Neonatal nursing is a subspecialty that deals with the health of newborns that experience any number of common and not-so-common problems shortly after birth. Thanks to significant advancements in prenatal screening, neonatal medicine and technology, low-birth weight-newborn survival rates continue to increase. In fact, according to the National Association of Neonatal Nurses (NANN), survival rates for low-birthweight infants in the US are 10 times better now than they were just 15 years ago.
As advanced practice registered nurses (APRNs), neonatal nurse practitioners may provide care to neonates and infants that are healthy, though their specialized expertise makes them indispensable to treating those with complex acute, critical and chronic health conditions like birth defects, infections, prematurity, and cardiac problems, among many others.
Whether serving in a primary care role or serving the acute and critical care needs of neonates, neonatal NPs perform comprehensive assessments and diagnostic evaluations, as well as develop treatment plans for symptom and disease management.
It is typical for neonatal nurse practitioners to provide care to newborns until the time they are discharged from the hospital. While this window of time typically just accounts for the first days or weeks after a child is born, for some profoundly ill or premature infants it may take many months. Therefore, neonatal nurse practitioners are educated and skilled to provide care to young patients from birth to age two.
Neonatal nurse practitioners use an evidence-based approach that includes serving as educators, researchers, consultants, and advocates. Their professional focus is on:
- Health promotion
- Disease prevention
- Health maintenance
- Parental counseling and education
- Diagnoses and treatment of acute and chronic illnesses
Neonatal nurse practitioners provide complex monitoring and ongoing management of intensive therapies in a variety of settings, although most neonatal nursing occurs in hospital-based neonatal intensive and convalescent settings.
The job duties and responsibilities of neonatal nurse practitioners include:
- Obtaining health histories and performing comprehensive assessments
- Collaborating with neonatologists regarding plan of care
- Stabilizing and transporting infants via both ground and air transportation
- Incorporating developmental care in the delivery of patient care
- Promoting family-centered care and healthy infant-parent attachment
- Writing orders
- Performing patient rounds
- Working alongside the neonatal team to care for infants
- Obtaining operative/procedure consents
How to Become a Neonatal Nurse Practitioner: Earning an MSN in Preparation for National Certification and State Licensure
To become a neonatal nurse practitioner, an RN would be expected to start by earning a Master of Science in Nursing (MSN) with a Neonatal Nurse Practitioner track in order to qualify for national certification and state APRN licensure.
RNs with unencumbered licenses in good standing who have completed their master’s programs would be eligible to test for the Neonatal Nurse Practitioner-Board Certified (NNP-BC) credential through the National Certification Corporation.
To qualify for admission into a traditional MSN-Neonatal Nurse Practitioner program, incoming students would be expected to possess a Bachelor of Science in Nursing (BSN) and hold an active RN license.
However, because these programs tend to be highly competitive, it is commonplace for institutions to require candidates to also possess:
- Minimum undergraduate GPAs
- Minimum GRE scores
- Letters of recommendation
- Experience working in the Neonatal Intensive Care Unit (NICU)
Most neonatal nurse practitioners begin their careers as staff RNs caring for critically ill newborns in a Level III Neonatal Intensive Care Unit (NICU) or providing supportive care for convalescent or mildly ill neonates in a Level II NICU. Moving on to become a nurse practitioner, however, requires a nurse practitioner graduate degree in neonatal nursing.
MSN Program Options
Although traditional MSN programs accommodate students with BSNs, not all RNs possess this level of education. Therefore, many institutions offer a variety of MSN programs designed to accommodate those with different educational backgrounds:
- RN-to-MSN Programs for RNs with an Associate Degree in Nursing: RN-to-MSN programs (also often referred to as accelerated MSN programs), allow RNs that possess associate’s degrees in nursing to earn both their BSN and MSN in one, accelerated program. While traditional MSN programs take about two years to complete, these programs take about three years to complete.
- Direct-Entry MSN Programs for Non-Nursing Professionals with a Bachelor’s Degree in an Area Other than Nursing: Direct-entry MSN programs are designed for nontraditional nursing students that possess a bachelor’s degree in a major other than nursing. Designed to appeal to career changers, direct-entry MSN degrees (also often called entry-level MSN degrees) allow students to first earn their RN license before going on to complete all of the required components of the BSN and MSN.
Many institutions also design MSN programs as:
- Part-time programs
- Fully or partially online programs
Online MSN programs allow students to complete most or all of the didactic requirements of their program through web-based learning and then complete the clinical requirements of their program at partner sites close to home. In most cases, students are able to complete clinical requirements at their current place of employment.
What to Expect from Content in MSN Programs with a Neonatal NP Track
An MSN-Neonatal Nurse Practitioner degree program prepares students to design, implement, and evaluate healthcare strategies for high-risk infants and their families, which would involve:
- Attending high-risk deliveries
- Performing comprehensive assessments and diagnostic evaluations
- Coordinating care across the continuum
Graduates of MSN-Neonatal Nurse Practitioner degree programs possess the skills and competencies required to assume an advanced practice role as a neonatal nurse practitioner, where they deftly:
- Apply theory and research
- Expand their knowledge by identifying research problems, participating in research, and engaging in evidence-based practice
- Utilize their leadership skills for positive policy change
- Adapt to a constantly changing healthcare environment
- Contribute to the advancement of the profession
Comprehensive MSN-Neonatal Nurse Practitioner programs earn accreditation through the Commission on Collegiate Nursing Education (CCNE), which ensures that programs meet the curriculum guidelines of the National Organization of Nurse Practitioner Faculties and the National Association of Neonatal Nurses.
The two, major components of an accredited MSN-Neonatal Nurse Practitioner program are:
The coursework of an MSN-Neonatal Nurse Practitioner program supports skills development and provides advanced knowledge in:
- Acute neonatal pathophysiology
- Diagnostic and therapeutic management of acutely ill and convalescent neonates/infants
- Ethical issues in acute care
- Family/child development and theory
- Maternal-fetal health risks
- Neonatal nutrition and pharmacologic management
- Neonatal/infant health assessment
- Pediatric/neonatal physiology
- Professional role development of the neonatal nurse practitioner
Most neonatal nurse practitioner master’s degree programs progress from intermediate to chronic care; with the latter half of the programs focusing on the critical care setting.
The clinical experiences of an MSN-Neonatal Nurse Practitioner program round out the graduate course of study by immersing students in direct patient care across the continuum. During clinical sequences, students begin applying the theoretical components of their education.
Clinical experiences occur across a variety of clinical environments that specialize in caring for neonates and infants with complex healthcare needs. Sites include hospitals, primary care settings, medical centers, community clinics, ambulatory care centers, and specialty clinics.
Although MSN-Neonatal Nurse Practitioner degree programs vary according to the number of clinical hours required to complete the program, they must include at least 600 clinical hours to meet the requirements for national certification as a Neonatal Nurse Practitioner through the NCC.