Neonatal Nurse Practitioner

rnkaytee · Jul 20, 2016

I just finished my NNP degree so I'm not the expert but a typical day at our hospital looks like this: we round on all of the patients with the MD and discuss treatment plans, assess the babies and chart/put in orders. As far as procedures, the NNP is one of the most intense procedure-based specialty as we put in central lines, intubate, place chest tubes, and perform LPs. I do miss getting to know the parents at the bedside - being an NNP is more computer work than I anticipated. There are a few other NNPs on the board that I hope will chime in.

stm94 · Jul 25, 2016

Besides me and SteveNNP, there really aren't any NNPs that are active on AN here that I know about (any lurkers, feel free to join the party). There have been a few people who have posted in years past once or twice that are NNPs, but aren't active now. There are currently a few active student NNPs and I think they would have valuable insight to add to your question.
That being said, since it's not asked very much or talked about, sure, let me answer from my own perspective. I've been a NNP for almost year now. I knew I wanted to be a NP in nursing school, but thought I would do acute care adults or FNP. I hadn't realized that a special ICU just for babies existed until I heard about it from a NICU RN at a dinner that I went to in college. The idea fascinated me and luckily I started doing my peds rotation during the next semester and fell in love with the idea of pediatrics (I have to laugh now because I can't ever imagine myself doing general peds)- and NICU. I was fortunate enough to be put into a NICU for my senior practicum and being the large planner that I was, went out and sought a NICU job 6 months before I graduated at a top 10 children's hospital across the country. When I worked as a RN, I was pleasantly surprised how much I liked bedside RN care and actually considered not doing NNP school.
But as time went on, I decided that I really wanted to do it and told myself that even if I didn't like it, I could always go back to being a bedside RN (and actually a couple of our senior nurses had done just that). Went to school, loved it, started work, love it, and now can't imagine going back to the bedside. I've written several posts about this before so I won't belabor the point, but there are so many benefits of being a NP over being a RN. One of the biggest is less emotional energy spent at the bedside, i.e. not having to ask someone to "use the bathroom" (because someone has to watch your patients while you do so), the freedom to go eat almost whenever you'd like, not being tied to a monitor that goes off every few minutes, and not having to be with parents all day long who may eat all of your energy. I have the most absolute respect for bedside RNs because I think their job is tougher than mine in many ways.
I currently work at an academic institution in the southwest and I love it. My day usually starts early in the morning when I get report on my patients (depending on acuity, anywhere from 7-12 patients), and then I "pre-round" meaning that I run through all the "numbers" like weights and vital signs, any events overnight, and calculate things like number of calories per kg & weight trend for the previous week, and review the medication list. I make a plan for the day and then start rounding with a physician a couple of hours later. Usually I get a chance to do a physical assessment on all my kids and get to talk to the nurses to see if they have any particular concerns. We round until around lunch time. Sometimes there's a conference to go to to have an hour's lecture on a neonatal topic (I love going when I'm not too busy, but my phone does tend to ring a lot during this). Before this, I have to write in all my orders for the day- especially things like TPN (IV nutrition) and enteral (formula) nutrition because they are on a deadline by our pharmacy & formula room.
Then in the afternoon, I write my "notes" for the day (detailing my assessment & plan- this is the type of thing that hospitals use to bill insurances for payment) and call parents updating them on their child. The afternoon is a mixture of catch-up and putting out "fires," i.e. when the nurse calls me with concerns that I try to troubleshoot and/or admits or discharges (of course the "fires" and admits can come at any time). I also get to do invasive procedures like lumbar punctures, intubations (placing a breathing tube down the trachea for infants that aren't able to effectively breathe for themselves), place umbilical IV lines, go to deliveries, etc etc.
In the late afternoon, I will update a sheet for the night shift detailing all of my patients including their diagnoses, respiratory support, current feedings, and plans/changes made for the day.
There are some very busy days of course, but that's true in most hospitalist type roles, most especially an intensivist role. I love what I do and I can't think of anything else I'd rather be doing. Hope this helps.

This was posted on a post in the NICU/Neonatal section. But I was curious about the NNP and babyNP answered it fully! Hope this helps!