How do I 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 the very young. ‘Neonates’ are actually infants who are four weeks of age or younger, according to Medline Plus, a website sponsored through the National Institutes of Health (NIH), and it is during this period that infections often occur and genetic abnormalities become apparent. NNPs specialize in detecting these conditions, and also in working with babies who are born prematurely. In a Level II neonatal intensive care unit (NICU), they might work with infants born pre-term but past 32 weeks or who are moderately ill or convalescing from Level IIl care. In a Level III NICU, they may be providing care for newborns and infants with critical illnesses or who are very high-risk.

Registered nurses (RNs) become APRNs for a variety of reasons. In fact, 60 percent of respondents to a survey called “Neonatal Nurse Practitioners: Influencers on Career Choice” (login required) said they decided to pursue an education to become an advanced practice nurse while working as a RN, while just 22 percent said they made this decision prior to their RN education. According to the survey, there are slightly fewer than 4,000 NNPs working in the U.S., and many of them decided to enter the field because of a specific interest in the neonatal patient population. Other reasons for RNs entering the NNP field include greater autonomy and the ability to offer more comprehensive care.

Certifications and Requirements to Become a Neonatal Nurse Practitioner

RNs can pursue a master’s degree in NNP care or look for a bridge program to take them directly from a bachelor’s of science in nursing (BSN) to a doctor of nursing practice (DNP). If they already have a master’s degree in a non-specialty nursing area, they can pursue a post-master’s certificate or a DNP. Students in both master’s and doctoral level program need to complete clinical hours, which give them the opportunity to work in their specialty setting and with their specialty patient population. They will learn about advanced 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 be necessary to complete their degree. When they are through with their education, students can seek neonatal nurse practitioner certification through the National Certification Corporation. Requirements for eligibility include:

  • Current RN licensure
  • Completion of an accredited, graduate level NP program
  • A graduate of such a program following 2006

Applicants can choose to take a paper-and-pencil test available at academic testing centers across the U.S. or a computerized test. As of mid-2014, the testing fee was $325, which included a $50 application fee and a $275 testing fee. A 34-page guide is available on the NCC website to help candidates prepare for the exam and gain an idea about what to expect as they work toward national certification. As part of the Advanced Practice Registered Nurses (APRN) Consensus Model, NNPs are expected to need this national certification to be able to be licensed as an APRN by 2015. In fact, typically an RN license, an advanced degree and national certification is needed to seek APRN licensure within a state. On its website, the American Association of Nurse Practitioners (AANP) offers a full listing about what is required state-to-state, what model of APRN practice each follows, and what nursing board RNs can contact to find out about licensure and requirements.

Deciding to become a NNP is no easy task. It takes both time and money. Many NNP programs take more than 40 credits hours to complete, which can be two to three years working full-time or more if completing a program on a part-time basis. Online neonatal nurse practitioner programs can be a benefit to nurses who are busy with a full-time career, but need flexibility to be able to complete their schoolwork. This can be especially pertinent if they work 10 to 12 hour shifts or may want to do their work on a ‘lunch break’ that occurs during the middle of a night shift.

Steps to Becoming a Neonatal Nurse Practitioner

There are many ways to become a neonatal nurse practitioner, including from various degree levels. Students may want to consider working on their DNP only because the American Association of Colleges of Nursing (AACN) is recommending that the DPN become the new standard of learning for NPs as of 2015. This is to help NPs gain more skills in leadership and advocacy, be on par with other health care professionals who have more education and to help to improve healthcare outcomes all around. Here are several neonatal nurse practitioner education options:

  1. From a BSN to a master’s degree
    Students with a bachelor’s of science in nursing can find any number of programs at the master’s level to help them advance their skills. Often, these master’s programs give them experience in Level I, II and III nurseries and train them how to work with high-risk newborns. Programs vary in terms of requirements. Regis University, out of Denver, for example, requires students to complete 43 hours, while the master’s program through the University of Missouri at Kansas City requires 45.
  2. Post-master’s certificate
    A number of schools offer a post-master’s certificate for students who wish to gain clinical training and instruction in NNP care. The University of Cincinnati is one of these and even makes it post-master’s certificate available through partial online learning. Vanderbilt University, based out of Nashville, also offers a post-master’s certificate in NNP as well as several others in different NP specialty areas.
  3. BSN-to-DNP or Post-Master’s DNP
    Finally, students can take that ultimate step to maximize their learning by working on a DNP. Students wishing to complete a bridge program should realize that they will be making a significant investment in learning as they will have a substantial number of credit hours to complete. For example, the NNP bridge program available through the University of Florida, out of Gainesville, is 93 credits. Students who already have a master’s degree in nursing can also advance toward their DNP. Arizona State University, out of Phoenix, has such a program, available in a hybrid-online format that prepares students for NCC certification, but that also allows them to choose a nurse educator role that requires additional coursework.