Although many people think all nurses do the same things, nothing could be further from the truth. All nurses do have knowledge that provides the foundation for nursing practice (achieved through either an associate’s or bachelor’s degree), but most also choose an area of specialty and acquire additional skills and expertise specific to that area. In addition, a nurse may hold an advanced master’s or doctorate degree.
Your baby’s nurse is at the bedside more than any other professional. She is your baby’s caregiver and advocate, as well as your primary source of information.
Registered Nurse
The person who provides the moment to moment care for your baby (besides you!) is your baby’s bedside nurse, usually a registered nurse (RN). A neonatal nurse is an RN who is highly educated to provide nursing care for infants and their families. The nurse caring for your baby learned NICU clinical skills through an extensive orientation program and clinical preceptorship in the NICU. You may see an RN with the designation “RNC-NIC,” which means the nurse has also passed a national specialty examination in neonatal intensive care nursing.
This person may be assigned to care for just your baby or for up to 3 additional babies. The staffing assignment is determined by the skills of your nurse and how much support your baby requires at that time.
Nurses work collaboratively with physicians and other members of the health care team; they are not assistants. Nurses function independently, and their specific roles vary depending on the setting. An RN may supervise a team of other professionals and assistants who help care for patients.
Neonatal nurses are at your baby’s bedside 24 hours a day. They assess your baby’s current condition and progress, carry out the physician’s orders, and notify the physician team (physician, neonatal nurse practitioner [NNP], or neonatal physician assistant) of any changes in your baby’s status. The RN may make recommendations to the physician or the team based on his or her assessment of your baby. The RN also plans and implements all nursing care, such as bathing, feeding, positioning, administering prescribed medications, and managing intravenous (IV) and arterial lines. In addition, RNs are very involved in parent education and discharge planning.
The nursing team is supported and led by a charge nurse who oversees the nursing operation for each nursing shift. Behind the scenes, you will often find a NICU nurse manager who provides nursing supervision and leadership for the whole unit and all of the nursing staff.
Clinical Nurse Specialist
A clinical nurse specialist (CNS) (or clinical nurse educator) helps advance the practice of the nursing team. A CNS is an RN with an advanced degree who acts as an expert and resource person for nursing staff. Clinical nurse specialists are involved in many different areas on the unit, including staff education, nursing research, quality improvement, consultation, direct patient care, and program development. Together with the medical team and the nursing staff, the CNS assists the NICU team with your baby’s care by making specific recommendations and offering new ideas or techniques to ensure the best possible plan of care.
Licensed Practical Nurse/Licensed Vocational Nurse
A licensed practical nurse (LPN) or licensed vocational nurse (LVN) has graduated from a state-approved technical school or community college and must pass a national written examination. The LPN/LVN provides basic bedside care and works under the direction of an RN.