1. Section Editor(s): STOKOWSKI, LAURA A. RN, MS

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Neonatal nurse practitioners (NNPs): Do you ever wonder if other NNPs work as hard as you do? Do other NNPs find the role as rewarding, or as challenging, as you do? Do they make more (or less) money than you?


Here are some answers for you.


An Internet-based survey of 271 NNPs who were attendees at an advanced practice nursing conference provided a glimpse of the NNP workforce in the United States. The respondents were mostly masters-prepared (79%), female (95%), and working in level III NICUs, slightly more than half in private hospitals. Their average age was 46 years, and more than one third expected to retire within 10 years.


The shifts and hours worked by the NNPs varied. Most worked from 8 to 24 hours at a time; a few (2.6%) reported shift lengths of 36 to 48 hours.


The mean annual NNP salary was $86,700 (range: $50,000 to more than $110,000). There was no association between salary and variables such as age, educational preparation, facility type, position funding source, or the number of NICUs covered. Approximately 36% reported that they billed for services such as procedures, consultations, admissions, and NICU management. Half of the respondents reported to the department of medicine; the remainder were split between the department of nursing and a combination of medicine and nursing.


A majority (86%) of respondents indicated that the need for NNPs had increased in the past 5 years. More than half reported that they had unfilled NNP positions and the time required to recruit a new NNP averaged 6 to 18 months. One-third had substituted other providers, such as physician assistants, pediatric nurse practitioners, or hospitalists, to provide coverage in the NICU.


When asked what motivated them to become NNPs, most respondents indicated that primary motivators were autonomy and advanced knowledge. The greatest rewards associated with the role, reported by respondents, were enhanced contribution to the multidisciplinary team, autonomy, and increased status and professionalism. Overload of responsibilities, the shortage of NNPs, stressful work schedules, and low pay were most often cited as challenges of the NNP role.


The authors of this study concluded that there is a mismatch between the need for NNPs and the available NNP workforce. Recruitment measures are urgently required to increase enrollment in NNP programs.




1. Cusson RM, Buus-Frank ME, Flanagan VA, Miller S, Zukowsky K, Rasmussen L. A survey of the current neonatal nurse practitioner workforce. J Perinatol. 2008;28:830-836.