Any Neonatoal NP (NNP) at your units?

katrina4 · Jul 3, 2004

CapeMaui

Great question...I actually had the same concerns. I am applying to an advanced BSN course (I have a bachelors/masters in another field) with the intent of eventually going on for my MSN. I have always been interested in the NICU and being an NNP. My main problem is that there are no NNP programs in Pittsburgh and I am not willing to relocate my family.

My friend is a PNP and she has said that while there definitely are more opportunities for PNPs, there are many more PNPs than NNPs in our area (maybe because we don't have a NNP program) and therefore the supply/demand equals itself out. But she did tell me that when she worked in the NICU as an RN, most of the NNPs worked the night/weekend shifts.

You might want to try calling the hospials or even checking their job postings. I have found by looking at job postings that some of the NICUs around here require their applicants to be CRNPs, but not necessarily NNPs. But as a previous posting stated, maybe these NPs don't have quite the same roles as a NNP.

One other thought. I have looked into a NNP program at Penn State. They require 3 years of experience in a NICU as an RN before applying to the program. I don't think most PNP programs require this level of expereince.

katrina4 · Jul 3, 2004

CapeMaui

Great question...I actually had the same concerns. I am applying to an advanced BSN course (I have a bachelors/masters in another field) with the intent of eventually going on for my MSN. I have always been interested in the NICU and being an NNP. My main problem is that there are no NNP programs in Pittsburgh and I am not willing to relocate my family.

My friend is a PNP and she has said that while there definitely are more opportunities for PNPs, there are many more PNPs than NNPs in our area (maybe because we don't have a NNP program) and therefore the supply/demand equals itself out. But she did tell me that when she worked in the NICU as an RN, most of the NNPs worked the night/weekend shifts.

You might want to try calling the hospials or even checking their job postings. I have found by looking at job postings that some of the NICUs around here require their applicants to be CRNPs, but not necessarily NNPs. But as a previous posting stated, maybe these NPs don't have quite the same roles as a NNP.

One other thought. I have looked into a NNP program at Penn State. They require 3 years of experience in a NICU as an RN before applying to the program. I don't think most PNP programs require this level of expereince.

CapeMaui · Jul 3, 2004

One other thought. I have looked into a NNP program at Penn State. They require 3 years of experience in a NICU as an RN before applying to the program. I don't think most PNP programs require this level of expereince.

Thanks Katrina, for sharing the above info! It's really helpful. Where I am, I have 2 schools to choose from for NNP, one is a distance program (eventhough they are within driving distance) and the other is on campaus. Both require that you work at least 1 year for p/t study or 2 years for f/t study. Not as strict as Penn State. For PNP program of the same schools, they also require the same experience. I know that I won't be going on right after I graduate in Dec., but I like to look ahead and plan, especially since I want to have a baby sometime soon :)

I was on a few different children's hospital's sites yesterday (they're all local hospitals) and all of them had listed NNPs on their staff list, along with neonatologists and fellowships. So I think there will be places to work. However, I am worried, like you, that they may be getting the shifts the MD's don't want, ie, nights and weekends. I guess when I start working in Jan/Feb, I can get a better sense of how it works for the hospital I choose.

I took your advise and looked at some job listings. Most of the ones for NNPs listed 'variable' under shift schedule, so I think it's really up to the person who does the scheduling? thoughts?

nekhismom - at your old unit with the NNPs, did they work mostly nights and weekends? How were they treated?

Thanks!

CapeMaui · Jul 3, 2004

One other thought. I have looked into a NNP program at Penn State. They require 3 years of experience in a NICU as an RN before applying to the program. I don't think most PNP programs require this level of expereince.

Thanks Katrina, for sharing the above info! It's really helpful. Where I am, I have 2 schools to choose from for NNP, one is a distance program (eventhough they are within driving distance) and the other is on campaus. Both require that you work at least 1 year for p/t study or 2 years for f/t study. Not as strict as Penn State. For PNP program of the same schools, they also require the same experience. I know that I won't be going on right after I graduate in Dec., but I like to look ahead and plan, especially since I want to have a baby sometime soon :)

I was on a few different children's hospital's sites yesterday (they're all local hospitals) and all of them had listed NNPs on their staff list, along with neonatologists and fellowships. So I think there will be places to work. However, I am worried, like you, that they may be getting the shifts the MD's don't want, ie, nights and weekends. I guess when I start working in Jan/Feb, I can get a better sense of how it works for the hospital I choose.

I took your advise and looked at some job listings. Most of the ones for NNPs listed 'variable' under shift schedule, so I think it's really up to the person who does the scheduling? thoughts?

nekhismom - at your old unit with the NNPs, did they work mostly nights and weekends? How were they treated?

Thanks!

nekhismom · Jul 5, 2004

nekhismom - at your old unit with the NNPs, did they work mostly nights and weekends? How were they treated?
Thanks!

Well, they were treated great!! We had NNP coverage 24/7, so they worked all shifts. They were "assigned" to a shift, so they had a regular rotation, but they also covered for each other for vacations, sick time, etc. And they did work weekends, but only because everyone had to work eow in order to be employed there.

CapeMaui · Jul 5, 2004

Thanks nekhismom! It's great to know that NNPs are very welcomed at some places. I hope whereever I end up in the future will have the same kind of culture!

Gompers, BSN, RN · Jul 5, 2004

However, I am worried, like you, that they may be getting the shifts the MD's don't want, ie, nights and weekends.

I don't know about other hospitals, but the ones I've been at that had NNPs didn't work like that at all. The MDs and NNPs aren't even employed under the same department and their schedules have nothing to do with each other. NNPs cannot work alone, they need to have MD support for legal reasons. At least that's what I've always known. They can order meds and such, but a nurse can't give them until they've been approved by an MD, etc. So it's not like the MDs are some gods that get to pick and choose nice weekday schedules while the NNPs are stuck with nights and weekends. Basically, residents and fellows usually have to pull the long hours, overnights, weekends, etc. The attendings have more of a normal schedule but sometimes do have to come in during the night or weekend if things are crazy. And NNPs, it depends on the unit.

Like I mentioned before, we don't have very many left so they only work days. But it's not some fantastic set-up!!! It actually sucks really badly, to tell you the truth. The NNPs work days so they can do rounds on the babies and plan their care. Then when they go home for the night, the fellows cover their babies. The problem is that there is a constant war going on between the docs and the NNPs because of this. The NNPs will go home for the night and don't like the docs to change their orders. But when things go wild overnight and it must be done, either the doc doesn't want to rock the boat so he won't change the order and the kid will suffer until morning - or he'll change it and get hell from the NNPs for it. So really, it's kind of miserable. It was much better when we had an NNP on the unit 24/7.

BittyBabyGrower, MSN, RN · Jul 5, 2004

In the state I live in, NNP's do have prescriptive privledges...they all went and took an exam and we can now take off their med orders without a co-sign. Has made live a whole lot easier on us! Actually, any APN in our state can write scripts as long as they have taken the exam. There is a list of approved meds that they can write for without an MD's cosig.

Our NNP's work either 7a-7p or 7p-7a. Our step down practioner works 6a-3p. They all take turns covering weekends and holidays. There are residents there all day and night, so they have to find their own coverage is someone bails...they don't even ask the NNP's to do this. They are completely separate from the medical side.

nekhismom · Jul 6, 2004

The NNP's where I was at did have prescriptive authority. Didn't need a doc's co-sign. We did not have medical residents or fellows in our NICU, as our director did not want them "experimenting" on our babies. :rotfl: She much preferred NNP's. So, no, NNP's did NOT have to cover the medical staff's "holes" because they were separate from the docs.

Gompers, BSN, RN · Jul 6, 2004

The NNP's where I was at did have prescriptive authority. Didn't need a doc's co-sign. We did not have medical residents or fellows in our NICU, as our director did not want them "experimenting" on our babies. :rotfl: She much preferred NNP's. So, no, NNP's did NOT have to cover the medical staff's "holes" because they were separate from the docs.

Don't have much choice about having residents if you work in a large university teaching hospital!!! I agree, sometimes they have no clue what they're doing. But how in the world are doctors ever going to become neonatalogists if they don't train fellows? At least here, they have to stay full-time for 3 years, and they cover nights - at times I'd rather have them with me than the attendings because procedures are just second nature to them by the end of their training.

BUT to answer the NNP-hopefuls' questions - we've all agreed on one thing, and it's that the NNPs and MDs work for separate departments and thus their schedules really don't affect each other at all. NNPs may work days, nights, weekends, and holidays - it all depends on the hospital AND that hospital's current staffing. Things can change in a heartbeat.

CapeMaui · Jul 7, 2004

Thank you all for the new information!! That's so helpful!

I guess how the NNPs and MDs work together really depends on the hospital. Where I volunteered and shadowed, the RNs explained to me that the NNPs actually worked under the neonatology dept, so they all worked under the head neonatologist, alongside other neonatologists. I'm sure if I end up in a teaching hospital (which I have my eyes on), I will get to see how they work together first hand. I'm not sure about their prescription previleges though, I guess it's different with each state? I'm going to have to do some research on that.

I started this thread to see how NNPs are treated across the nation and wanted to see what they're job/career viability is as it is a pretty unknown field. Even some of my teachers didn't know there's a NNP position!! I was kind of surprised. But now that I've heard from all of you, I am more comforted in the direction I've chosen. Who knows, maybe after I work on the unit and see how they actually work together, I may decide that it's not for me. But for now, I can't wait to start working with the wee ones :)

If anyone else has any other info, PLEASE SHARE :chuckle Thanks!!

Gompers, BSN, RN · Jul 7, 2004

I guess how the NNPs and MDs work together really depends on the hospital. Where I volunteered and shadowed, the RNs explained to me that the NNPs actually worked under the neonatology dept, so they all worked under the head neonatologist, alongside other neonatologists. I'm sure if I end up in a teaching hospital (which I have my eyes on), I will get to see how they work together first hand. I'm not sure about their prescription previleges though, I guess it's different with each state? I'm going to have to do some research on that.

Yes, they do work under the neonatalogy department with the attendings, but what I meant to say is that they are STAFFED under nursing usually so their schedules and the residents' schedules have no bearing on each other, as they are considered different departments when it comes to budgets and such. Does that make sense?

As far as prescription priviledges go, that may change before you get your NNP so don't worry too much about that. More states may approve of them, or others may take away the priviledge, who knows. It doesn't make a huge amount of difference on our unit - all it means is that we can't chart the meds off in the computer until the MD has approved it for administration. I've never seen a doc refuse to cosign something, so really just a matter of paperwork, etc.