Lots of NICU's losing their designation and turning MANY level III NICU's into Level II's

[nurse1432]

I know that at least in Texas, tons of our Level III NICU's have become Level II's.... yikes. But they are still accepting the same patients as before.

Is this happening anywhere else?

This is of concern to me because I was planning on applying to NNP school which requires Level III NICU experience. My last hospital was a III and now a II. The new hospital I am at now has the same issue.

What gives?

Thanks for any input!

[NICUmiiki, DNP, NP]

Might be a regulatory change in Texas. There was a recent change in my state, but it didn't have a big impact. I haven't noticed this in my area. Do you have provider at all times? I know some of the Level IIs around us don't have providers 24/7.

[anicu]

We are a level III with 24/7 doctors and NNPS. I'm in Memphis but haven't heard of this. I don't expect ours to ever change.

[Jory, MSN, APRN, CNM]

I don't think it's a matter of them "losing" it...it's a matter of them choosing to downgrade due to close proximity to a Level III and overall, how the census is doing.

[adventure_rn, MSN, NP]

I know I'm a little late to the party but...is it possible that your unit was really only accepting Level II-ish kids to begin with? The point of the Level III/IV requirement is to ensure that you're very familiar with sicker kids like micros. In my experience, most Level II units have an age and weight cut-off (i.e. no kids under 28 weeks), and they'll transfer out kids who need to be intubated long-term. If your unit is taking the exact same patient population, then it probably wasn't really functioning as a Level III to begin with. Unless you have a lot of experience working with that patient population (i.e. kids as young as 23 weeks requiring long-term intubation/ventilation) your 'Level III' experience probably isn't as high-acuity as you really need, anyway. You may still be able to find a program that will accept your experience, but you're probably doing yourself a disservice starting an NNP program unless you've had true Level III/IV experience at your former Level III. You seriously don't want to be trying to learn micros, high-frequency ventilation, cooling, and complex surgeries on the fly. If I were in your shoes, I'd be scoping out other Level III/IV units to get a year or two of true high-acuity experience under my belt.