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Health Care, Nutrition & Pediatrics Meet 2019: Neonatal nursing - S K Mohanasundari - All India Institute of Medical Sciences

S K Mohanasundari

Neonatal nursing is a subspecialty of nursing. Neonatal nursing generally encompasses care for those infants who experience problems shortly after their birth, but it also encompasses care for infants who experience long-term problems related to their prematurity or illness after their birth. And, prematurity is a serious public health apprehension. Several new-borns are hospitalized for long time with complex medical circumstances. And, a few neonatal nurses may care for infants up to about two (2) years of age. Whereas most neonatal nurses care for infants from the time of birth (from birth-discharge) until they are discharged from the hospital. Healthcare institutions have varying entry-level requirements for neonatal nurses. Neonatal nurses are Registered Nurses (RNs). Some countries or institutions may also require a midwifery qualification. Whereas some institutions may accept newly graduated RNs (Registered Nurses) who have passed the NCLEX (National Council Licensure Examination) exam; and others may require additional experience working in adult-health or medical/surgical nursing. Also, some countries offer postgraduate degrees in neonatal nursing and various doctorates. And, Neonatal nursing needs a high degree of dedication, skill and emotional strength. Also, these dedicated specialists care for the most crumbly patients there are–sick and premature newborns. During the first few months of their birth Neonatal nurses are main care giver for premature infants/neonates and they are the link between medical team and parents. Neonatal nurses have to pass/update the information about the breastfeeding of neonates and medical status pf their baby. Neonatal Nurse act as a several performer because neonatal nurse  should create a treatment plan initially and should implement that plan and have to monitor the status of the infants regularly and should able to operate incubators, ventilators and phototherapy as advancements in technology has been improved. Neonatal nursing works with newborn infants born with different problems for e.g., ranging from prematurity, birth defects, infections, cardiac malformations, and surgical problems.

And, a nurse practitioner may be required to hold a postgraduate degree.  It is necessary for a nurse undergo the specific training with an undergraduate degree in nursing. The National Association of Neonatal Nurses recommends minimum two years' experience working in a NICU before taking graduate classes for them. All nurses working in a birthing centre have an important role in assessing the newborn immediately after their birth. There are four different levels of neonatal nursery where a neonatal nurse might work. Such as Level I??? In this level, it consists of caring for healthy newborns or infants, Level II – In this level, provides intermediate or special care for premature or ill newborns/neonates, Level III- In this level the Neonatal intensive-care unit (NICU), treats newborn/neonates  who cannot be treated in the other levels and are in need of high technology to survive, such as breathing and feeding tubes, and Level IV-  In this level includes all the skills of the level III which are mentioned but involves the extensive care the most critically and complex newborns. And few neonatal nurses work in all 4 levels. There have been some major changes in the Neonatal Care over the past 120 years, such as like, some of these changes include the invention of the incubator, changes in respiratory care, and the development of surfactants. Duties of a neonatal nurse usually include supplying vital nutrients to newborns/neonate, changing feeding tubes, administering medication, observing vital signs, performing intubations and using monitoring devices. In the common situation where for premature and sick newborns/neonates lungs are not fully developed, they must be certain infants are breathing and maturing properly i.e., in regular way. All nurses working in a birthing centre have an important role in assessing the newborn immediately after birth. Neonatal nurses work together with upper-level nurses and physicians to facilitate treatment plans and examinations. Because being a Neonatal nurse as it was their major responsibility. Neonatal nurses can also work with speech-language pathologists (a scientist who studies the causes and effects of diseases, especially one who examines laboratory samples of body tissue for diagnostic or forensic purposes.) who specialise in the assessment and treatment of feeding, swallowing and communication in preterm infants/newborns. They have regular interaction with patients' families, therefore are required to educate parents or relative on the infant's medical condition and should prepare care instructions after the infant is discharged from the hospital.