Concerning Neonatal NP -- I would love to hear your experience

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I would like to learn more about the day of an AC-NNP -- I am at the stage in nursing school where I need to plan for the future, and I am drawn to NICU. I am aware that I should probably get a position in a level III NICU as a RN for two years first, but I want to confirm that AC-NNP is really for me. I could read the scope of practice; However, there is bond to be differences between the actual duties and the theoretical capabilities. Therefore, I would love to hear about anyone's experience as a NNP or anyone's experience of NNPs they knew!

As well, I am really enjoying this forum of nurses from varied background and viewpoints -- it is a place to learn, to vent, to celebrate, to encourage and be encouraged... A very wonderful forum to visit indeed! :wink2:

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Specializes in Neonatal ICU (Cardiothoracic).

Hi, and welcome to AN!

Unfortunately, there are only a few practicing NNP's on this forum, which is not surprising considering the number of NNPs in practice! I am currently working on my MSN-NNP degree, and will be finishing up next December. I work with around 15-18 NNPs, so I can give you a glimpse at what they do. However keep in mind that every NICU is different. Some units utilize NNPs in more of a resident-like role, while some have much more autonomy. Some are assigned purely to delivery room/OR/Transport.

I work at a very large children's teaching hospital in NYC. The NNPs here are assigned to a team made up of NNPs, a fellow, PAs and house docs that cares for primarily cardiac, surgical and complex patients, although a lot of preemies end up in the mix. The other team is made up of residents and a fellow, and cares for mainly preemies and less-critical term infants.

Each NNP is assigned to 6-8 pts, rounds with the fellow and is responsible completely for their pts. They write medication, IV, vent, lab orders, intubate, place PICC, peripheral and arterial lines, chest tubes, umbilical lines, perform art sticks, etc. They interpret labs and xrays, manage critical postop open heart patients, run codes, perform delivery room resuscitations, etc. They consult with parents, genetics and peds cardiology....

They keep the fellow updated, and use her/him as a backup if things get hairy.

Hope this helps!

Stephen

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Hi,

You mentioned PAs in your post. I'm curious...does your NICU utilize PAs? If so, what is their role, and how does it differ from that of the NNPs?

Thanks!

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Specializes in Neonatal ICU (Cardiothoracic).
Hi,

You mentioned PAs in your post. I'm curious...does your NICU utilize PAs? If so, what is their role, and how does it differ from that of the NNPs?

Thanks!

Yes, we have one PA, and one is in orientation. Their role is exactly the same as the NNPs and house docs.

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Yes, we have one PA, and one is in orientation. Their role is exactly the same as the NNPs and house docs.

Thanks for the reply. Did these PAs do fellowships or did they receive their training in neonatology on the job?

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Specializes in Neonatal ICU (Cardiothoracic).

They learned on the job. Ours had peds experience, but had a VERY steep learning curve when she started, compared to the NNPs that had years of NICU experience to begin with...

Weining, I am not sure what the requirements are in Canada, but in the US, NNPs must have 2 years of Level III experience before graduation. A lot of people get one year, and continue working throughout grad school.

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I will have to ask around, but I think University of Toronto is asking for a certain number of hours. It would be very helpful if I could get last year of experience while I am getting my Master in Nur. Sc., so when I apply for the AC-NNP certificate, I will be have the hours I need. As well, I guess there is a huge difference between Acute Care - NNP and NNP (the general variety)? Thanks!

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I will have to ask around, but I think University of Toronto is asking for a certain number of hours. It would be very helpful if I could get last year of experience while I am getting my Master in Nur. Sc., so when I apply for the AC-NNP certificate, I will be have the hours I need. As well, I guess there is a huge difference between Acute Care - NNP and NNP (the general variety)? Thanks!

Steve can correct me if I'm wrong but there is only one type of NNP here. The only non-acute care I've seen NNPs do is well baby checks in the newborn nursery. There is only one NNP certification here in the US.

David Carpenter, PA-C

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Specializes in Neonatal ICU (Cardiothoracic).

David's correct. There is only one NNP certification/credential here in the U.S. through NCC. That's not to say you couldn't do non-acute or outpatient care, but you are still limited to the 0-2 age group.

Perhaps your nursing school advisor could give you specifics about Canadian NNPs.

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Thank you! I shall ask my adviser once school starts.

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They learned on the job. Ours had peds experience, but had a VERY steep learning curve when she started, compared to the NNPs that had years of NICU experience to begin with...

Weining, I am not sure what the requirements are in Canada, but in the US, NNPs must have 2 years of Level III experience before graduation. A lot of people get one year, and continue working throughout grad school.

I would think it would be really tough for PA's to get a job in the NICU. Were there just not enough NNP's available or what?

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Specializes in Neonatal ICU (Cardiothoracic).

We have a very high census, between 65-80 babies. We are the regional cardiac center, and keep our cardiacs postop. We also are a regional ECMO center. I believe we have around 15 NNP/PA/House docs on one team, and they are looking for 5-8 more. The problem is that only 5-6 NNPs graduate each year in the NYC area. Definitely more demand than supply.

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