Neonatal NP Programs
A neonatal nurse practitioner (NNP) is an advanced practice registered nurse who diagnoses and treats infants with a variety of health problems, including prematurity, cardiac malformations, birth defects, infections, chronic illnesses, surgical complications, and other health issues. According to the National Association of Neonatal Nurse Practitioners’ (NANNP) 2016 Neonatal Nurse Practitioner Workforce Survey, NNPs only make up three percent of more than 205,000 nurse practitioners in the U.S. While NNPs are among the most experienced and satisfied with their professions, there is a rising NNP vacancy rate across the United States.
NNPs work with high-risk newborns—a subfield that can be both challenging and supremely rewarding—and are given generous privileges of practice depending on their state. The AANP (2017) reports that in many northwest and midwestern states, NNPs carry out many of the same duties as physicians, diagnosing illnesses and managing treatment plans without the approval of an overseeing physician. Other states—many concentrated in the south—may restrict the practice of NNPs and give doctors and other healthcare professionals the authority to supervise NNPs.
CareerOneStop (2017)—a data organization sponsored by the U.S. Department of Labor— reports that 78 percent of all NPs have master’s degrees, and another 14 percent have doctoral or professional degrees. While pursuing a master of science in nursing (MSN) may be the most common way to become a NNP, there is a new terminal degree for the profession on the rise: the doctor of nursing practice (DNP). The American Association of Colleges of Nursing (AACN 2017) recommends a DNP for the most comprehensive, advanced nursing practice training, especially for NNPs aspiring to top organizational or leadership positions. Generally, to qualify for an MSN or DNP program, prospective NNPs will need at least two years of clinical experience in level II, III and IV neonatal intensive care units (NICUs).
To clarify, there are four different levels of NICUs, including:
- Level I – for healthy newborns
- Level II – specialty care nurseries for infants with moderate health issues
- Level III – subspecialty NICUs for newborns who are premature or in critical condition
- Level IV – known as regional NICUs, these facilities are for infants who are in life-threatening or extreme conditions
Read on to discover how to become a NNP, including the required education and certifications, as well as what to expect from a NNP graduate program.
How to Become an NNP
Here is one possible path to becoming a neonatal nurse practitioner (NNP):
Graduate from high school. Those seeking to work as NNPs are advised to excel in secondary school science courses, especially anatomy, psychology, chemistry, and biology. Also, students may consider volunteer work with neonates where available, assisting in clinics, hospitals, and other healthcare settings. This coursework and experience can prepare students for the college application process.
Pursue a bachelor of science in nursing (BSN) or a similar degree (4 years). While there are a variety of academic points of entry for NNPs (e.g., associate’s degrees, non-nursing bachelor’s degrees, etc.), many choose to pursue a BSN because it fulfills course prerequisites in nursing. BSN programs typically feature courses such as health assessment, cultural variation & nursing practice, and clinical applications of anatomy & physiology. At this stage, students are advised to seek out nursing programs accredited by a recognized authority such as the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). The selective accreditation process gauges program effectiveness by measuring quality of faculty, curricula, and facilities, among other factors. It is important to seek out accredited programs not only to ensure that they deliver necessary nursing training, but also to qualify students for RN licensure through the NCLEX-RN exam (see below).
Become a registered nurse (RN) and get experience working with neonates (2 years). As part of associate’s and bachelor’s degrees in nursing, students typically receive training and earn RN licensure by passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). After that, NNPs may need at least two years of experience working in neonatal intensive care units (NICUs), particularly a Level III NICU.
Pursue a graduate degree in nursing (1 – 3 years). After garnering healthcare experience working with newborns, NNPs typically pursue a graduate degree in nursing. As stated above, there are two main degrees—the master of science in nursing (MSN) and the doctor of nursing practice (DNP)—which may have flexible academic points-of-entry. For those with a bachelor’s degree in a non-nursing field, the University of California, San Francisco (UCSF) offers a three-year master’s entry program in nursing (MEPN). As part of the curriculum, students become RNs through didactic coursework, clinical hours, and testing (i.e., NCLEX-RN), which are generally completed by BSN students. After that, they can choose their MS specialty. Other programs, such as the online NNP master’s program at East Carolina University, admit experienced nurses who achieved a minimum 3.0 GPA in an associate’s degree nursing program. That said, a majority of graduate programs in nursing call for BSN-graduates. In NNP master’s programs, students take courses such as advanced pharmacotherapeutics, pathophysiology of human disease, and diagnostic reasoning & clinical decision-making for NNPs. As part of the programs, students typically complete at least 600 direct patient care clinical hours in a healthcare setting. Admissions materials for graduate NNP programs may include:
- Resume or curriculum vitae (CV)
- Official university transcripts
- Neonatal Resuscitation Program certification
- A 1-2 page personal statement detailing the student’s objectives
- Letters of recommendation from mentors such as professors, NICU clinical supervisors, and other relevant colleagues
- At least 1-2 years experience working in a neonatal intensive care unit
- Interview (in-person or web-based)
- Proof of registered nurse (RN) licensure in the U.S., either unencumbered (i.e., nationwide) or in a specific state
- Graduate Record Examination (GRE) or Miller Analogies Test (MAT) scores
- Proof of immunizations and/or drug-screening
- Application fee
- Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) scores for non-native speakers of English
Get certified by national and/or state nursing boards (timeline varies). After graduating from an MSN or DNP program, aspiring NNPs typically seek national and state-based certifications. The National Certification Corporation (NCC) offers a three-year, national NNP certification. This certification allows NNPs to use the credential NNP-BC® (Neonatal Nurse Practitioner – Board Certified). Prerequisites for this certification include having a graduate NP degree from an accredited program; being an RN; and passing an exam within eight years of graduation from the program. Certification is critical to being able to practice. In fact, the American Academy of Nurse Practitioners Certification Board (AANPCB 2016) reports 81,602 NPs maintain an active national certification. Finally, there are also local (i.e., state-based) nursing boards which license, register, and certify NPs. The National Council of State Boards in Nursing (NCSBN) provides a useful list of state boards of nursing.
Maintain NNP licenses, registrations, and certifications (timeline varies). Every three years, NNPs must renew their NCC national certification by completing a specialty assessment. This evaluation determines the number of required continuing education (CE) hours and subject areas where the NNP needs to brush up on his or her knowledge. The NNP will have to complete the CE as part of the recertification process.
Many practicing NNPs choose to join professional associations which provide a number of opportunities, including job boards, CE classes, networking events, conferences, seminars, and more. Here are some common associations for NPs and NNPs:
Online Neonatal NP Programs
Online NNP programs may allow working NPs to fulfill direct patient care clinical requirements in a preceptorship close to his or her home. Courses may be completed online (or as a mix of web-based and on-campus work). These programs may be ideal for people at a distance from NNP schools or with commitments (e.g., parenting) that prevent them from attending campus-based program requirements.
Here are four featured online and hybrid NNP programs:
- The University of Texas in Galveston provides an online NNP master’s program and boasts a 90 percent passing rate on the National Certification Corporation (NCC) NNP-BC® exam. This program gives students 780 hours of clinical experience and features courses such as innovations in community health practices, public policy, and pathophysiology. Students are required to travel to Galveston only once per clinical semester. Please note that applicants must have a BSN degree and two years of experience in a Level III NICU to be eligible for admission.
- Baylor University of Waco, Texas provides an online, CCNE-accredited, 75-credit DNP program for BSN graduates with two years of experience in a Level III NICU. Baylor’s comprehensive curricula—including courses such as roles & business of the APRN, scientific inquiry, and clinical epidemiology—adheres to program guidelines established by the National Association of Neonatal Nurses (NANN).
- The University of Illinois, Chicago (UIC) has a unique, online DNP program for prospective NNPs interested in the superlative, terminal degree training in the field that may qualify them for future leadership positions. UIC gives instruction in areas such as advanced neonatal management (I/II/III), essentials of patient and family-centered care, and advanced training in pharmacology. Students can complete a majority of their academic classes online while completing their preceptorships close to their homes.
- The University of Connecticut offers a 44-credit online NNP program that also requires three on-campus visits over the course of the program. In addition, prior to beginning the program, applicants are required to have at least two years of experience as an RN in a Level III NICU.
Other online NNP programs of note include:
Highly Regarded Neonatal NP Programs
In addition to the online NNP programs, here are five featured schools for this subspecialty:
- The Arizona State University (ASU) offers a DNP program for NNPs that is available in both fulltime and parttime course formats. ASU’s program provides instruction in advanced clinical skills, management of complex & chronic conditions in neonates, and healthcare outcomes management, in addition to an impressive 1,125 supervised clinical hours to give students a chance to utilize their newfound competencies.
- Emory University of Atlanta provides a master of science in nursing (MSN) program for aspiring NNPs, the only program of its kind in the state of Georgia. With advanced training for NNPs in primary, acute, and critical care, Emory prepares its students with rigorous coursework (campus-based, hybrid, and online) and more than 700 hours of supervised clinical practicums. In a post-program survey, 52 percent of MSN graduates at Emory (2016-17) reported finding work immediately after completing the program.
- Northeastern University of Boston offers a MS in NNP to nurses with at least two years of experience in a neonatal intensive care unit (NICU), preparing students to provide healthcare in Level II/III NICUs. Northeastern gives instruction in common neonatal diseases, early assessment, and nursing management & technology, rounding out the didactic instruction with ample hands-on experience around local hospitals and clinics (e.g., Massachusetts General Hospital, Beth Israel Deaconess Hospital, UMass Memorial Health Care).
- The University of Rochester in New York hosts a NNP master’s degree program, offering an impressive 952 hours of hands-on supervised clinical training. Rochester’s renowned faculty gives students training in nursing care of high-risk neonates, ethics & public policy in healthcare, and advanced pharmacology. Please note that this school also has an accelerated program for non-nurses (APNN) for bachelor’s degree holders in other fields, provided they have completed prerequisite coursework.
- The University of Indianapolis offers a NNP master’s program, a partnership between Indiana University’s School of Medicine and IU’s Riley Hospital for Children. It is the only program of its kind in the state, with 690 required clinical hours and courses taught by experienced physicians. The core courses such as neonatal advanced pathophysiology, issues & policies in healthcare, and nursing research design & methodology are offered in online formats, although clinical courses are predominantly taught on-site.
Other well-regarded NNP programs with similar coursework and requirements include:
Finally, the National Association of Neonatal Nurses (NANN)—the group responsible for establishing “National Neonatal Nurses Day” on September 15—has a continually updated list of NNP programs available for prospective students in this growing subfield of nursing practice.
Students seeking neonatal nurse practitioner schools should look for programs accredited either through the Accreditation Commission for Education in Nursing, Inc. (ACEN) or the Commission on Collegiate Nursing Education (CCNE). The ACEN accredits diploma, certificate and degree-level programs in nursing, while the CCNE accredits baccalaureate programs, graduate-level programs and residency programs. Accreditation can be important for several reasons. First, it assures the student that they will find the needed rigor and quality in their program and have the training to be able to perform successfully in their field following graduation. Also, accreditation may be necessary for national certification and licensure. In fact, once nurses have completed an accredited NNP program, they may be eligible to sit for national certification available through the National Certification Corporation (NCC).
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