The Expanded Nursing Role in the Neonatal Intensive Care Unit

Facilitators of and Constraints to Neonatal Nurse Practitioner Practice: Comparing Nursing and Medical Models

“…The role of the NNP was developed to provide continuity and consistency of care that was felt to be crucial to VOLUME 8, NUMBER 4, APRIL, 1996 improvement of overall morbidity and mortality rates in neonatal intensive care units (Bellig, 1980). Originally, the role was implemented in nurseries, where there was a deficit in physician coverage and it was believed that nursing could provide the continuity of care necessary for improved patient outcomes (Bellig, 1983;Hall, Smith, Jackson, Perks, & Walton, 1992;Schultz, Liptak, & Ioravanti, 1994).…”

“…Deficits in the amount of time supported by medical resident coverage are the result of continued reductions in time that pediatric residents spend in the neonatal intensive care unit (NICU) during their residency p r o gram (Bellig, 1980;Hunsberger et al, 1992;Mitchell et al, 1991). The cutbacks imposed by the American Medical Association are an effort to increase the quality of the residency experience for primary care pediatricians, who will not routinely encounter these complicated patients in their practice and, therefore, require limited exposure to them during training (Mitchell et al, 1991;Watkins, Kirchhoff, Hartigan, & Karp, 1992).…”

“…For many years, one solution to the demand for providers of clinical coverage was the use of the NNP (Bellig, 1980;Hunsberger et al, 1992;Mitchell et al, 1991;Tschetter & Sorenson, 1991). The rapid and continued increase in the number of NNPs required to meet this deficit in health care delivery has afforded limited time for the NNP profession to examine its goals and secure career longevity.…”