What Does a Neonatal Nurse Practitioner (NNP) Do? All You Need to Know

A neonatal nurse practitioner (NNP) is an advanced practice nurse who cares for infants who require intensive care immediately after birth. They expertly manage newborn conditions like respiratory distress, low birth weight, congenital heart diseases, and electrolyte imbalance. These healthcare providers usually work in a neonatal intensive care unit (NICU) alongside neonatal nurses, neonatologists, respiratory therapists, and other clinical staff. 

Curious what it takes to become one of these providers? In this article, we do a deep dive into the role of NNPs, explain what they do, and review the necessary schooling and clinical experience required to start your NNP journey. 

What do Neonatal Nurse Practitioners (NNP) do?

Neonatal nurse practitioners perform a variety of duties relating to providing care to sick and premature neonates and newborns. Specific duties include:

♡ Ordering and interpreting diagnostic and laboratory tests.

♡ Monitoring vital signs. 

♡ Performing bedside procedures like intubation and central line placement.

♡ Starting and maintain IV lines, specifically central catheters and umbilical lines

♡ Diagnosing and treating acute and chronic conditions.

♡ Documenting a thorough maternal medical history, along with any perinatal diagnoses and symptoms.

♡ Detecting changes in a patient’s health and altering the treatment plan when necessary.

♡ Educating patients and family members on their newborn’s disease process and plan of care.

♡ Monitoring and adjusting specialized equipment like incubators, ventilators, heart/lung bypass machines, total body cooling, and dialysis equipment to help patients meet their clinical goals.

♡ Leading neonatal resuscitation efforts alongside other team members.

♡ Communicating with other frontline clinicians and bedside nurses.

♡ Prescribing medications (independently or in a collaborative agreement with a physician, depending on the state of practice).

♡ Assisting with patient admission and discharge. 

♡ Participating in post-discharge primary care management.

♡ Participating in high-risk newborn transport.

♡ Leading staff education programs.

NNPs, like other nursing professionals, often work 12-hour shifts in acute-care hospitals. They are often expected to work day and night shifts and may be required to work on-call shifts for emergency deliveries or patient decompensation on a non-acute unit. 

What Steps Are Required to Become an NNP?

A neonatal nurse practitioner is an advanced professional nursing position. This process takes around 6 years from start to finish. Below, we outline the general steps required to become a licensed neonatal nurse practitioner. 

Steps to Become a Neonatal Nurse Practitioner:

1. Go to nursing school to get your nursing degree (ADN or BSN).

2. Pass the NCLEX.

3. Work as an RN (it’s best to get experience in a labor and delivery unit, postpartum unit, birthing center, or NICU to prepare for your NNP journey). Most NP programs prefer applicants with at least 1-2 years of bedside experience. 

4. Apply to a master’s nursing degree program (MSN or DNP).

5. Pass your boards to get your advanced practice registered nurse (APRN) nursing license.

6. Start working as an NNP!

Which Degree Program Should I Choose to Become an NNP?

You’ll need to earn either your MSN or DNP from an accredited program with a specialty in neonatal nursing. There are three main degree pathways you can take to become a neonatal nurse practitioner:

1. MSN-NP: One of the most common options for NP programs, the MSN-NP is for students who already have their BSN and enroll directly into the program at the graduate level. These programs usually take 2-3 years to complete. 

   - Basic requirements: The applicant must possess a BSN degree.

2. DNP: Doctorate Nurse Practitioner programs allow students to receive their doctorate degrees while meeting the requirements to become an NP. The DNP is generally suited for nurses who plan on working in an academic or research-based setting or want to go on to teach nursing courses in a university or college. These programs usually take 3-4 years to complete. 

   - Basic requirements: The applicant must already possess a BSN degree.

3. Postgraduate Certificate: If you have a graduate degree that is different from the area that you wish to specialize in, you can search for a school that offers a post-graduate certification option to allow you to enroll directly into the program.

   - Basic requirements: Post-grad certificate programs require you to either possess your Master’s Degree of Science in Nursing (MSN) or have a Nurse Practitioner qualification in another specialty.

What Are the Top 10 NNP Programs in the U.S.?

Now that you know what it takes to become an NNP, you may be curious — which colleges and universities offer NNP specialty programs? Below, we list some of the highest-rated NNP programs across the country. 

• Vanderbilt University

• University of Pennsylvania

• University of Virginia

• Ohio State University

• Duke University

• Case Western Reserve University

• University of California- San Francisco

• Emory University

• University of Connecticut

• University of Alabama- Birmingham

Resources for Every Step of Your Nursing Journey

The first step to becoming a great NNP is becoming more comfortable and confident as a bedside nurse. At NICUity, we’ve got tons of educational materials, online review courses, and bedside tools to boost your career and improve your clinical practice. 

Victoria (Tori) Meskin, MSN, RNC-NIC, has been a NICU nurse since 2012, caring for critically ill newborns in acute and high-acuity neonatal settings throughout Southern California. Board-certified in neonatal intensive care and experienced as a travel NICU nurse, she is also the co-founder and CEO of NICUity, a modern resource hub supporting NICU professionals and families through practical education, tools, and community. Outside of the bedside, Tori is a mom, wife, content creator, and nurse who shares the honest, relatable side of motherhood, nurse life, and entrepreneurship, offering practical tips and encouragement for healthcare providers and modern moms alike. Discover her latest resources and recommendations at www.tipsfromtori.com or reach out at lily@smallscreenmarketing.com.