How to Become a Neonatal Nurse Practitioner

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Neonatal nurse practitioners (NNPs) are advanced practice registered nurses (APRNs) with graduate-level degrees, specifically trained to work with newborn infants. According to the World Health Organization, newborn infants are 28 days of age or younger and it is during this critical period that infants are at high risk of infections and developmental abnormalities, as well as other life-threatening issues. NNPs specialize in detecting these conditions and tend to infants who are born prematurely and transferred to neonatal intensive care units (NICUs).

Registered nurses become NNPs for a variety of reasons, including a specific interest in the neonatal patient population and its families and the ability to both practice greater autonomy and offer more comprehensive care. The level in which neonatal nurse practitioners can practice is based on their state’s practice authority. In addition, neonatal care is one of the highest-paying nurse practitioner fields. According to the most recent American Association of Nurse Practitioners National NP Compensation Survey, responding neonatal nurse practitioners’ average base salary was $112,893.

Some master’s programs, including one available at the University of California, San Francisco, require prospective neonatal nurse practitioners to have at least two years of acute care experience with infants, particularly working in a NICU. Read on to discover the detailed steps to become a neonatal nurse practitioner.

Certifications and Requirements to Become a Neonatal Nurse Practitioner

The first step to become a neonatal nurse practitioner is to complete a registered nursing program. From there, RNs can pursue a master’s of science in nursing (MSN) or a doctor of nursing practice (DNP)—both of which are offered in the NNP specialization. For instance, Loyola University New Orleans offers an online BSN-to-DNP program, which can take up to three years or more to complete, depending on whether prospective students are attending full-time or part-time.

Generally, students in both master’s and doctoral level programs need to complete between 550 (MSN) and 1,000 (DNP) clinical hours, which afford them the opportunity to work in a neonatal setting with newborn infants and their families. Prospective NNPs learn about advanced health assessment, pathophysiology, and pharmacology as it relates to neonatal care and may take classes in advocacy, ethics, and policy. A capstone project or research project could also be necessary to complete their degree.

Upon completion of a master’s or doctoral degree, practitioners typically seek neonatal nurse practitioner certification (NP-BC) through the National Certification Corporation. The National Certification Corporation also offers many resources, including a guide to the exam to help candidates learn what to expect as they work towards national certification.

Steps to Becoming a Neonatal Nurse Practitioner

STEP 1: Graduate from high school. Aspiring NNPs will typically excel in courses such as psychology, chemistry, biology, and statistics. Additionally, some people choose to volunteer in hospitals to gain experience in nurturing and caring for infants and families. At this stage, aspiring neonatal NPs are encouraged to achieve strong grades in science and math subjects, paying thought to writing skills as well to develop effective communication abilities.

STEP 2: Earn an associate’s or bachelor’s degree in nursing (2-4 years). Students typically earn their RN license as part of an associate’s or bachelor’s program in nursing. Requirements may vary by state, but generally involve showing proof of having completed an approved training program and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Typical courses in a bachelor of science in nursing (BSN) program, for example, include anatomy and physiology, lifespan development, microbiology, community health nursing, and principles of ethics, among others. To qualify for graduate school admissions, students are encouraged to seek out undergraduate programs accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).

STEP 3: Get experience working in a neonatal acute care clinical setting (at least 2 years). In order to qualify for an NNP graduate program, candidates typically need to have at least two years of clinical experience in a neonatal intensive care unit (NICU) or a similar clinical setting. There are four levels. Please note that applicants to programs generally need experience in Level II, III, or IV settings:

  • Level I – Basic neonatal nurseries for relatively healthy newborns
  • Level II – Specialty care nurseries for infants with moderate health problems
  • Level III – Subspecialty neonatal intensive care units (NICUs) for newborn infants who are extremely premature or in critical condition
  • Level IV – Regional NICUs for newborn infants in extreme critical condition

STEP 4: Pursue a MSN or DNP with a specialty in neonatal nursing (2-4 years). NNP programs feature courses such as advanced practice nursing in neonatal patients, evidence-based practice, physical assessment and diagnostic reasoning, advanced physiology across the lifespan, neonatal assessment, and population health in a global survey. In addition, students are required to complete between 550 and 1,000 neonatal nurse practitioner clinical hours. Please note that for candidates with a bachelor’s degree, MSN programs generally take two years to complete, while DNP programs take three or four years.

STEP 5: Obtain national certification and state licensing (timeline varies). The National Certification Corporation (NCC) offers a three-year neonatal NP certification. Prerequisites for this certification include having a graduate NP degree from an approved program, being an RN, and passing an exam within eight years of graduation from a qualifying program. Additionally, states have varying requirements for NP licensure and generally include an application, proof of a qualifying education, and a passing score on an examination. Reach out to local boards of nursing for details.

STEP 6: Maintain certification (every 3 years). This three-year certification must be maintained following a “continuing competency specialty assessment,” which determines the number of continuing education (CE) hours required (between 15 and 50). To learn more, please check out the NCC Continuing Competency Initiative Guide.