The process of childbirth and neonatal care in the United States is usually a fairly smooth process. We have one of the lowest infant mortality rates in the world, and it’s safe to say that most complications in the delivery room can be foreseen and rectified before they become fatal to either mother or child.

When a child is born and requires extra care, however, the job usually falls to a Neonatal Nurse Practitioner. This is a highly skilled advanced practitioner role, providing specialized care for newborns and infants up to the age of two who experience a range of health issues. These issues may include premature birth (including low birth weight), heart defects, genetic disorders, respiratory problems and a range of other issues that may see a baby in neonatal intensive care.

What does a neonatal nurse practitioner do?

The role of a neonatal nurse practitioner can be very varied and will vary greatly depending on the setting that the Neonatal Nurse Practitioner finds themselves in.

In any given day, a general NNP workload may include:

• Monitoring the patient’s vital signs and assessing any changes
• Taking blood and maintaining IV fluids
• Working with medical doctors to distribute and administer medication
• Supporting parents and families through neonatal and postpartum care
• Taking diagnostic tests and performing procedures
• Organizing and leading a team of healthcare professionals in the Neonatal Intensive care team.

What does it take to become a neonatal nurse practitioner? states that neonatal nurse practitioners need to have:

“Exceptional dexterity, vision, agility and should be highly observant with excellent hearing to ensure the well-being of infants under their care”.

The infants in the NNP’s care will be in different states of health, and it can be quite hard on the emotions, NNPs need to be aware of the issues they will face and be mentally prepared to face them head-on.

A neonatal nurse practitioner will hold qualifications of the highest level, usually with many years of experience behind them, they are responsible for a lot of decisions at a high level, and fast pace. As well as a strong medical background and excellent qualifications, individuals will need to be of strong mental character with an intense interest in the care and needs of newborn babies and their families.

What is the difference between a neonatal nurse and a neonatal nurse practitioner?

The difference between a Neonatal Nurse and a Neonatal Nurse Practitioner is qualifications and experience in the field. The NN has passed the NCLEX-RN exams and works within the NICU under the instruction of both the present physicians and Neonatal Nurse Practitioners.

An NN will usually only have one baby assigned to them and will be responsible for monitoring that baby and managing their treatment plan. The Neonatal Nurse Practitioner will usually have more than one baby or child under their immediate care within any one day.

The Neonatal Nurse Practitioner is an advanced care practitioner who has acquired their MSN (Masters Degree in Nursing) or the DPN (Doctor of Nursing Practice) is a higher level and works directly under a medical doctor.

The higher level of qualification translates to a more intensive workload and high stakes decisions. The NNP can in any one day be responsible for diagnostics, performing procedures (such as intubation), changing treatment plans, ordering lab work, and other more advanced practices under the supervision of a physician.

How much does a neonatal nurse practitioner make?

As a Neonatal Nurse Practitioner, you can expect to earn in the region of $59,000 according to the Association of Neonatal Nurses. The demand for neonatal nursing is expected to keep growing in the next decade, and the demand for advanced care practitioners will follow the trend.

It is possible to practice as a Neonatal Nurse Practitioner with a Masters of Science in Nursing, but we are seeing more and more that the Doctor of Nursing Practice is the standard entry requirements for this specialist field, commanding a higher level of skill, education and of course salary to follow.

What are the levels of neonatal care?

Neonatal care is required at all levels. Many expectant parents don’t realize the different levels of care in NICU, it’s part of the advance practitioner’s remit to ensure that communication is passed clearly between the medical staff and the expectant and new parents. Setting minds at ease for new parents is just as important as the life-saving care for babies and infants that they provide.

Neonatal care comes in 3 or 4 levels:

Well Baby Nursery – As the name implies, this is for healthy babies with no special medical issues. Babies here have usually been born close or on their due date and don’t require any special attention further than the usual routine assessment, care, and screening. Although the babies on the Well Baby Nursery are generally well, the nurseries are usually equipped to assist in the stabilization of babies with more complex medical issues before they are transferred to NICU.

Special Care Nursery – Special Care Nurseries are equipped to care for babies that are moderately premature, usually born around 32 weeks, or those who require some more advanced care than a fully healthy baby would such as IV antibiotics, jaundice, heat issues or extra monitoring.

Level 3 NICU – The definition of Level 3 NICU can change between states, but all will be able to provide babies born at more than 28 weeks with respiratory help as well as make provisions for IV fluids. In some states, Level 3 ICU is the highest level of neonatal care, meaning they will be able to provide the further support discussed below.

Level 4 NICU – This is not a classification used by all hospitals and all states, but for those who do, Level 4 NICU is the highest level of NICU care for babies with the most complex medical needs. Babies in level 4 NICU can be as young as only 22 weeks gestational age and smaller than 1lb 13oz. Level 4 NICU provides support for very sick babies who need advanced respiratory support, IV fluid support, and more invasive neonatal surgeries such as heart surgery.

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