I think Finnegan scoring system is the universal system that is used. As for the 2nd RN check, I think its a great idea. I just came from a unit that has quite a few withdrawal babies . I usually work nights and I try to keep the environment as quiet as possible and my score tends to be lower. I will come in 12hrs later and the scores are way higher and infants has increase dose of morphine so I dont mind the 2nd RN checking the scores with me. Last wk I attended the ANN conference in Orlando and NAS was one of the most popular seminars. Some units do use the 2 RN check, sending babies home on low dose Morphine, the use of Morphine and Phenobarbital as well as Clonidine to treat these babies.