You’re an outstanding labor and delivery RN, a seasoned veteran of the NICU, or someone who just loves helping mothers-to-be. You’ve come the right place. If you’re already decided to aim for a DNP in neonatalogy or perinatalogy, feel free to skip ahead to our program listings. But if you’d like some background on the two disciplines, info on NCC certifications, and a summary of the DNP curriculum, read on!
Becoming a Neonatal Nurse Practitioner
What’s the Difference Between Neonatal and Perinatal?
Both neonatal nurse practitioners (NNPs) and perinatal nurse practitioners are key players in the time around childbirth. The difference between the two lies in the scope of their duties. NNPs are involved with caring for newborn infants (neonates) who are at high risk or have critical health issues. Perinatal NPs tend to be responsible for helping mothers and babies in the period “around birth” – i.e. pregnancy, labor, and postpartum care.
The 4 Levels of Neonatal Care
- Level I – Well Newborn Nursery: Care for healthy, full-term infants. The role of an NNP in this situation is very limited.
- Level II – Special Care Nursery: Care for premature and sick infants in need of constant attention.
- Level III – Neonatal Intensive Care Unit (NICU): Care for critically ill neonates or premature infants with life-threatening health issues. These newborn babies may require ventilation or invasive care and must be monitored around the clock.
- Level IV – Regional NICU: The highest level of neonatal care. Regional NICUs conduct surgical repairs for complex congenital or acquired conditions and have a full staff of pediatric specialists on hand.
Perinatal vs. Neonatal
|Perinatal Nurse Practitioner||Neonatal Nurse Practitioner (NNP)|
|Definition||Perinatal NPs are advanced practice registered nurses (APRNs) who provide healthcare to women and their infants during pregnancy, childbirth, and the postpartum period. Depending on their role and healthcare setting, perinatal NPs may be asked to assist with high-risk pregnancies and complicated labors.||Neonatal nurse practitioners (NNPs) are advanced practice registered nurses (APRNs) who care for high-risk newborns in an in-patient neonatal setting (e.g. NICU). Their patients may include premature infants and/or babies with low birth weights, respiratory distress, cardiac problems, genetic disorders, and congenital abnormalities.|
|Role||In addition to administering treatments and interventions, perinatal NPs often act as trusted advisers and primary care providers. They counsel mothers on topics such as prenatal health, childbirth techniques, breastfeeding, and postpartum issues (e.g. depression), and usher families through a life-changing event.||Because neonates are so vulnerable, NNPs frequently deal with life and death situations. In addition to being responsible for delicate treatments and procedures (e.g. intubation), NNPs must be ready to talk to a frightened family about the state of their infant’s health and the steps that the team is taking to treat underlying medical problems.|
Neonatology Certification Requirements
Once you have completed a master’s degree or DNP in nursing with a neonatal nurse practitioner focus, you are eligible to sit for national certification exams and pursue advanced state licensure. Since the American Nurses Credentialing Center (ANCC) has retired their perinatal nursing credential, we’ve listed neonatal certifications offered by the National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Specialties (NCC).
However, please talk to your university and check with your State Board of Nursing for advice on which credentials to pursue. States will specify exactly which certifications you must have before they are willing to grant you an NNP license. DNP programs should also clearly state that they are accredited and able to prepare you for board certification. If you can’t find the information on the program website, ask the school for its student pass rates on certification exams.
The NCC offers a variety of specialty and sub-specialty certifications for neonatal nurse practitioners, including:
- Neonatal Nurse Practitioner (NNP-BC)
- Women’s Health Care Nurse Practitioner (WHNP-BC)
- Inpatient Obstetric Nursing (RNC-OB)
- Maternal Newborn Nursing (RNC-MNN)
- Low Risk Neonatal Nursing (RNC-LRN)
- Neonatal Intensive Care Nursing (RNC-NIC)
- Electronic Fetal Monitoring (C-EFM)
- Neonatal Pediatric Transport (C-NPT)
The most common one you’ll see in employment profiles is the NNP-BC.
- Hold a current, active RN license
- Earn a master’s, post-master’s qualification, or DNP from a neonatal nurse practitioner program.
- Pass the NNP-BC exam administered by the NCC (applicants must take the certification examination within 8 years of graduation).
- Maintain your certification through continuing education.
Please check the NCC website for further details on eligibility requirements.
Helpful Professional Organizations
- American Association of Colleges of Nursing (AACN)
- American Association of Nurse Practitioners (AANP)
- American Nurses Credentialing Center (ANCC)
- The Academy of Neonatal Nursing (ANN)
- Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)
- National Association of Neonatal Nurses (NANN)
- National Association of Neonatal Nurse Practitioners (NANNP)
- National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Specialties (NCC)
The Neonatal Nurse Practitioner DNP
Typical DNP Curriculum
Most neonatal programs are listed as “graduate tracks” or “concentrations” in DNP degrees. In other words, you start by taking general APRN courses and gradually concentrate on newborn health. Compare your options. Although most nurse practitioner DNP programs are targeted at NNPs, there are a number of program listings for perinatal nurse specialists. (We talk more about the specialist role in our profile of clinical nurse specialists.)
Neonatology is a highly technical field, so look for programs that will expose you to a wide variety of clinical experiences in a range of settings (e.g. children’s hospitals, step-down units, newborn nurseries, developmental follow-up clinics, and primary care settings). A fully qualified NNP should be prepared to assess – and care for – high-risk newborn infants in Level I, Level II, and Level III units. Ask if the programs meets the NCC certification requirements.
In terms of coursework, you can expect hardcore classes in areas such as embryology, neonatal physiology, pathophysiology, genetics, advanced neonatal assessment, and neonatal pharmacology and pharmacotherapeutics. Since every DNP includes training in leadership and evidence-based practice, you may also be taking courses in research methods, biostatistics, healthcare policy, healthcare systems, and information technology. Your degree will culminate in an individual DNP capstone project.
Most NNP DNP programs will expect you to have at least 1-2 years of RN experience in a Level III NICU or neonatal intensive care nursery. Some schools may be willing to consider acute or critical care in a pediatric in-patient unit. Perinatal NPs may wish to work as a labor and delivery nurse to gain experience with high-risk pregnancies. It’s always a good idea to spend some time shadowing an APRN in your specialty before you make the decision to pursue a DNP.
Brush up on your first aid certifications. As well as the Basic Life Support for Health Care Providers certification, schools may require you to have Advanced Life Support (ALS) and Pediatric Advanced Life Support (PALS) certifications and/or additional NICU or neonatal resuscitation qualifications. For perinatal NPs, the American Association of Family Physicians offers an optional protocol called Advanced Life Support for Obstetrics (ALSO).
Examples of DNP Capstone Projects
- Delayed Umbilical Cord Clamping in the Delivery Room for Infants 24-32 Weeks Gestation. (Duke University)
- National Survey of Gavage Feeding Practices Used in Very Low Birth Weight Infants. (Ohio State University)