Neonatal Nurse Practitioner Specialization Guide - 2022

Last Reviewed: April 3rd, 2022

What does a Neonatal Nurse Practitioner do?

Nurse practitioners (NPs), specifically neonatal nurse practitioners (NNPs), hold a very valuable role within the field of medicine. These healthcare professionals are essential to the functioning of neonatal units, and their skills are unparalleled when it comes to communicating with families and providing high-quality medical care. They are able to use their skills and passions to help others by expanding their education, enhancing their training, and gaining much more specialized experience.

Nurse practitioners are healthcare professionals who have acquired a valid RN license, a Master of Science in Nursing (or Doctor of Nursing Practice), and extensive clinical training within their specific field. These very specialized healthcare professionals are able to hold positions within a variety of different areas of medicine. These branches include family medicine, pediatric medicine, women’s health medicine, adult-geriatric medicine, psychiatric mental health, and neonatal medicine settings.

Neonatal nurse practitioners specialize to provide medical care to newborns, specifically those who are high risk. Included in this category are babies who are born prematurely and babies with infections, along with any babies who are born with congenital conditions. NNPs are highly trained to deal with very specialized conditions and circumstances they may encounter, which makes them an incredibly valuable resource for practices to have. Some specialized duties and knowledge neonatal nurse practitioners are expected to perform and know are as follows:

Duties and Knowledge of Neonatal Nurse Practitioners

  • Interprets the role of the NNP to the infant’s family, other healthcare professionals, and the community.
  • Determines the health literacy needs of infant’s family in planning care.
  • Advocates for quality patient care.
  • Assists families in dealing with system complexities.
  • Conforms to the Code of Ethics of the National Association of Neonatal Nurses.
  • Obtains a thorough health history to include maternal medical, antepartum, intrapartum, newborn, and interim history.
  • Performs a complete, systems-focused examination to include physical, behavioral, and developmental assessments.
  • Develops a comprehensive database that includes pertinent history, diagnostic tests, and physical and developmental assessment.
  • Demonstrates critical thinking and diagnostic reasoning skills in clinical decision making.
  • Establishes priorities of care.
  • Initiates therapeutic interventions according to established standards of care.
  • Demonstrates competency in the technical skills considered essential for NNP practice according to the standards set forth by national, professional organizations.
  • Intervenes according to established standards of care to resuscitate and stabilize compromised newborns and infants.
  • Implements developmentally appropriate care.
  • Ensures that principles of pain management are applied to all aspects of neonatal and infant care.
  • Documents assessment, plan, interventions, and outcomes of care.
  • Considers community and family resources and strengths, when planning patient care and follow up needs across the continuum of care.
  • Communicates with family members and caregivers regarding the newborn and infant’s healthcare status and needs.
  • Applies principles of crisis management to assist family members in coping with their infant’s illness.
  • Participates in the learning needs of students and other healthcare professionals.
  • Participates as a member of an interdisciplinary team through the development of collaborative and innovative practices.
  • Identifies strategies to deliver culturally sensitive, high-quality care free of personal biases.
  • Applies principles of neonatal pharmacotherapeutics to clinical practice.

NPs have been sought out more and more throughout the past several years, and that trend is only projected to grow. Depending on the state where the nurse practitioner is practicing medicine, there is a range of independence and autonomy these NPs can practice with. Some NPs are even able to open their own practices and clinics. Within the neonatal specialization in particular, neonatal nurse practitioners differ from registered nurses in that they have obtained higher levels of education and clinical experience in the realm of caring for babies who need extra help when they are born. Much of this additional training is focused primarily on helping infants have the best start possible in life, especially when that start begins on rocky terrain. The roles and duties of NNPs can vary on a day-to-day basis, but the overall responsibility to provide high-quality care to newborns who need some extra help getting their start in the world remains constant.

Some duties of NNPs (as listed above) involve analyzing and streamlining the healthcare process, minimizing risks for everyone involved, and developing healthcare systems so that they become more efficient, effective, and patient-centered. One of the biggest challenges for healthcare professionals tends to be organization. Nurse practitioners have the training and skills to deploy highly effective systems of organization that can benefit both hospitals and clinics on very high levels. Between providing exceptional patient care and streamlining and maintaining vital administrative processes, NNPs serve as a critical foundation for neonatal care.

A Typical Day for a Neonatal Nurse Practitioner

While there is hardly a typical day in the life of a neonatal nurse practitioner, most days would include few key aspects of providing care. This would include assessments on the newborns, both in terms of their gestational age and their physical development. These assessments are very thorough, and they provide important indicators as to how these babies are responding to care. There is a lot that rests upon the results of these tests. These assessments help NNPs to identify an appropriate plan of care for each baby. Depending on the scope of practice allowed for nurse practitioners, nurse practitioners will be able to implement different levels of care to help these babies according to the plans that they create.

Neonatal nurse practitioners also spend time collaborating with other healthcare professionals, such as doctors and registered nurses. Depending on the scope of practice in the state where each NNP works, they may be responsible for performing and analyzing diagnostic tests. They are also often in charge of collecting detailed histories of their patients.

One of the most important duties of an NNP is to intervene when medically necessary, such as when a newborn needs to be resuscitated. NNPs are often in the first line of defense when it comes to caring for babies in these critical moments.

NNPs also provide valuable education and consultation to other healthcare professionals and parents of these babies. Since they have an extensive level of knowledge and training within the neonatal medical field, they are able to provide valuable information to healthcare providers and families alike. Since they work one-on-one with their patients so often, they are able to develop a very close professional relationship with them. This allows them to convey information in a gentle, yet analytical manner that can prove to be very effective even within difficult circumstances.

There are two primary types of shift schedules for nurse practitioners. The first type of schedule is the day shift schedule, where an NP works a more average workday to acquire 40 hours throughout the course of the week. The other type of schedule that is often seen among nurse practitioners is a 24-hour shift schedule. There are also day/night shift rotations and day shift rotations, although day shift rotations are the least utilized. The preferences are split almost equally with about 42% of NPs preferring to work the day shift and 40% preferring the night shift.

Career Stability and Projections

Nurse practitioners have significant job stability, and the projections for the future of the career are also excellent. The current projections for job growth for nurse practitioners across the country in general is to grow 28.2% from 2018 to 2028 (BLS Employment Projections). That is significantly higher than the projected job growth for most other professions.

Much of the reason for this projection is that the need for medical care in general is expected to increase significantly. Part of this job growth and career stability is thought to be due to an increased effort to minimize health problems in newborns. These goals for newborn health act in direct correlation to the massive need for more neonatal nurse practitioners. Given that physicians are becoming increasingly cautious when it comes to maternity and newborn care, this makes a lot of sense. For those wishing to become nurse practitioners, the job outlook is excellent.

For those hoping to begin careers as neonatal nurse practitioners, the potential is even greater. There are so many ways to connect passion for helping newborns with a fulfilling career, and current projections make this that much more optimistic.

Career Satisfaction Levels

Career satisfaction statistics for nurse practitioners are excellent overall. According to one major survey of neonatal nurse practitioners, 73% of neonatal nurse practitioners are satisfied with their career. 60% are happy with the amount of paid time off and vacation days they are allowed, and 61% are satisfied with their retirement benefits. Another survey found that 82.4% of nurse practitioners are either satisfied or very satisfied with their careers. In both studies, job satisfaction consisted of both overall career satisfaction, satisfaction with benefits offered, satisfaction with time off and vacation days, and satisfaction with financial compensation for the job (see Common Nurse Practitioner Career Benefits). Most importantly, job satisfaction stemmed from the way that nurse practitioners feel about the aspects of their career overall, including the level of appreciation, autonomy within the profession, and appropriate compensation.

These high levels of satisfaction bode well for those considering working towards becoming an NNP. Relative to other professions, NNPs seem to be very content with their career choices. This may partially be due to the fact that there is so much mobility within the profession. Once someone has earned a Master of Science in Nursing  (or Doctor of Nursing Practice), there are many different options available to them within the field of healthcare. Given that nurse practitioners can choose to practice medicine within a hospital setting, in clinics, or alongside doctors in private practices, there are many different options open to nurse practitioners, particularly those who specialize as NNPs.

Depending on the state in which the NNP practices, they may even be able to open their own clinic. Hospitals and doctors’ offices are always looking for nurses who have extensive experience and knowledge. Demand for nurse practitioners is high, which means that for most NNPs, the world is their oyster.

The Downsides of Being a Neonatal Nurse Practitioner

Currently, one of the most common complaints of neonatal nurse practitioners is that they are overworked. The COVID-19 pandemic has put a strain on healthcare workers, and an astounding lack of appreciation for their hard work is wearing thin for some. Hopefully this is a temporary struggle that will fade as vaccination rates rise and the pandemic wanes; however, it would be remiss to ignore the fact that this has been a very real struggle for nurse practitioners in general throughout the duration of the pandemic.

Along with feeling overworked, many nurse practitioners feel underappreciated. They have gone above and beyond to provide high-quality care to their patients during the pandemic, and they feel that their hard work has been largely disregarded.

Another major issue is that a large percentage of nurse practitioners feel that they have insufficient time to spend with each patient. This is an issue that is only going to continue to get worse if the demand for high-quality healthcare in the form of nurse practitioners is not met.

Finally, an additional current issue within the profession is lack of consensus among states and entities in terms of scope of practice. Federal review of responsibilities, oversight, supervision, and scope of practice would ensure that the standards for nurse practitioners remain high across the board.

Overview of Requirements to Become a Neonatal Nurse Practitioner

The process to become a nurse practitioner can seem daunting, but it can also prove to be a very valuable experience for those who have a true passion for the medical field. For those who have a passion for the medical field and would like to enrich their nursing career, becoming a nurse practitioner can be a great decision. In particular, becoming a neonatal nurse practitioner is undoubtedly worth it for those who have a desire to help give babies the best start in life.

To become a nurse practitioner, interested candidates must first become a registered nurse. There are several different routes that one can take to get to that point. These include  Once someone is a registered nurse in good standing, they can apply to attend graduate school for a Masters of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), where they can then study to become a nurse practitioner. MSN programs can take between 18 months and 3 years to complete and Doctorate programs can take an additional year or two. For those looking to become neonatal nurse practitioners, the graduate school process will include a variety of foundational classes that are essential to practicing higher levels of medicine, followed by courses that center around caring for babies.

Once future NNPs have received the appropriate amount of education, they will earn a certain amount of clinical hours spent learning by hands-on practice the best ways to care for their neonatal patients. The process to satisfy requirements for licensure varies by state, but the basic requirements for becoming a nurse practitioner are the same across the board. Students studying to become nurse practitioners must complete both classroom and clinical experience in order to gain licensure, and all must hold a valid RN license. If you’re interested in becoming a nurse practitioner, explore the specific nurse practitioner licensing requirements and processes in your state.