The Neonatal Certified Registered Nurse Practitioner (NNP) functions in an expanded nursing role in a collaborative practice agreement with and under the direction of the attending Neonatalogist.  The CRNP provides direct and collaborative care to infants and their families in the delivery room, WBN, NICU, and other areas, e.g., Emergency Department in age appropriate population.  In addition to all technical skills approved for RNs in the NICU, the NNP provides some expanded role services which have traditionally been the responsibility of the physician.

1. Reviews the maternal history and the events of labor and delivery to identify the at-risk infant.
2. Attends high-risk deliveries; resuscitates and stabilizes infants.
3. Under the direction of the attending Neonatologist, manages infants in the NICU to include the following functions:
4. Obtains comprehensive perinatal history;
5. Performs physical assessment of all body systems and interprets findings;
6. Interprets laboratory, x-ray, and biophysical monitoring data;
7. Formulates diagnoses using historical and clinical data;
8. Plans and orders diagnostic and therapeutic measures – orders are co-signed by Neonatologist.
9. Performs diagnostic and therapeutic procedures:

      (1)        Obtains comprehensive perinatal history;

(2)        Introduction of needle or catheters for intravascular infusion or for laboratory

            sampling.

      (3)        Endotracheal intubation.

      (4)        Bag and Mask ventilation.

      (5)        Needle aspiration of pneumothorax.

      (6)        Umbilical vessel catheterization.

      (7)        Lumbar tap.

      (8)        Suprapubic bladder tap.

      (9)        Chest tube insertion.

      (10)      Exchange transfusions.

      (11)       Instillation of surfactant products via ETT.

      (12)       Per Q Cath insertion.

      (13)       UAC/UVC/PAL insertion.

1. Documents assessment, intervention and evaluation in the following formats using appropriate terminology.

      (1)        Admission Notes

      (2)        Daily progress Notes – problem oriented

      (3)        Procedure Notes

      (4)        Transfer Notes

      (5)        Discharge Summaries

      (6)        Dictations

1. Initiates and manages technical aspects of maintaining an infant on continuous positive airway pressure or mechanical ventilation and initiates appropriate changes when necessary according to established protocols.
2. Institutes appropriate emergency measures for infants experiencing apnea, shock and cardiac arrest according to established protocols.
3. In collaboration with the Nurse Manager, Team Leader and NICU Educator identifies and plans methods for meeting the learning needs of staff and patients’ families.
   

6. Participates in the planning and evaluation of nursing and medical care policies and procedures to include Performance Improvement.
7. Identifies areas where research is indicated. Participates in research through the development,testing, evaluation and/or implementation of new theories, products or research findings.
8. Maintains professional growth and development.
9. Attends continuing education programs for certification maintenance.
10. Fosters an environment in which inquiry and application of new knowledge are an integral part of nursing practice by participation in seminars, workshops and professional organizations.
11. Assists with the evaluation and orientation of new practitioners and practitioner students.
12. Acts as preceptor for nurse practitioner students.
13. Assists with the orientation and education of Family Practice Residents and Medical Students rotating in the NICU.
14. Collaborates with the interdisciplinary team to determine and achieve health goals and improve the quality of patient care.
15. Participates in those experiences which facilitate the processes of communication and collaboration (huddles, rounds, case conferences, nursing staff meetings, etc.).
16. Participates in decision making, planning, and problem-solving operations of the nursing department and medical staff through membership on committees, working groups, and ad hoc task forces.
17. Assists in developing, maintaining, and updating standards, policies, procedures, and patient management protocols.
18. Keeps up to date and informed on current trends, issues, and management techniques by utilization of current literature.
19. Performs initial and annual competency per job class.

DCH Standards:      

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

1. Education – Graduation from a school of nursing; M.S.N. preferred with specialty in Maternal-Infant Nursing or completion of a Neonatal Nurse Practitioner certificate program and BSN required.
2. Must pass National Certification as Neonatal Nurse Practitioner.
3. Registration – Current RN licensure in the State of Alabama.
4. Certified Registered Nurse Practitioner Licensure.
5. Experience – A minimum of (2) two years of experience in a Level III NICU, preferred.
6. Current American Heart Association (AHA) Basic Life Support (BLS) Provider and AHA Neonatal Resuscitation (NRP) training required.
7. Must be able to read, write legibly, speak, and comprehend English.

WORK CONTEXT

• Demonstrate leadership skills
• Requires decision making that will affect others
• Responsible to achieve outcomes
• Must be able to communicate clearly and accurately
• Ability to delegate to team members and students
• Address conflict and stressful situation
• Communicate with different personalities and engage in face to face discussion
• Dealing with unpleasant or verbally/physically aggressive personalities
• Must be able to use computers, electronic mail, telephone and texting
• Must be able to work in groups
• Must be able to perform structured and unstructured work
• Must be meet time pressure and time lines
• Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions
• Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc.

PHYSICAL FACTORS

• Heavy work. Exerting up to 100 pounds of force occasionally, and/or up to 50 pounds of force frequently, and/or up to 20 pounds of force constantly to move objects.

• Must be able to tolerate prolonged periods of standing and walking
• Must be able to reach reasonable distances in any direction
• Must be able to stand, walk, kneel, bend, sit and stoop
• Must be able to run in an emergency
• Must have the ability to exert maximum muscle force to lift, push, pull and carry objects
• Must be able to move fingers in a coordinated manner and must be ablet o feel and perceive temperature, texture, shape and size with fingertips
• Must be able to perform the duties with or without reasonable accommodation.
• Must possess stamina to provide 24-hour management for assigned area(s) of responsibility
• Hearing and vision must be normal or corrected to within normal range.

Physical presence onsite is essential.