Medical advances and improvements in medical technology have made all the difference in making sure that even premature infants are able to thrive, going on to normal, healthy lives without anything to remind them of the rough start they had in those first days of life. There couldn’t be a better time to celebrate this progress than today, when preterm births number nearly 15 million annually and continue to rise, according to figures published by the World Health Organization.
And there couldn’t be a better healthcare environment in which these advances can take place, thanks to neonatal healthcare teams armed with the skills and knowledge necessary to care for the sickest, most fragile infants within the first months of their lives.
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Neonatal nurse practitioners are part of a highly skilled group of healthcare professionals who provide advanced care to newborn infants experiencing problems resulting from preterm birth, ranging from cardiac conditions to birth defects. The expert care neonatal nurse practitioners provide is one of the major reasons that survival rates are nearly ten times better than they were just 15 years ago.
It’s all in a day’s work for these expert care providers, but for the parents experiencing the stress of a sick infant, the tireless care and support they provide is above and beyond what would be expected of anybody simply doing a job. That’s because for these NPs, it really is much more than that.
High-Risk, High-Reward: The Job of the Neonatal Nurse Practitioner
Neonatal nurse practitioners care for the youngest of patients at all levels of the neonatal intensive care unit (level II, III, or IV). Outside of the NICU, they also often work in community-based settings where they provide high-risk follow-up care. While the provision of care is usually limited to just a few months following a premature birth, the scope of these nursing professionals allows them to care for babies to age two.
Neonatal nurse practitioners are part of the interdisciplinary healthcare team that includes neonatologists, physician assistants, geneticists, surgeons, and neonatal RNs, all of whom work collaboratively to provide comprehensive, critical care to infants. They may also attend high-risk births and serve with teams of specialists, such as pediatric pulmonologists, pediatric gastroenterologists, pediatric hematologists, pediatric cardiologists, and more.
Their expertise in neonatal care is comprehensive, allowing them to examine, assess, diagnose, and develop/manage care plans for their neonatal patients. These pros of the neonatal NICU team are experts in areas like neonatal resuscitation, intubation, central line placement, chest tube insertion, lumbar puncture, and more.
Education and Certification Requirements to Become a Neonatal Nurse Practitioner
While the MSN remains the minimum educational requirement to become a neonatal nurse practitioner, the push by some industry groups in recent years to see the DNP become the new standard minimum in advanced practice nursing has led to the proliferation of DNP programs designed for both BSN- and MSN-prepared nurses.
The National Association for Neonatal Nurses recommends doctoral preparation for any neonatal NP in practice beyond 2020. Doctoral-level preparation among neonatal NPs also allows these advanced practice nursing professionals to remain on par with other doctorate-level practitioners in the interdisciplinary healthcare team, including psychologists, physical therapists, audiologists, occupational therapists, and more.
Most DNP programs leading to initial APRN certification in an NP role and patient population focus are glad to accept students with an active and unencumbered RN license. But because of the highly complex nature of DNP-NNP programs, applicants must also have between one and two years of full-time clinical practice experience as an RN in the care of critically ill neonates or infants in critical care inpatient settings to be admitted to an MSN or DNP program leading to initial APRN licensure. Some programs accept students without this experience but will require the completion of the necessary RN experience before beginning the clinical component of the program.
MSN-DNP programs consist of about 36 credits and two years of full-time study, while BSN-DNP programs consist of about 73 credits of full-time study. Some DNP-NNP programs are designed for practicing APRNs who want to add the NNP population focus to their current APRN license.
The DNP-NNP includes courses and clinical experiences that are designed to meet the AACN’s 8 DNP Essentials and prepare the student for national certification as an NPP. Beyond that, some of the additional specialty courses in this track include:
- Maternal Risk and Neonatal Health Promotion
- Management of the Sick Neonate
- Neonatal Disease Process
DNP programs include about 500 hours of clinical experiences, which include both clinical immersions and formal internships, as well as a DNP final project, which serves as a scholarly project that details a real-world project related to the neonatal nurse practitioner role.
Graduates of a DNP-NNP program are eligible to take the National Certification Corporation’s Neonatal Nurse Practitioner Certification (NNP-BC) exam and earn state licensure as an neonatal nurse practitioner.
Practice Autonomy and Prescriptive Privileges for Neonatal Nurse Practitioners
While neonatal nurse practitioners usually work in teams in the NICU setting, where they collaborate with everyone from neonatologists to surgeons to pediatricians, they still serve as licensed, independent practitioners with prescriptive authority who can diagnose, assess, and treat patients and prescribe diagnostic tests.
In 28 states and Washington D.C., these APRNs can work in a completely autonomous capacity, while in the remaining states, they must enter into some sort of physician collaborative agreement or practice with physician oversight.
Salary Expectations for Neonatal Nurse Practitioners
A 2019 Medscape APRN Compensation Report revealed that while the overall average salary for nurse practitioners was $108,000, those employed by medical/hospital groups earned slightly more, at $109,000, and those who worked in in-patient settings earned an average salary of $116,000.
NPs with a doctorate degree earned more than their MSN peers—$114,000 vs. $107,000.