neonatal/ NNP

When i become a neonatal nurse, do i have the option of working only in level II or most neonatal nurse work in level III?

You can either work in a Level II or Level IIIa-c unit, or a unit that has a combination of subunits, like a Level IIIc + a stepdown level II nursery. The majority of urban/teaching hospitals are level IIIs while a lot of outlying/rural/community hospitals are level IIs.

I am a student NNP, and work with a team of 12-15 NNPs at work. Their role includes delivery room management, transports, managing 8-10 pts (orders, lines, drips, intubations, etc) and precepting. They take the same pre/postop cardiac patients that the physicans take. They are supervised by the unit fellow on call, as well as the attending on call. You will need your master's degree to function as an NNP, while there are a few bachelors prepared NPs, the educational standard is at the masters level, with plans for a DNP as a entry-level NP degree by 2015.

Best of luck!

Stephen

That seems like a weird setup to me. Most of the NICUs I've seen have a group of NPs with no neonatologists or fellows. These NPs are 100% independent and dont collaborate or work with doctors at all.

That sounds like an unsafe practice to me.... All NICUs I've been in have had at least a medical director and a few neos. It's insane for a hospital to staff a NICU with only NNPs, and probably illegal. Perhaps if the NNPs are there as part of a neonatology group , such as in a level II outlying NICU.

Totally agree with SteveRN21

NPs who do not collaborate or work with doctors at all are just asking for trouble. I suspect that NNPs in the areas where platon20 describes still have some type of physician collaboration and I'm positive they consult with physicians as well as other APNs. 100% independence does not equal no physician input.

Not necessarily. NNPs may not always be able to bill for services being in an inpatient dept, as opposed to a FNP or PNP in an independent practice. All NPs at my hospital are paid at the same base rate regardless of specialty, and are paid more for RN/NP experience, degree, and if the work a rotating schedule.

Not necessarily. NNPs may not always be able to bill for services being in an inpatient dept, as opposed to a FNP or PNP in an independent practice. All NPs at my hospital are paid at the same base rate regardless of specialty, and are paid more for RN/NP experience, degree, and if the work a rotating schedule.

Actually its the other way around. NNPs should be one of the highest billing NP professions. According to the advance website they have the second highest average salary of any NP setting.

For the most part inpatient medicine pays relatively poorly (as does primary care. What does pay is procedures. For example if you have a sick new infant you get umbilical venous catheterization, umbilical arterial catheterization, and intubation to start with. All of those pay very well. Also unlike regular inpatient service critical care time is billed in one hour units. The ICU part of the NICU means that for every hour or part of an hour you put in you get paid. Add to that the fact that most neonates either have insurance or get insurance shortly after birth (and Medicaid is usually backdated) and you have a great payor mix even with Medicaid rates.

I have seen three different models. The most common seems to be that the NNPs (and PAs for that matter) are employees of the physician practice or physician group practice. The other models are that the NNPs are hospital employees and the physicians have a group practice or University type systems where everyone is an employee. In group practices it is easy enough to bill under cobilling and the collections are very good. In a University system you can do the same. In systems where the NNPs are hospital employees it gets hard to bill since the NNPs are not under the same NPI as the physicians. I have never worked in this system so I am not sure how people get around this (or if they do).

David Carpenter, PA-C

Yeah.... our NNPs fall under the nursing dept actually, and are member of the local union (like all RNs here) The last hospital I worked at, the neos all worked for Pediatrix, here they are employed by the hospital system. I'm sure the pt is billed the same regardless of who's doing the procedures. I'm sure I'll get to learn all this fascinating billing mumbo-jumbo at some point in my education.