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Becoming a Neonatal NP

I would love to one day become a Neonatal Nurse Practitioner (NNP) so I was wondering if some of you current NNPs could tell me a few things I'm curious about:

What is an average work day like for a NNP?

What is the difference between a NICU nurse and an NNP?

Best programs to become an NNP?

Any other information that you think would be useful would be greatly appreciated! Thank you for reading!

I'd advise you to work in a NICU and shadow an NNP several times before you even consider the NNP route. I once thought I wanted to be an NNP, but after working in a nicu for 4 years as an RN, NO WAY IN H*LL!! lol They have a tremendous amount of responsibility, not that other NPs dont, but it is a very acute care setting.

babyNP., APRN

Specializes in NICU.

There aren't any regular NNP posters that I'm aware of, but I'll go ahead and answer your questions. I'm a new graduate, so I haven't fully been in the role, but did experience a bit of it while in school.

What is an average work day like for a NNP?

It depends on the unit. Most NNPs work 12 hour shifts, 16 hours, or 24 hours. In general, in the morning, a NNP gets his/her caseload of patients (how many depends on the acuity, i.e. how sick each patient is), looks at the chart for the last day or so to get "numbers" like vital signs, intake/output, and checks over if anything significant has changed. Then they usually go to rounds, where they will discuss each patient with a doctor (in some smaller NICUs, it may be just the NNP) and nurse and come up with a plan of care (decide what orders should be changed based on the infant's status, for example, if an infant is starting is doing well with his oxygen saturation levels and work of breathing, may decide to decrease the oxygen support). Depending on the unit, they may also attend deliveries to resuscitate infants that need it, perform invasive procedures like intubation, lumbar punctures, arterial punctures, central IV line placement (ex: umbilical venous catheterization, PICC line), chest tube placement for a collapse lung, etc etc. They also discuss medical updates with parents and coordinate discharge plans. The role can be very different from place to place, but that's an overview.

What is the difference between a NICU nurse and an NNP?

An RN gives total care to the infant. They do "cares" which means that they take vital signs, change diapers, feed infants, monitor the infant's health, and call the NNP or doctor with any changes. They also do a lot of parent teaching and are essential to be the doctor/NNP's eyes and ears to subtle changes in the infant's status: in this world, you can have a healthy baby feeding well to one dying within 12 hours and it's the NICU nurse's assessment skills that can make a huge difference in catching the signs of a downward trend.

A NNP, on the other hand, decides on the plan of care (with consultation with a doctor as each unit's policy dictates) and makes the decisions on "what to do."

Best programs to become an NNP?

There's no lists of ranked "best" programs. There is a list of ranked best "pediatric NP" programs at US News and World Report, but the two roles are very different from each other and many of those schools don't offer NNP programs. Actually, there are only about 30 or so NNP programs in the country. Many of them are online and many of them require that you set up your own clinical site. This is very hard for many students to do (and is why I chose a program that set it up for me) and I wouldn't recommend it unless you have a good relationship with hospitals that will let you do it.

As a starting point, you'll need your bachelor's in nursing. Technically you only need an associates degree in nursing to get into NICU, but it's getting harder and harder to get hired as an ADN into the NICU as a new grad vs a BSN and you'll need the BSN for entry into graduate school anyway.

Keep us posted on how things go!

Thank you so much BabyNP! You gave me so much helpful information, thanks for taking the time!


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