A Day in the Life of a Neonatal Nurse

09/09/24 11:24 AM PST

Neonatal Nurses Week is September 14th-20th 2024. Established in 2000 by the National Association of Neonatal Nurses (NANN), members of the neonatal community use Neonatal Nurses Week to honor nurse colleagues and show pride in being a neonatal nurse or neonatal APRN.

Neonatal nurses are dedicated professionals who provide specialized care for newborns requiring medical attention. While neonatal nurses can care for all infants, including infants without medical complications, they are a key care provider for hospitalized infants born with a wide range of complications such as prematurity, infection, cardiac malformations, birth defects, and other problems.

From the start of their shift to routine care and monitoring, these nurses ensure the well-being of these vulnerable infants. They collaborate closely with a multidisciplinary team of healthcare professionals to provide comprehensive care, monitor vital signs, administer medications, and perform life-saving interventions.

To become a neonatal nurse, individuals must complete a Bachelor of Science in Nursing (BSN) program and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Additional certifications, such as the Neonatal Resuscitation Program (NRP) and Neonatal Intensive Care Nursing (RNC-NIC), further enhance their expertise in this specialized field.

The Beginning of a Shift

The handover process and nurse communication during shift changes ensure seamless care in the neonatal unit. As one nurse’s shift ends, another takes over, and vital patient information needs to be effectively communicated. This communication is shared between the entire healthcare team to ensure continuity of care. Neonatologists, respiratory therapists, occupational therapists, and lactation consultants are just a few examples of the professionals contributing to the care team. By working together, healthcare professionals can provide the best possible care and support for these vulnerable infants.

During handover, nurses will discuss each patient’s condition, any changes in their medical status, and the care plan for the day. This information exchange helps the incoming nurse understand each infant’s specific needs and ensures continuity of care.

After the handover process, neonatal nurses can prepare for the day ahead. This includes setting up equipment, such as ventilators, incubators, and monitors that may be needed in an emergency throughout the shift, and checking they are functioning correctly. They also review patient records to familiarize themselves with the medical history, ongoing treatments, and any pending procedures.

Routine Care and Monitoring

Neonatal nurses provide routine care and monitoring for premature and sick newborns. Their expertise and dedication ensure that these fragile infants receive the best possible care during their time in the neonatal intensive care unit (NICU).

Feeding and nutrition – Neonatal nurses will closely monitor the feeding of premature and sick newborns, as their delicate systems require specialized attention. Whether through breastfeeding, bottle feeding, or using a feeding tube, they will ensure the feeding plan is maintained and providing the results that are desired by the care team.
Administering medications – They will administer medications, such as antibiotics or pain relief. These will always need to be meticulously calculated and administered to the correct dosages, prioritizing the safety and well-being of the newborns.
Monitoring vital signs – Neonatal Nurses will continuously assess the newborns’ heart rate, respiratory rate, blood pressure, and oxygen levels, ensuring that any changes or abnormalities are promptly addressed.
Diapers and hygiene – They will spend a significant amount of time changing diapers, bathing infants, and ensuring that each patient’s environment is clean and free from potential sources of infection.
Supporting families and providing emotional care – Having a baby in the NICU can be a stressful and emotional experience for parents. Neonatal nurses will offer a listening ear, and provide support and reassurance during this challenging time. They educate families about the care, involve them in the decision-making process, and offer guidance on bonding with their babies in the NICU.
Charting and documentation – Often overlooked by others, charting is a crucial step in healthcare. Every time a patient is seen, monitored, given medications, and fed, it needs to be noted down. This avoids any overdosing, or missed vital changes, and allows for a smoother handover process.

Neonatal Emergencies

Babies are fragile and have extremely weakened immune systems, especially when they are born prematurely or with a medical condition. This makes them especially susceptible to infections and complications in those initial days and months after birth. While in the NICU, neonatal nurses will usually be the first to observe an emergency in the baby’s condition.

Neonatal nurses will need to be quick to notice vital sign changes and understand when medical intervention is necessary. Time will be of the essence in these circumstances. They will be checking for infants who may present with hypothermia, lethargy, increased sleeping, poor feeding, jaundice, vomiting, changes in their respiratory pattern, or abnormal vital signs.

Neonatal nursing is an extremely demanding career. Newborns don’t typically follow a schedule, which means the nurses must be on duty at all times, and often work 12-hour shifts. They will also frequently face extremely difficult and emotionally challenging cases. This can take a huge toll on the mental health of the entire healthcare team.

However, neonatal nursing is also an extremely rewarding career. Caring for our most vulnerable and watching them grow stronger and stronger until discharge. Neonatal nurses can take pride in giving these babies a chance at survival and supporting families during the most difficult time in their lives.

While no one wants to need a neonatal nurse during their child’s birth, you can rest assured the neonatal nurses will do everything in their power to ensure a happy and healthy outcome for you. During Neonatal Nurses Week (and every week), take the time to thank and appreciate your local neonatal nurses today!

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