Expanding the caregiving environment for advanced practice neonatal nurses

A nurse practitioner model of practice in the neonatal intensive care unit

PURPOSE

The purpose of this study was to describe the practice of the nurse practitioner (NP) in the neonatal intensive care unit (NICU) in an attempt to define an advanced practice nursing model that is unique to NP practice in the NICU.

DESIGN

This qualitative research used an ethnographic case study design to answer the research question: 'What is the practice model of nurse practitioners working in the NICU?'

METHODS

Seven nurse practitioners working in five level II/III NICUs in Massachusetts and Rhode Island were interviewed and observed in practice. Audiotaped interviews using open-ended questions and field notes from participant observations were analyzed for patterns of behavior.

RESULTS

These nurse practitioners practiced within a model of advanced practice nursing that emphasized health, holism, and caring within the highly technological and medical NICU environment.

CLINICAL IMPLICATIONS

A model of NP practice in the NICU is emerging and needs further development and testing. Nurse educators and administrators must find ways to support the nursing model in the advanced practice nursing role in the NICU. Nurse practitioners need to be more active in promoting a clearer understanding of their practice and contributions to the NICU care delivery team.

The role of the neonatal nurse practitioner in post NICU follow-up

This descriptive correlational study explored the role of neonatal nurse practitioners (NNPs) in postneonatal intensive care unit follow-up. A random sample of 505 NNPs completed a researcher-developed instrument pretested for reliability and validity. There was overwhelming agreement (96%) that a role exists for NNPs in follow-up. In total, 52% felt qualified to provide follow-up and 22% were currently in the role. NNPs with previous primary care experience (P = 0.010) were more involved in follow-up. NNPs with additional certification (P = 0.016) or previous primary care experience (P = 0.003) felt more qualified to provide follow-up care. Facilitators and barriers to the role were identified by NNPs providing follow-up care.

Career opportunities for neonatal nurses

This article will outline career opportunities now available for neonatal nurses in acute care and community settings. Healthcare reform has increased the emphasis on health promotion, holistic care, and patient teaching, vital aspects of all nursing education and practice. Nurses choosing to capitalize on these strengths have opportunities to develop and shape their future nursing careers.