The evolution of the neonatal nurse practitioner role in Australia: A discussion paper

Aim The neonatal nurse practitioner role originated in the 1960's in the Unites States from a short fall in physicians. This occurred because of changes in medical training which reduced time in specialist areas and in conjunction, the demand for neonatal care increased due to the survival of premature babies and advances in specialised care. The aim of this review is to identify the discrepancies between roles and responsibilities, highlight the challenges NNP face and explore possible role development opportunities to make the position sustainable. Method Current review of the literature (MESH TERMS – neonatal and/or nurse practitioner, Australia) revealed fourteen published articles and government documents identifying requirements for endorsement and standards for nurse practitioner practice. Result Neonatal nurse practitioners spend most of their time delivering direct patient care regardless of the clinical setting, however elements of research, education and leadership are still incorporated within clinical practice. Alongside the clinical role, antenatal counselling, facilitation of communication amongst the multidisciplinary team and parents, prescribing, ordering diagnostic tests have all became core components to define the scope of the NNP. However, as the role has expanded NNP must adapt to changes to continue to be recognised as a valuable member of the multidisciplinary team especially as registered nurses start to take on extended roles. Conclusion The senior clinical role of the neonatal nurse practitioner continues to evolve. There are challenges to be overcome, however there are now more than thirty neonatal nurse practitioners in Australia and together the possibilities for expansion of their role are limitless. This can only be of benefit to our babies, their families and the nursing profession.