Neonatal Nurse Practitioner Application Essay
Neonatal Nurse Practitioner
Historical Background. Neonatal refers to the first six weeks after birth (Jones 2004, Nursing 2000). Neonatology or neonatal care is, thus, the medical specialty in taking care of newborns, sick and premature babies. Neonatal nurses specialize in helping these babies survive and successfully live through the first 28 days of life. This kind of care requires the artful combination of high-tech and “high-touch” skills from these nurses. It has been available in specialized nurseries and intensive care units for infants since the 60s and has been evolving. It will be recalled that the late U.S. President John F. Kennedy’s son, Patrick Bouvier Kennedy, was born prematurely and underdeveloped in 1963. If the current level of neonatal were available at that time, the baby should have survived. Modern neonatal care enables prematurely born infants with as little as 22 or 23 weeks out of the normal 40 to survive (Jones, Nursing). The reported sudden death or relapse of an infant in1978 drew heightened attention to the coping needs of parents as significant stressors. This and other stressors, such as conflict about life and death, emphasized the involvement of neonatal nurses in the care of critically ill or dying infants (Engler 2004). Technological advances account for the increased capability of neonatal care to save the lives of premature infants. Statistics revealed that there are roughly 40,000 low birth weight infants born yearly in the U.S. Typical neonatal intensive care units or NICUs no longer consider most of these infants critically ill and beyond help. Most of them are doing well in most of these NICUs, the rest of these babies treated for hyperbilirunemia, a condition leading to jaundice, or for infections or recovering from surgery (Jones 2004).
The need for nurses to specialize on neonatal care in the 70s created that specialty, which combined high technology and high touch in order to help problem infants to survive (Jones 2004). Under the regionalization plan in the 80s, premature or very ill newborns would be transferred to the nearest center for this kind of care. This transport included the assessment of the infant’s condition, stabilization, and the provision of continuous high-level care. The neonatal nurse was an integral member of the transport team and the role of the transport nurse evolved from it (Jones).
A neonatal staff nurse works at a level I, II or III nursery (Jones 2004). Level I nursery is for healthy newborns. Mothers and their babies at present often share the same room because they stay only briefly in hospitals. Level II nursery is an intermediate or special care nursery for premature or ill babies. These babies may need supplemental oxygen, intravenous treatment, specialized feedings, or more time to mature before they are discharged from the hospital. And Level III is a neonatal intensive care unit or NICU for newborns in the first six weeks of life who cannot be treated at either Level I or II nursery. Babies at the NICU may be too small for their age, premature, or ill but full-term infants who need high-technology care. This care may require ventilators, special equipment, incubators, or surgery. NICUs are generally found in large general hospitals or in specialized children’s hospitals. Neonatal nurse practitioners directly provide that care needed by these infants (Jones).
Components of the Neonatal Nurse Practitioner
These role components in a typical hospital include practice, educator, consultancy and role modeling through professional growth and development (Creech 2005). The neonatal nurse practitioner or NNP extends direct neonatal patient care, works with six neonatalogists, attends all in-house high-risk deliveries, and provides resuscitation and stabilization management of all high-risk neonatal transports. She uses the case management model of care in her practice, manages a certain case load average on a monthly basis, manages the tiny baby population, works with advanced technology, takes charge of these special infants from admission to discharge, collaborates with the attending physician in implementing the plan o care, performs different invasive procedures, participates in family discussions, focuses on family communication and coordination, maintains an internal neonatal database, provides orientation and formal educational programs on neonatal service, and participates in fund-generating fund projects or activities (Creech).
Research Findings on the Development of the Role of NPNs recent study on the perceptions of NPNs and other nurses managing critically ill or dying infants in NICUs showed that they were comfortable with their role and involvement with the infants’ family in this difficult time (Engler 2004). These NPNs perceived and placed greater weight on the family’s need of them than the expectation of their peers or the administrative personnel. Those who spent more years at NICUs expressed greater capability in handling the situation, although most of them had no adequate training or preparation in bereavement or end-of-life care. Most of the respondents considered caring for the dying infant, the actual death, and cultural differences as influential or determining factors in their involvement with the infant’s family. The findings, therefore, emphasized the importance of providing education and training to these nurses on bereavement or end-of-life care and cultural competence in nursing curricula (Engler).
Parents of critically ill or dying infants needed and wanted compassionate support from their infants’ caregiver during very painful or stressful time (Engler 2004). The respondents filled that need by allowing the family members to hold the dying infant; by participating in grief conferences with the family and other caregivers; and by sitting and listening to family members’ outpour of grief. This time of deep grief was also stressful for the NNP. She may need to discuss difficult topics, like autopsy and organ donation, with the family. The NNP at Level 3 NICU was more comfortable caring for critically ill and/or dying infants and their families than those without the policy or experience. And language or cultural barrier also significantly affected the level of the NNP’s involvement with the patient’s family. She needed to learn their language to explain how to use a certain device or equipment, how the infant looked like, and what her name was. Over and above, providing this care was done on a daily basis as something both necessary and desirable. This act of giving of the self was what gave the family a voice in its infant’s care and where the NNP asserted great impact (Engler).
Professional Organization of NNPs
The National Organization of Neonatal Nurses or NANN is the organization of NNPs and the professional voice that shapes their practice (2006). Its vision is to improve the lives of all newborns, infants, and their families through excellence in neonatal nursing practice, education, research and professional development. It is guided by a Code of Ethics in making this contribution. Its fundamental principles bind members to recognize the worth, dignity and rights of patients and their family; use knowledge and skills for the advancement of human welfare and respect for individual differences; assume their primary responsibility towards the patient’s well-being; recognize family autonomy and its right to accurate, complete and understandable information for decision-making; respect the patient’s rights to privacy and confidentiality; maintain professional integrity in resolving conflicts; serve with competency and accountability; and assume responsibility for their own professional advancement (NNAN).
Ethical and Policy Issues
Nurses, NNPs in particular, confront two categories of ethical or moral diagnoses (Kopala 2005). One directly relates to the conflict, constituting an ethical dilemma. The other when a barrier stands on the way of an ethical choice. This situation is called moral distress. An ethical dilemma occurs when the decision-maker is stalled by conflicting alternatives or when one course of action seems right and wrong at the same time. Certain moral obligations require the patient to perform, or restrain him from performing, a particular course of action. He or she must carefully weigh and reflect the consequences and bases for alternatives or options. He may seek valued opinions, such a nursing diagnosis, or make the choice alone. On the other hand, barriers to a choice in ethical or moral action may be internal, external, institutional or situational. The NNP or neonatal nurse practitioner may directly help the patient or the family in appraising the situation through the “values clarification” NANDA-developed diagnosis. She may consult with other health care providers by using “multidisciplinary care conference,” which will include the family. She may also invite an ethicist or form an ethics committee, which will assure the patient’s rights are protected. In case of moral distress, the nurse may directly address or confront the barrier, teach or encourage the patient to take action or help the patient to remove the barrier to a decision on the course of action (Kopala).
Impact of Health Promotion and Disease Prevention on the Role of NNPs
Technological advances have been immensely enabling. Through them, healthcare professionals have been able to offer new treatment alternatives in addition or to supplement traditional ones (Kopala 2004). These technologies and wonder medicines have saved the lives of tiny babies and extended the lives of people with chronic illnesses. They have reduced prolonging life or postponing death to an option. Increased genetic and reproductive alternatives have also become available. Health care costs are, however, high and some resources are scarce. As a result, ethical issues and conflicts develop. Patients, their families and the health care community tend to have divergent views. They likewise often have conflicting beliefs on health and illness and views on what is right or wrong. The nurse’s experience of ethical dilemmas and moral distress are proportionate to of the patient and/or the family. The nurse, the patient or surrogate decision-maker and family struggle to discover what can be done to prevent, improve or cure a particular medical condition according to a common belief of what “ought” to be. Supports can come from sources, such as ethics consultants and committees, nurse ethicists, pastoral care providers and institutional review boards. As a consequence, the Joint Commission for Accreditation of Healthcare Organizations requires agencies seeking accreditation to come up with a mechanism to address ethical issues in patient care of these kinds. Ethics committees and ethics consultants fulfill this requirement. Institutional or medical ethics committees in many hospitals have been educating, providing case consultations, and making recommendations since the 80s. Many such committees have been involved in policy development, such as through a nurse ethicist or nursing ethics committee assisting practitioners in handling these ethical issues. Nursing and medical schools have also recognized the importance of knowledge and skills for future practitioners and incorporated the introduction and development of these knowledge and skills in their curricula (Kopala).
Technological advances in the last decade have substantially decreased neonatal mortality rate, yet 19,000 newborns continue to die in the U.S. each year (Engler 2004). The registered or advanced practice neonatal nurse practitioner is often involved with the patient’s family decisions in difficult or end-of-life times, such as withdrawing mechanical ventilation and the likelihood of the infant’s death. Her support is most crucial at times like these. She can and should take advantage of the opportunity to form a relationship of trust with the family, which is vital to the optimal care she provides. Central to this care is her recognition of the importance of the loss of the infant. From this awareness, she can develop or initiate additional interventions in this time of grief, such as organized telephone follow-ups and forming support groups for the grieving family (Engler).
Schools or institutions establish their own requirements for neonatal nurse practitioners (Jones 2004). Most of them assess the nurse’s ability to administer medications, do math calculations, start and maintain intravenous lines, conduct cardiopulmonary resuscitation, and perform corollary skills. These skills include suctioning, gavage feedings, and ventilator care. Some hospitals or medical centers hire NNPs after graduation from an accredited school and after passing the state board of nursing exams for licensure. The type and length of nursing experience also vary from one institution to another. In the current shortage of NNPs, the scarcity of qualified nurses is a deciding factor to most hospitals and medical centers. For their part, individual states or certifying bodies impose continuing education requirements on NNPs. There are no schools actually specializing in neonatal nursing. A nurse who aspires to be an NNP must obtain a master’s degree in neonatal nursing, but the most common way is to work at any of the three nursery levels. A Nursing graduate should first acquire experience as a registered nurse in a NICU and then go to graduate school to become an NNP or clinical nurse specialist in order to qualify to work as an NNP (Jones).
The current shortage in nurses virtually insures nursing applicants of jobs in neonatal nursing (Jones 2004). The general downsizing conducted a few years ago reduced the volume of nursing pursing advanced practice education. This drove aspirants to positions in neonatal nursing. The average NNPs is also middle-aged and, thus, likely to move to less stressful nursing areas and positions. Most nurse practitioners with no experience receive a starting annual salary of between $30,000 and $40,000. Experienced NNPs receive higher salaries. A full-time nurse receives a percentage of health care benefits remitted by her employer. She gets two weeks vacation, a life insurance, a retirement plan, and tuition reimbursements for continuing education. An NNP can also aspire for advancement. Most hospitals offer more employment opportunities to NNPs with a master’s or doctoral education. An NNP or clinical nurse specialist can expect higher job availability, responsibility and compensation. High-risk clinics for neonatal intensive care or home follow-up care also employ NNPs (Jones).
With almost 40,000 low-birth-weight babies born in the U.S. every year, there is clearly a growing market for NNPs (Jones 2004). The Workforce Report of the American Nurses Association and the Association of Nurse Executives in 1998 projected the shortage of acute care neonatal nurses to continue into the next decade. Neonatal nurse practitioners are privileged to work with newborns and experience the marvel of birth each day. It may not be as pleasant for NNPs working at NICUs because of occasional deaths of seriously ill or premature infants. But, on the whole, neonatal nursing is said to be one of the most rewarding nursing specialties available to qualified and willing nurses today (Jones).
1. Creech, R. (2005). Neonatal Nurse Practitioner Program. Leaders in Medicine: United Health Systems of Eastern Carolina. http://www.uhseast.com/body-cfm?id=329
2. Engler, A.J. (2004). Neonatal Staff and Advanced Practice Nurses’ Perceptions of Bereavement/End-of-Life Care of Families of Critically Il and/or Dying Infants. Critical Care Nurse: American Association of Critical-Care Nurses
3. Jones, J. (2004). Neonatal Nursing: the First Six Weeks. Critical Care Nurse: American Association of Critical-Care Nurses
4. Kopala, B. (2005). Ethical Dilemma and Moral Distress: Proposed New NANDA Diagnoses. International Journal of Nursing Terminologies and Classifications: Nursecom, Inc.
5. Nursing (2002). Spotlight on Neonatal Nursing. Springhouse Corporation
Get Professional Assignment Help Cheaply
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Why Choose Our Academic Writing Service?
- Plagiarism free papers
- Timely delivery
- Any deadline
- Skilled, Experienced Native English Writers
- Subject-relevant academic writer
- Adherence to paper instructions
- Ability to tackle bulk assignments
- Reasonable prices
- 24/7 Customer Support
- Get superb grades consistently
Online Academic Help With Different Subjects
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
What discipline/subjects do you deal in?
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Are your writers competent enough to handle my paper?
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
What if I don’t like the paper?
There is a very low likelihood that you won’t like the paper.
- When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
- We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.
In the event that you don’t like your paper:
- The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
- We will have a different writer write the paper from scratch.
- Last resort, if the above does not work, we will refund your money.
Will the professor find out I didn’t write the paper myself?
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
What if the paper is plagiarized?
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
When will I get my paper?
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
Will anyone find out that I used your services?
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
How our Assignment Help Service Works
1. Place an order
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
2. Pay for the order
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
3. Track the progress
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
4. Download the paper
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!