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Neonatal nursing is a specialized practice of caring for newborn infants (neo meaning new, natal meaning birth) up to 28 days subsequent to birth. There are three different levels of working as a neonatal nurse: Level I consists of caring for healthy newborns, Level II caring for either premature or ill newborns, and Level III caring for newborns who cannot be treated in the other levels and are in need of high technology to survive. It is the neonatal nurse’s choice whether they wish to work in the intensive care units with the healthy born babies or with the ill and/or premature babies. Level I nurses are not in as much need anymore because the mother and newborn baby stay in the same room together. Also the mothers stay is very short compared to past stays after giving birth. In the 1950s a stay consisted of 8-14 days, now in the present it is common for a mother to leave 12-24 hours after giving birth, with the exception that the vaginal delivery had no complications.^[1] Level II nurses are more common than Level I because babies that are born prematurely or ill need constant attention. They are responsible for making sure the newborn has the care it needs. It may include giving supplemented oxygen to intravenous therapy to the newborn before the baby is allowed to go to their new home with their mother and father. Level III also known as Neonatal Intensive Care Unit (NICU), nurses are as important as Level II nurses. Level III nurses are there to provide direct patient care for the newborns. These nurses are in charge of monitoring the ventilators or incubators, making sure the baby is responding well and/or having no complications. The nurse must check on the infant every hour on the hour and record the information taken by the ventilators, or blood pressure, etc. If a nurse tries to slack and “cut corners”, this is simply not allowed and they must work diligently and professionally. Neonatal nurses also work under the eye and direction of neonatologists (specialists that have additional training in newborn intensive care). The nurses also work with other NNP (Neonatal Nurse Practitioner), so their teamwork is critical and cannot afford them to slack in this area of nursing. The majority of the time of working for neonatal nurses consists of teamwork, therefore it is critical the nurse must be able to work in stressful situations and irregular hours. NICUs are more commonly found in large hospitals or in children’s hospitals, rather than the basic family physician hospitals. It is the nurses job to not only care for the infant but have good communication skills with people, parents in particular. The nurses responsibility is to teach the parents how to care for their infant in the correct manner. The nurse explains how to watch to signs or symptoms indicating something is wrong with the infant. This allows the parents to pay close attention so they know whether their baby is fine or is need of hospital attention.

Qualifications and Requirements

The entry-level requirements to a neonatal nurse is different for the specific location. Most hospitals require that the nurse is a graduate of an accredited RN (Registered Nurse) program and also from an accredited school of nursing with a BSN (Bachelor of Science in Nursing) or MSN (Masters of Science in Nursing). Most hospitals require that there is a three year minimum of clinical experience in hospital setting. Specifically for neonatal nurses it is required that there is certification as a Neonatal Resuscitation Provider and/or certification in either Neonatal Intensive Care Nursing or Neonatal Nurse Practitioner. The NICU requires a certification for that unit. For all of these qualifications, there must be a CNS (Clinical Nurse Specialist) or RN certification of the state chosen to work in. Not all, but some hospitals insists that the nurse has shown clinical competence and leadership skills. The most important qualifications include being able to use medications, other knowledge needed for patient care, cardiopulmonary resuscitation and math calculations, among knowing the equipment and how to use it.

Salary

The amount of pay varies from state to state and country to country, but the range lies between $30 and $80 per hour. It depends on the cost of living in a certain location on what the pay will be. Usually the pay for beginner neonatal nurses is between $30,000 and $48,000. However, the higher up in status for being a neonatal nurse ranges from $30,000 and $50,000 and for a neonatal nurse practitioner lies between $50,000 and $190,000. The salary range varies depending on how experienced and how much advanced training the nurse practitioner has received. There are also benefits, such as bonuses, which go up to as much as $5000. The major importance for salary is mainly where the location is and how much experience has been obtained. The job's salary varies throughout the world and has a big range in the differences of pay.

History to Present

The introduction to the title of Neonatal Nurse Practitioner surfaced in the 1970s. The ability to gain this title was influenced by higher care for ill newborns, the nurse practitioner movement, and medical staff shortages. Nearly after thirty years of new technology that has risen, NNP are now a member of the neonatal health care team worldwide. However, this occurred after many years of practice restrictions and restraints. NNP had to overcome isolation, title ambiguity, variable educational preparation, and underutilization. Since the foundation of NNP, neonatal care has allowed long-term outcomes for premature and ill neonates and reduced mortality rate. NICUs and neonatologists had been in high demand and have risen drastically over the past 30 years. Over the past 20 years the amount of preterm births rose by 27 percent and over the past 10 years the amount of multiple birth increased by 45 percent. However, with the increase in NICUs and neonatologists, there has been a shortage and demand for more NICU specialists to care for the infants. 90 percent of NICU members are nurses and in 2020 the nursing workforce is predicted to be greater than twenty percent lower of what is needed. Reasons for this being staff cuts, overtime, and unlicensed nurses to provide nursing care. To make up for the shortage the NICU does rotations between residents and NNP, which has been proven very effective.

References

Church-Balin, C. Preventing prematurity. Helping Prematures.2003.

COINN. Global Unity for Neonatal Nurses. Frequently Asked Questions. January 1, 2004-2007.

Dole, Elizabeth and Baines, Luci Johnson.Nurses for a Healthier Tomrrow Career Info

Goodman, DC. The uneven landscape of newborn intensive care services: variation in the neonatology workforce. 2001. Neonate Care Services

Klinetop, Suzanne. Neonatal Nurse Practitioner. NNP

Selga, Ana May A. MD. Hospital Length Of Stay and Readmission Rates For Normal Deliveries Hospital Stay

The Times. Best Local Jobs Job Listing. 2006.