Description
Assess, diagnose, and manage premature and ill newborns in NICU and delivery settings, independently and with the perinatal team. Order, perform, and interpret neonatal tests and imaging; manage respiratory support, fluids, nutrition, and medications; and perform neonatal procedures. Provide delivery room stabilization, ongoing critical care, family education, and discharge planning. May prescribe medications. Must be a registered nurse with specialized graduate education and neonatal nurse practitioner certification.
- • Stabilize and resuscitate newborns at delivery per NRP guidelines.
- • Assess gestational age, growth, and exam findings to form diagnoses.
- • Order, perform, and interpret neonatal labs, blood gases, bilirubin, cultures, and imaging.
- • Develop evidence-based care plans for preterm and term infants.
- • Manage respiratory distress with CPAP, ventilation, surfactant, and oxygen therapy.
- • Prescribe and titrate weight-based medications, fluids, and parenteral nutrition as authorized.
- • Initiate sepsis evaluations; start empiric antibiotics and tailor to results.
- • Diagnose and treat hypoglycemia, hyperbilirubinemia, apnea of prematurity, PDA, and feeding intolerance.
- • Co-manage complex or surgical conditions with neonatologists and subspecialists; refer when needed.
- • Perform intubation, umbilical line placement, lumbar puncture, needle thoracostomy, and PICC insertion.
- • Monitor and adjust thermoregulation, fluids, and electrolytes.
- • Advance enteral feedings; support human milk use and fortification.
- • Detect and manage adverse drug reactions in neonates.
- • Educate families on infant status, breastfeeding/pumping, safe sleep, and home care.
- • Coordinate discharge readiness, car seat testing, newborn metabolic, hearing, and CCHD screening.
- • Arrange referrals to pediatric subspecialists and early intervention services.
- • Implement phototherapy and exchange transfusion protocols for jaundice.
- • Prevent and monitor complications of prematurity, including BPD, NEC, IVH, and ROP.
- • Document comprehensive assessments, plans, procedures, and progress notes.
- • Lead or participate in interprofessional rounds and safe handoffs.
- • Participate in quality improvement, infection prevention, and central line bundle compliance.
- • Maintain current neonatal guidelines, skills, and certifications (e.g., NRP).
- • Comply with state practice laws, credentialing, and payer requirements for NNP practice.
- • Supervise, mentor, or coordinate nursing and support staff in the NICU.
- • Advocate for family access to lactation support, social work, and community resources.
- • Schedule and communicate post-discharge follow-up with primary care and high-risk infant clinics.
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O*NET occupational data (work activities, skills, knowledge).
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Last reviewed: Jan 2026
