Neonatal Nurse Practitioners Care for Tiniest Patients

Texas Children's Hospital's Neonatal Intensive Care Unit cares for some of the tiniest and sickest babies in the hospital. Participating in the care and management of these patients is an elite cadre of more than 20 neonatal nurse practitioners - registered nurses with advanced skills and education - who are an integral part of the health care team.

NNPs also can be found in Infant Care and the Premature Nursery, providing primary case management in roles similar to residents. They help maintain protocol in the unit and are valuable educational resources to nurses, respiratory therapists, residents and fellows. Each practitioner providing case management is responsible for up to eight NICU patients and as many as 13 Infant Care or Premature Nursery patients.

"The practitioner arrives early in the morning to perform physical exams and evaluate patient data such as tests, lab results, X-rays and information from the daily nursing flowsheets," said Jan Romito, an NNP. "In coordination with neonatal nurses, respiratory therapists and developmental support team members, the practitioner will troubleshoot overnight problems and begin to make changes in the plan of care."

Working with the patient health care team, the NNP provides parent education and discharge planning. During morning rounds, the NNP collaborates to establish a plan of care with the attending physician and fellow.

NNPs are team leaders on Texas Children's Kangaroo Crew® ground and flight transport systems and can be reached daily by pager to attend high-risk deliveries at St. Luke's Episcopal Hospital and The Methodist Hospital when requested.

In addition, NNPs are part of the in-house transport team, assisting with tests and procedures.

"The NNP role at Texas Children's has evolved to become the backbone of our care of critically ill neonates in the newborn center," said Dr. James Adams, medical director of the NNP Service, NICU and neonatal transport team. Dr. Adams initiated the NNP role at Texas Children's.

NNPs have other important roles in the hospital including overseeing neonatal resuscitation program certification, coordinating the annual Baylor College of Medicine Perinatal Nursing Symposium, training nurses in Turkey and Guatemala in basic neonatal care and assisting with clinical development of student practitioners.

"Texas Children's is a great place to work," said Romito. "We offer the hospital a lot, and the hospital gives us many opportunities. We're always looking for qualified people and, as the hospital continues to grow, we'll be needing even more staff."

For details about NNP positions at Texas Children's Hospital, visit the enhanced and newly designed Web site at http://www.texaschildrenshospital.org.

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©2006 Texas Medical Center

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