1. Samson, Linda F. PhD, RN, BC, NEA, BC

Article Content

The most recent edition of the classic resource for neonatal nurses focuses on providing a comprehensive tool not only for nurses but also for all individuals providing care to critically ill neonates and their families in a rapidly changing global environment where there are differences in available resources for care between low-resource countries and those with greater resource availability. In addition, according to the authors, this edition adds focus to integrated interprofessional care that is evidence-based and provides analysis of cost-effectiveness of care options. At the same time, the text retains the content that has made it an invaluable resource for 20 years-well-developed foundational content in physiologic and embryologic content to support understanding of each neonatal body system, a thorough understanding of the pathophysiology of neonatal disease, genetics, medical, surgical, and psychological care of the infant and family. Although the text is described by the authors as a resource for nurses in both low-resource and higher-resource countries, the preface defines the roles of clinical nurse specialist and neonatal nurse practitioner. The definitions and roles of clinical nurse specialist and neonatal nurse practitioner are based on position statements and competencies of a professional association, the National Association of Neonatal Nurses, based in the United States and as such may not necessarily be reflective of roles and job titles in other countries.


The fifth edition has been divided into 8 units and 3 appendices. The first 7 units are the content for the text and are further divided into 42 content chapters. Unit VIII is designed to provide diagnostic and care protocols to support the advanced practice role.


The first unit is titled "Prenatal Considerations and Care." This unit contains 2 chapters, both of which are rearranged in this edition from unit VII in the fourth edition. The first chapter discusses fetal development including the environmental influences on the developing fetus and the critical periods during the developmental process. Extensive graphical depictions are provided to document the developmental stages of the various systems. The second chapter includes prenatal, intrapartal, and postpartal risk factors. Global efforts to meet World Health Organization Millennium Development Goals are included in this chapter as a reflection of efforts to improve maternal and child health worldwide.


Unit II: Intrapartal and Newborn Care has 3 chapters. The first 2 on resuscitation and stabilization and assessment contain material that was also previously in unit VII in the fourth edition. A new chapter on the normal newborn has been added to this unit. In keeping with the focus of the fifth edition to provide a comprehensive, integrated, and global resource, this chapter is an excellent addition to the text. Content in the chapter addresses the World Health Organization/UNICEF Hospital-Friendly Health Initiative, describes changes in practice that promote successful breast-feeding, and lays a strong foundation of normal newborn assessment and screening as it relates to recognizing problems in the neonate.


Unit III: Systems Assessment and Management of Disorders encompasses chapters 6 to 18 and includes the systems content contained in the fourth edition, although revised and rearranged for the fifth edition. The chapter on "Emerging Technologies for Management of Respiratory Disorders" has been moved from this unit and retitled to match its placement in the fifth edition in Unit IV: Special Considerations.


Unit IV: Special Considerations contains 7 chapters in addition to the one on "Emerging Technologies in Neonatal Care: Health Care Simulation for Neonatal Care" that has been moved to this unit. Two new chapters have been added, including one on "Emerging Infections" and one on "Nutritional Management of Premature Infants." These chapters greatly enhance the understanding of the special considerations in managing neonates in a changing environment. The use of callouts of evidence-based practice and online resources for case studies makes the materials particularly useful. Each of the chapters is also accompanied by extensive current references.


Unit V: Vulnerable Populations includes 3 distinct chapters. Two chapters, one on the newborn or infant transplant patient and the other on the extremely low-birth-weight patient, have been rewritten to reflect the revised model and approach in the fifth edition. The former content on the "Substance Exposed Newborn" has been replaced with a new chapter on the "Late Preterm Infant." With the new focus on global health initiative, this content is particularly relevant since many of these infants are the ones who develop complications because their size fools caregivers into believing that they will not experience any of the complications of prematurity. The information on long-term outcomes and evidence-based practice is particularly useful.


Unit VI: Environmental Health and Family-Centered Care in the NICU and Beyond combines the content that was included in units IV and V in the fourth edition, with updating for currency and fit with the refocus and new framework. Content on parental bereavement has been eliminated as a separate chapter within this edition.


Unit VII: Neonatal Care in the New Millennium: Challenges and Opportunities includes 7 chapters that update information from the 6 chapters in unit VI of the fourth edition. These updates move from topics such as "Electronic Medical Records and Technology" in the fourth edition to "Neonatal Care Using Informatics" in the fifth edition and "Impact of Genetics on Neonatal Care" in the fourth edition to "Human Genetics and Genomics: Impact on Neonatal Care" in the fifth edition. A new chapter has been added on "Neonatal Care From a Global Perspective." This chapter provides examples of nursing care challenges in many countries. The examples provide the rationale for ongoing education and the need for the WHO Millennium Development Goals.


Unit VIII: Diagnostic and Care Protocols is new to the fifth edition. The unit provides almost 75 pages of protocols and with 3 additional appendices, an extensive set of references for practice.


Together with the extensive content revisions identified, it is clear that the fifth edition of this classic work is truly a comprehensive must-have resource for all neonatal nurses.


-Linda F. Samson, PhD, RN, BC, NEA, BC


College of Health & Human Services


Governors State University


Highland Park, Illinois


School of Public Health


University of Illinois at Chicago