Pros and Cons of Being a Neonatal Nurse Practitioner
Neonatal nurse practitioners (NNP), also referred to as advanced practice registered nurses (APRN), work with newborns, often in critical-care settings. Consider this career by reading the pros and cons listed below to weigh factors such as the cost and time requirements of graduate school and your ability to deal with stress.
| Pros of a Career as a Neonatal Nurse Practitioner |
|---|
| Above-average salaries ($97,990 mean salary for nurse practitioners in 2014)** |
| High job-growth field (31% growth for nurse practitioners from 2012-2022)** |
| Ability to work independently** |
| Varied job activities** |
| Cons of a Career as a Neonatal Nurse Practitioner |
|---|
| Highly stressful work** |
| Lengthy education requirements (6+ years)** |
| Continuing education, certification and licensing requirements*** |
| Exposure to diseases and other workplace hazards** |
Sources: *American Academy of Nurse Practitioners, **U.S. Bureau of Labor Statistics, ***National Council of State Boards of Nursing and the National Certification Corporation.
Career Information
Job Description and Duties
NNPs are a part of a group of health care specialists, referred to as non-physician practitioners (NPP), who are licensed to assess, diagnose and treat patients under the oversight of a licensed physician or surgeon. As an NNP, you would likely play a central role as part of a team caring for pre-term and full-term babies who may be critically or chronically ill. Your work might involve managing the clinical care given to patients, teaching family members how to provide ongoing home care, and/or coordinating discharge planning and follow-up care.
Salary and Career Prospects Info
In 2014, the U.S. Bureau of Labor Statistics (BLS) reported salaries for nurse practitioners varied from $68,830 (for the bottom-earning 10%) to $131,050 (for the top-earning 10%). According to a 2011 survey done by the American Academy of Nurse Practitioners, full-time NNPs earned base annual salaries of almost $108,000, with a total income figure of about $125,000 (a figure which included productivity bonuses). The BLS projected that job opportunities in the field of registered nursing would increase by 31% between 2012 and 2022 (www.bls.gov).
What Are the Requirements?
Education, Licensing and Certifications
To become an NNP, you'll need to earn a master's degree and pass a certification exam. Application requirements for master's degree programs include having a bachelor's degree in nursing and RN licensure (earned by passing the National Council Licensure Examination for Registered Nurses); experience in neonatal or critical care nursing is often also a prerequisite for application. In an NNP degree program, you'll take classes such as embryology, pathophysiology, neonatal physiology and pharmacology. You'll complete clinical practicum courses on site in varying health care settings.
NNP certification requires passing an exam administered by the National Certification Corporation (NCC). The exam covers competency areas such as infant assessment, family integration, disease processes, care management and legal and ethical issues in the practice of nursing.
In addition to federal requirements, states have their own regulations regarding licensure and certifications. Depending upon the job or location, you may need certifications in Basic Life Support (BLS), Pediatric Advanced Life Support (PALS), Neonatal Resuscitation Program (NRP) and NPP licensing, as well as licensing to prescribe and dispense controlled substances and other pharmaceuticals.
Skills
Because you'll be working in highly emotional settings with critically ill babies, you'll need to be compassionate and calm. You'll also need to be able to communicate clearly and to effectively coordinate care with a variety of providers. Stamina is also required, because you'll be usually on your feet working long shifts.
What Do Employers Look For?
A survey of jobs posted as available in November 2012 showed that employers seeking NNPs required current state licensing and, in some cases, medication approvals. Coordination with team members, leadership ability and teaching skills were noted as required or preferred talents. A sampling of jobs advertised is follows:
- A Rhode Island hospital advertised for an NNP to provide clinical care for patients. Responsibilities included teaching, discharge planning and resource coordination for follow-up care. Professional nurse licensure in Rhode Island, completion of an NP program at the master's level and NPP license were required.
- A Florida children's hospital sought an NNP with demonstrated expertise in clinical management of high-risk newborns. Completion of an approved neonatal critical care NP program, ARNP certification through NCC, NRP certification and a Florida license were required. Two years of experience were also required.
- A California children's hospital posted an opening for an NNP to provide primary care to acutely, critically and/or chronically ill and well neonates, providing assessment, diagnosis and implementation of care for patients and families. Minimum qualifications included RN and NP licensing, NNP, NRP and CPR/BLS certifications, and license to furnish controlled substance privileges (within six months of hire). Two years of experience as an NNP and/or two years of experience within the neonatal ICU were preferred.
- A New York health care provider advertised for an NNP for a Special Care Nursery in one of its hospitals, with rotations expected through another two hospitals' neonatal intensive care units. Previous neonatal nursing experience was strongly preferred, and a master's degree from an accredited NP program was required. Also required were RN and NNP New York State licenses, NNP certification from the NCC and NRP instructor certification.
How to Stand Out
Additional Credentials
Prior to earning an NP degree, you might look at two credentials that are available to RNs as well as NNPs, either of which would demonstrate dedication and competence. The Pediatric Nursing Certification Board (www.pcnb.org) administers pediatric certification exams for registered nurses, and the American Association of Critical-Care Nurses administers certification exams for nurses who have significant experience in critical care settings (www.aacn.org).
Adding credentials to your resume typically allows you to apply for more jobs and may enhance a management-focused resume. The NCC certifies a variety of neonatal specialties such as neonatal intensive care, low-risk neonatal nursing, electronic fetal monitoring and neonatal pediatric transport.
Other Careers to Consider
Registered Nurse (RN)
While RNs, with a median yearly salary of about $66,000, earn less than NNPs, you wouldn't need to earn a master's degree or pass additional exams. As an RN, you'd enjoy the same projected increase of 26% in job opportunities between 2010 and 2020, and would likely have a broader range of job possibilities. You can become an RN with an associate's degree plus passage of the licensing exam, and would need to complete continuing education and licensing renewal requirements.
Physician Assistant (PA)
If you are interested in pursuing a master's degree in health care and working closely with patients, but not necessarily in nursing, you might look at this option. PAs assess, diagnose and treat patients; they may specialize, but don't need to do so. The BLS reported average salaries of about $89,000 annually for PAs, and projected increases in job opportunities of 30% between 2010 and 2020.
Pediatrician
Pediatricians work with children, from infancy through late adolescence, and can specialize in areas such as neonatology or surgery. This is a field to consider if you want to treat patients free from the required oversight of another medical professional. In comparison to becoming an NNP, you'd need to be willing to complete up to 12 years of post-graduate work, depending upon specialization, but you would likely earn significantly more upon graduation; in 2011, the BLS reported a mean annual salary figure of around $158,000 for general pediatricians. Between 2010 and 2020, job opportunities for physicians in general were projected to increase by 24%.
