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What Is a Neonatal Nurse Practitioner (NNP)?

When nurses go through nursing school and eventually out into the nursing field to find jobs, they often have specialties in mind. For those who don’t, who are just beginning, or who are looking to change it up, the variety of specialties out there can be overwhelming. One such specialty you could consider is neonatal nursing.

You can begin working in neonatal nursing as a registered nurse. It’s a great career choice for nurses who want to care for newborns and their families. For those who love the field and want to go further, you can work to become a neonatal nurse practitioner (NNP). Here’s what you need to know if you’re considering a career as an NNP.

What Does an NNP Do?

An NNP provides care to at-risk newborns and infants. Some examples of high-risk conditions that would need an NNP to provide care are low birth weight, complications from premature birth like lung issues, congenital heart problems, and infections.

NNPs are in charge of making sure these infants are well taken care of. This includes diagnosing conditions, managing treatments, and educating the infant’s caregivers to make sure good care continues at home. While some problems can resolve over a few weeks or months, NNPs may need to follow the same patient until the infant turns two years old for more chronic conditions.

Responsibilities of an NNP

NNPs have many responsibilities that can vary depending on where they work. Some NNPs care for new mothers before and after giving birth and take care of healthy infants. Once babies are born, NNPs on labor and delivery floors could be the ones to take a newborn’s weight and measurements, bathe them, and monitor their health during their stay. In the case of emergencies, NNPs can perform resuscitation, which could be needed at any time after delivery. They also educate families on infant care, including breastfeeding if the mother is able.

Many NNPs specialize in taking care of infants with health concerns, such as premature birth, drug addiction, or genetic disorders.  In these areas of treatment, NNP responsibilities include managing ventilators for infants in critical condition or starting IV lines. 

Ultimately, it’s the NNP’s responsibility to support the mental, emotional, and physical aspects of their young patients while also making sure families understand how to properly care for their babies when they bring them home.

Where Do NNPs Work?

NNPs typically work in any unit or hospital that provides maternity care and in neonatal intensive care units (NICUs) of hospitals. They may also work in out-patient clinics, medical centers, private practices, and other community-based settings. 

Working with neonates is very specialized work, even with healthy infants. NNPs can work at any level of infant care, and those levels are determined by the amount of care and attention the patients need on a daily basis. What level of care a neonate needs depends on the infant’s birth weight, gestational age, and other vital signs. The higher the level, the more care is needed.

There are four levels of neonatal care:

●     Level I: Newborn nursery care. At this level, NNPs provide care to infants that are healthy and are carried full-term.

●     Level II: Intermediate care unit/nursery. NNPs work to care for sick or premature infants who need a health care professional to spend dedicated time with them. You can usually expect infants in this level of care to recover quickly. 

●     Level III: NICU. The infants in this level experience severe illness and critical health conditions that require a lot of attention and intensive care. These infants may have been born before 32 weeks gestation and need life support, or they may have a condition that requires surgery before they can go home.

●     Level IV: Regional neonatal intensive care unit. This level is reserved for infants that need critical care, usually due to a very premature birth. These infants often need very specialized and complex surgeries or equipment that they couldn’t get in a normal hospital’s NICU.

Career Outlook for NNPs

If you’re considering a career as a neonatal nurse practitioner, you’ll be joining a fast-growing field with high demand. As of 2019, there were 290,000 licensed NNPs in the United States, and it’s estimated that we’ll need even more in the coming years.

NNPs have critical roles in the medical field. So you’ll need extensive education and training to build the necessary skills for the job. That’s why NNPs earn a median total annual income of $130,500. This includes their base salary, incentives, and bonuses.

If an NNP holds a doctorate, they are likely to have more career choices and higher salaries than an NNP with a master’s degree. But even after graduating and getting licensed, neonatal nurse practitioners can and should continue their education like any other nurse by participating in training and contributing through conferences and events within the larger field of nursing.

How to Become an NNP

There are several steps to becoming a neonatal nurse practitioner. Like other nursing programs, you’ll need to complete clinical hours along with the required classwork for a degree. NNPs require at least a master’s degree along with several certifications and licensures.

  1. Finish an accredited nursing program. If you are not already a registered nurse, you’ll need to graduate from a nursing program to qualify to take the NCLEX-RN exam.
  2. Obtain RN certification. By passing the NCLEX-RN exam and getting licensed in your state, you’ll officially be able to work as an RN.
  3. Earn a Bachelor of Science in Nursing (BSN). Since NNP degrees are advanced degrees, you’ll need a BSN before you can continue into those programs. Although you can start practicing as an RN before you get a BSN, if you have the opportunity and resources to continue after your nursing program, take it. It will make it easier for you to find jobs in neonatal care.
  4. Complete two years of clinical experience in a neonatal setting. You also have the option of getting certifications that will help you specialize. Some of these certifications include maternal newborn nursing, inpatient obstetric nursing, low-risk neonatal intensive care nursing, and neonatal intensive care nursing.
  5. Enter into a Master of Science in Nursing (MSN) program and specialize in neonatal nursing. During your MSN program, you’ll need to complete between 550 and 1,100 clinical hours. Once you complete your MSN, you may wish to continue on and earn a Doctorate of Nursing Practice (DNP) before officially becoming an NNP.
  6. Obtain a nurse practitioner state license and a three-year NNP certification. To receive this certification, you’ll need to pass the exam within eight years of graduating from the advanced degree nursing program that you completed, and you’ll need to hold an RN license.

If you’re looking for per-diem shifts while you work toward becoming an NNP, Clipboard Health can help you find and book shifts that work with your schedule. Visit our Professionals page to learn more.

Michelle Paul

Michelle Paul is an RN Content Specialist at Clipboard Health. She has worked with a variety of patient demographics, ranging from young adults in foreign countries, to elderly residents in skilled nursing facilities, to healthy blood donors in her community. Her experience in content creation gives her a unique perspective on communication within the healthcare field.

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