Why Are There Neonatal NPs When There's Pediatric NPs

LoveMyBugs, BSN, CNA, RN · Oct 1, 2016

NICU is highly specialized.

most NICU babies are not even supposed to be born yet, the way they are cared for is very different than a pediatric pt.

Pediatric you have birth to 18-20 yrs of age and all of the development stages.

NICU babies same idea, caring for a 24 wheeler to a 40weeker each has developmental stages

most NICU nurses I know will not take care of a pt older than 6 months. The NICU in my facility dosent require the nurses to float to other floors.

NICU is an entirely different world. Either you love it or hate it. Same I would think for NPs.

CanadianRN16 · Oct 1, 2016

It's the same reason why NICUs exist, premature neonates have specific acute needs that require specialized training. Pediatric NPs learn how to address infants to adolescents, which is a broader education. Even PICU nurses can't just jump into a NICU without prior training.

TheCommuter, BSN, RN · Oct 1, 2016

Moved to the Nurse Practitioners forum for more feedback.

PG2018 · Oct 2, 2016

Because nursing has failed to ever produce comprehensive "advanced practice." Neonatology is a subspec of pediatrics so why nursing doesn't follow this ideology is beyond me.

babyNP., APRN · Oct 2, 2016

Some PNPs do work in the NICU, although it's more on the rare side and they usually have good NICU RN experience. It's largely a lack of exposure to a highly specialized area. They would need an extensive orientation, similar to physician assistants (who are taught as generalists with very little if any time in the NICU).

Keep in mind that NICU is also an ICU with intubated babies on pressors, post-ops, ECMO, etc etc and most PNPs do not have ICU experience; usually just acute care peds floor. Much higher learning curve. Acute care PNPs that work in the PICU generally have a PICU RN background- they don't go from having acute care experience to being a PICU PNP without any training.

PsychGuy, I would argue that it's not the job of nursing schools to teach folks how to work in an ICU. There's too much to cover in nursing to do that, and medical school is set up similarly.

guest769224 · Oct 3, 2016

Because nursing has failed to ever produce comprehensive "advanced practice." Neonatology is a subspec of pediatrics so why nursing doesn't follow this ideology is beyond me.

It isn't just nursing. Why are there neonatologists and pediatricians then?

Shookclays, ASN, BSN, CNA, RN · Oct 4, 2016

Some PNPs do work in the NICU, although it's more on the rare side and they usually have good NICU RN experience. It's largely a lack of exposure to a highly specialized area. They would need an extensive orientation, similar to physician assistants (who are taught as generalists with very little if any time in the NICU).
Keep in mind that NICU is also an ICU with intubated babies on pressors, post-ops, ECMO, etc etc and most PNPs do not have ICU experience; usually just acute care peds floor. Much higher learning curve. Acute care PNPs that work in the PICU generally have a PICU RN background- they don't go from having acute care experience to being a PICU PNP without any training.
PsychGuy, I would argue that it's not the job of nursing schools to teach folks how to work in an ICU. There's too much to cover in nursing to do that, and medical school is set up similarly.

Thank you! But I'm confused. What's the difference between a PNP working in acute care peds and a PNP working in the PICU?

subee, MSN, CRNA · Oct 4, 2016

Neonates are different PHYSIOLOGICALLY.

The general anatomy and physiology courses nurses take do not begin to address these little critters' needs. They Deserve highly specialized caregivers. Now would I want these nurses at my bedside after having my chest cracked open and my blood supply diverted outside of my body? No! But they are the only people qualified enough to work in NICU. The days of a general nursing practice are over. Too much to know. Even med-surf is a specialty. They have their own body of knowledge and it does not transfer well to NICU, psych or any other specialty.

babyNP., APRN · Oct 5, 2016

Thank you! But I'm confused. What's the difference between a PNP working in acute care peds and a PNP working in the PICU?

Well...one works in the PICU and works in acute care

The certification and generally the schooling is the same: acute care PNP (clinic is generally primary care PNP). The difference is that no PICU would hire a new grad PNP that didn't have PICU RN experience. There is way too much to know about an ICU to allow them to work in a place as a provider with no experience in an ICU. Maybe if it was an experienced PNP with acute care that wanted to transition, I guess, but would need an extensive orientation. Managing patients on ventilators, various drips, CRRT, ECMO, etc etc takes too much background knowledge for them to not have a basic understanding of it. This is also why grad schools virtually all required NICU RN experience before becoming a NNP. They expect you to already have a basic idea of pathophys and various treatments.

PG2018 · Oct 5, 2016

It isn't just nursing. Why are there neonatologists and pediatricians then?

Physicians are all trained essentially the same way. They get residencies. We get like 700 hours of observation. You're telling me nothing I don't know.

Skippingtowork · Oct 6, 2016

Physicians are all trained essentially the same way. They get residencies. We get like 700 hours of observation. You're telling me nothing I don't know.

PsycGuy, NNPs are trained in the neonatal intensive care and usually are NICU nurses. Often they have been performing procedures in the unit and sometimes are transport nurses. I do not know of any nurse practitioner program that consists of 700 "observation." Clinicals are hands-on experiences, as in any other medical profession, including nursing and medical assistants.

If you are dissatisfied with your training as an NP, you have the option of returning to bedside nursing.