. National Certification Corporation utilizes applied measurement professionals to administer its tests.

A pediatric nurse practitioner (PNP) is a nurse practitioner who specializes in care for newborns, infants, toddlers, pre-schoolers, school-aged children, adolescents, and young adults. Nurse practitioners have an in-depth knowledge and experience in pediatric healthcare including well childcare, and prevention/management of common pediatric acute illnesses and chronic conditions. This care is provided to support optimal health of children within the context of their family, community, and environmental setting. In order to be a pediatric nurse practitioner one must be compassionate, resourceful, good at communicating and have good attention to detail. In the past couple decades, the job of a nurse practitioner has nearly doubled in the United States. Pediatric nurse practitioner numbers have stayed relatively the same. It is expected that the demand for the PNPs will start to increase in our society. This demand comes from children with chronic illnesses which are surviving and having diseases. PNPs are mostly taking over offices over the physicians, but still work side by side.

Advanced practice registered nurses (APRNs) are registered nurses with graduate degrees in nursing. APRN roles include: certified nurse midwife, clinical nurse specialist, certified registered nurse anesthetist, and nurse practitioner. APRNs assess, diagnose, manage patient medical problems, order diagnostic tests, and prescribe medications. Rules, regulations, and credentialing for APRNs vary by state. This page outlines the regulatory processes for nurse practitioners in Wisconsin, including education, certification, licensing, and credentialing. Regulatory and credentialing processes are continuously changing, and the information contained on this page is current as of November 2015.

An acute care nurse practitioner (ACNP) is a registered nurse who has completed an accredited graduate-level educational program that prepares them as a nurse practitioner. This program includes supervised clinical practice to acquire advanced knowledge, skills, and abilities. This education and training qualifies them to independently: (1) perform comprehensive health assessments; (2) order and interpret the full spectrum of diagnostic tests and procedures; (3) use a differential diagnosis to reach a medical diagnosis; and (4) order, provide, and evaluate the outcomes of interventions. The purpose of the ACNP is to provide advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions. This care is continuous and comprehensive and may be provided in any setting where the patient may be found. The ACNP is a licensed independent practitioner and may autonomously provide care. Whenever appropriate, the ACNP considers formal consultation and/or collaboration involving patients, caregivers, nurses, physicians, and other members of the interprofessional team.

Advanced Practice Registered Nurse (APRN) refers to a nurse with advanced education, typically at least a master's degree, and certification by a national certifying program. The APRN provides specialized and multifaceted care and are able to do 60 to 80 percent of preventative and primary care done by physicians. Minnesota Statutes section 148.171, subd. 3 states that in Minnesota, APRN "means an individual licensed as a registered nurse by the board, and certified by a national nurse certification organization acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist, nurse midwife, or nurse practitionerr".

References

  1. 1 2 3 4 Honeyfield, M.E. (2009). "Neonatal nurse practitioners: Past, present, and future". Advances in Neonatal Care. 9 (3): 125–128. doi:10.1097/ANC.0b013e3181a8369f. PMID   19542775.
  2. 1 2 3 4 5 Johnson, P.J. (2002). "The history of the neonatal nurse practitioner: Reflections from "Under the Looking Glass."". Neonatal Network. 21 (5): 51–60. doi:10.1891/0730-0832.21.5.51. PMID   12240457. S2CID   36933338.
  3. ↑ Trotter, C (1994). "Neonatal nurse practitioners: A descriptive evaluation of an advanced practice role". Neonatal Network. 13 (1): 39–47. PMID   8114659.
  4. ↑ American Nurses Association. (1975). Guidelines for short-term continuing education programs for the nurse clinician in intensive neonatal care and the nurse clinician in intensive maternal-fetal care. Kansas City, MO.
  5. ↑ National Association of Neonatal Nurses. (2000). Position statement 2201: Advanced practice neonatal nurse role. Glenview, IL.
  6. ↑ National Association of Neonatal Nurse Practitioners. (2007). About NANNP. Retrieved from www.nannp.org
  7. ↑ Nagle, C. W., & Perlmutter, D. F. (2000). The evolution of the nurse practitioner role in the neonatal intensive care unit. American Journal of Perinatology, 17(5), 225–228.
  8. ↑ National Council of State Boards of Nursing. (2013). APRN maps. Retrieved from www.ncsbn.org/2567.htm
  9. ↑ "Neonatal Nurse Practitioner (NNP) Career Guide". Nurse.org. Retrieved 2022-02-16.
  10. 1 2 "How to Become a Neonatal Nurse Practitioner (NNP)". Nursing License Map. Retrieved 2022-03-01.
  11. ↑ "Certification exams". NCC. Retrieved 12 January 2014.
  12. ↑ "How Many Hours Do Nurse Practitioners Work Per Week? – Flight Nursing 101" . Retrieved 2022-03-06.
  13. ↑ "How to Become a Neonatal Nurse Practitioner (NNP)". Brookline College. 2021-11-18. Retrieved 2022-03-09.
  14. ↑ Salary.com, Site built by. "Nurse Practitioner - Neonatal Salary". Salary.com. Retrieved 2022-03-01.
  15. ↑ "Neonatal Nurse Practitioner: Job Information and Requirements". bestaccreditedcolleges.org. Retrieved 2022-03-01.
  16. ↑ Snapp, Barbara; Moore, Tiffany A.; Wallman, Carol; Staebler, Suzanne (2021). "2020 Neonatal Nurse Practitioner Workforce Survey: An Executive Summary". Advances in Neonatal Care. 21 (3): 242–246. doi:10.1097/ANC.0000000000000903. ISSN   1536-0903. PMID   34010856. S2CID   234793019.
  17. ↑ "Neonatal Nurse Practitioner Demographics And Statistics In The US".
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