What Is a Neonatal (NICU) Nurse Practitioner?

Medically Reviewed by Poonam Sachdev on April 28, 2022
4 min read

The tiniest humans are cared for by neonatal (NICU) nurses. Neonates are babies born prematurely: i.e., before undergoing a full nine months of gestation. These babies have low birth weights and may also have medical conditions and critical illnesses.

A NICU nurse is charged with caring for these special babies. Doing so can be sad, and it can be joyous, but it is definitely not for the faint of heart. There is a hierarchy of treatment professionals in the NICU, including the NICU nurse practitioner. 

Also charged with caring for these tiny babies, a NICU nurse practitioner takes on additional duties due to their training and additional knowledge base.

Neonatal nurses work in the NICU as caregivers specializing in nursing that deals with premature newborns. These NICU babies can have a variety of medical problems, including:

The first month of life for these young ones is defined as the neonatal period, but they will often remain sick for months. Neonatal nurses care for these infants that have medical problems at birth and continue to do so in the long term. 

Nurse practitioners have, in recent years, become a highly regarded choice of health partner for many Americans. These clinicians blend expertise in clinical diagnostics with treating health conditions. An extra emphasis is placed on health management and disease prevention, making Nurse Practitioners providers who bring a personal touch to healthcare with a comprehensive viewpoint.

Nurse practitioners complete a master's or doctoral degree and complete advanced clinical training, often learning more than what is required for the standard registered nurse (RN) degree. Academic and clinical courses help to prepare these nurses with specialized knowledge and clinical adequacy to practice primary care medicine, offer acute and long-term care, and navigate numerous healthcare settings. 

To become accredited, NPs go through extreme national certification, peer review, clinical evaluations, and code-of-ethics training. Continued learning and professional development are also required to remain accredited and employed.

Nurse practitioners participate in lay health and professional forums. They conduct research and are able to apply it practically in clinics. They promote improved clinical outcomes and quality health care.

In collaboration with other medical professionals, nurse practitioners provide several services in healthcare settings, including:

  • Managing the overall care of patients
  • Ordering medications and other treatments
  • Diagnosing and treating conditions like diabetes, infections, high blood pressure, and injuries
  • Counseling
  • Ordering, administering, and explaining diagnostic tests such as x-rays and lab work
  • Educating patients about positive health, lifestyle choices, and disease prevention

Specialties and subspecialty areas include: 

  • Family Health 
  • Gerontology 
  • Neonatal Health 
  • Acute Care 
  • Pediatric/Child Health 
  • Psychiatric/Mental Health 
  • Oncology
  • Women's Health 
  • Dermatology
  • Neurology
  • Hematology
  • Oncology

The first 28 days of life are the neonatal period for newborns. Neonatal nurses are well-trained to care for low-need infants, but a neonatal nurse practitioner often serves as the more advanced provider who is tasked with caring for newborns in need of specialized care.

Neonatal nurse practitioners care for sick and premature newborns in the:

  • NICU
  • delivery rooms
  • specialty clinics  
  • emergency rooms

NNPs are often the primary caregivers to ill or premature newborns because of the neonates’ constant need for monitoring. The neonate being cared for by the NNP will need focused, specific care due to low birth weight, heart abnormalities, respiratory distress, congenital malformations, or other disorders. 

NNPs work under the instruction of a neonatologist or neonatal fellow, but they are able to take full responsibility for their patients. They are able to apply medical judgment to diagnose, assess, and initiate medical action.

Before you become a nurse practitioner, you have to become a nurse. Nursing education can come via three routes in an accredited school of nursing:

  • Obtain an associate degree following 2 to 3 years at a community or junior college.
  • Obtain a diploma degree through a hospital-based nursing school. These programs are losing popularity, though, and are being phased out in most of the country.
  • Obtain a baccalaureate degree (BSN) earned at a college or university. This is the most flexible option when it comes to your career.

People with other degrees may still be able to enter an accelerated program to obtain a Bachelor of Science in Nursing (BSN) or a Master of Science in Nursing (MSN) in 1 to 2 years. 

Aspiring neonatal nurse practitioners can pursue a Doctor of Nursing Practice program that emphasizes learning about the neonatal patient population. A Master of Science in Nursing with a concentration in neonatology is also recognized as a national certification with advanced practice licensure for all state boards of nursing. 

Some nurses pursue a generalist MSN and eventually earn a NNP post-masters.

Most advanced degrees in neonatal nursing require two years of experience via Level III nursing as a requirement for eligibility. Most advanced programs include a core curriculum in:

  • neonatal physiology
  • neonatal pharmacology
  • embryology
  • pharmacotherapeutics
  • advanced neonatal assessment 

Neonatal nurse practitioners are able to be licensed in all states and the District of Columbia. They practice medicine under the rules and regulations of the medical governing board of the state they are licensed in. 

NNPs can provide care in urban, rural, and suburban communities. They can be found in medical settings including:

  • a private physician or NP practices
  • nursing homes
  • clinics
  • hospitals
  • emergency rooms
  • schools
  • colleges
  • urgent care sites
  • public health departments