Do you as an FNP see newborns?

anh06005, MSN, APRN, NP · Mar 5, 2015

FNP's are certified to see all ages. I have yet to see a newborn when I was with a FNP (or in the few weeks of working) but I did when I was with a pediatrician. Many parents take their babies to peds rather than family practice.

GoodNP · Mar 6, 2015

Thanks. I know in theory FNPs should be able to see the full spectrum. Womb to the tomb and all. It's just that most clinics I've seen do not allow their NPs or PAs to see the really little babies. This is a clinic policy, not from any BON or regulatory body.

The clinic where I work is an exception: NPs and PAs are expected to see babies, and it happens with some regularity. But the fact that most nearby clinics do not share this practice gives me pause.

anh06005, MSN, APRN, NP · Mar 6, 2015

Maybe they see it as a liability? The other clinics I mean.

If I was expected to see a newborn you better know I'd be looking some stuff up to refresh myself lol. A 6 month old with an ear infection? I'd just need to calculate the amoxicillin dose

GoodNP · Mar 6, 2015

Yeah. I wonder if this policy is overly cautious or if it is reasonable and then by default how I should judge my own clinic's policy and my own liability. It would be really encouraging to know if there are clinics out there where FNPs see babies and how it works for them.

pattyweb · Mar 8, 2015

I'm an FNP in a rural health clinic and do occasionally see newborn babies of less than 1-2 wks old. I have a few babies that I follow routinely for their well visits, but also cover for 2 of my family docs who may be either out or full when mom and baby can get there. One of those family docs does OB care and deliveries (actually delivered my baby), so we as a family practice clinic probably get a few more newborn babies than other clinics.

GoodNP · Mar 9, 2015

Thanks pattyweb. While I feel comfortable enough with babies and peds, knowing that most other clinics are so cautious makes me feel nervous. Psychological I guess. I did send an 8 day old to the ED last week for what appeared to be a pre-auricular cellulitis. I found out it was staph and the baby was hospitalized for 5 days. He's doing well, and it was apparently not an overreaction to send him to the ED, so there's that...

lovinglife2015 · Mar 23, 2015

Maybe they see it as a liability? The other clinics I mean.
If I was expected to see a newborn you better know I'd be looking some stuff up to refresh myself lol. A 6 month old with an ear infection? I'd just need to calculate the amoxicillin dose

In that case you should know that AAP no longer advises antibiotics for all ear infections.. Most minor ear infections clear without antibiotics.

The Diagnosis and Management of Acute Otitis Media

Antibiotics for ear infections: Pediatricians release new guidelines - CBS News

If pain is present, the new guidelines suggest the clinician should recommend pain relievers at first. Antibotics like amoxicillin should only be given to kids diagnosed with an ear infection who are showing severe symptoms -- such as pain and swelling -- for at least 48 hours or those who have a fever higher than 102.2 degrees Fahrenheit. Kids with an eardrum rupture should also be given immediate antibiotics

anh06005, MSN, APRN, NP · Mar 23, 2015

In that case you should know that AAP no longer advises antibiotics for all ear infections.. Most minor ear infections clear without antibiotics.
The Diagnosis and Management of Acute Otitis Media
Antibiotics for ear infections: Pediatricians release new guidelines - CBS News
If pain is present, the new guidelines suggest the clinician should recommend pain relievers at first. Antibotics like amoxicillin should only be given to kids diagnosed with an ear infection who are showing severe symptoms -- such as pain and swelling -- for at least 48 hours or those who have a fever higher than 102.2 degrees Fahrenheit. Kids with an eardrum rupture should also be given immediate antibiotics

Thanks for the info! I have seen the new guidelines and try to reason with patients and parents on waiting things out..... With some success + patient satisfaction.