A look into neonatal care: The various stages and the importance of neonatal nurses

Neonatal care refers to the care of newborns or infants in the first four weeks after birth. Neonatal nurses must have specialized knowledge and skills in caring for infants with medical or other complications.

This care helps ensure these youngest members of our society are healthy and safe throughout this delicate period. Though it’s tempting to think neonatal care revolves solely around physical health, that’s only one part of the equation. 

An overview of neonatal nurses

Neonatal nurses have special training in caring for babies and helping them grow into healthy children. They also help families with resources, information, and emotional support during this difficult time.

To become a neonatal nurse, you can enroll in neonatal nurse practitioner programs or associate degree nursing programs at an institution such as Baylor University. These programs will teach you how to care for premature infants from birth until they are discharged from the hospital. 

You’ll learn about clinical procedures, nutritional requirements, and infection control precautions. Additionally, you’ll gain experience through clinical rotations, where you’ll get hands-on training.

The main roles of neonatal nurses

Neonatal nurses play an essential role in helping to care for newborn babies in the neonatal intensive care unit (NICU). They are responsible for carrying out the following tasks in their daily work.

  • Preparing and checking medications

Neonatal nurses are responsible for preparing and checking medications to ensure they are safe, sterile and according to the prescribed dosage. This role is critical in the care process for neonates, as medication errors can have devastating consequences. 

  • Managing a baby’s fluids

Nurses monitor the baby’s fluid intake and output, blood sugar levels, blood pressure, respiratory rate and oxygen saturation. They also examine the stool for signs of infection or intestinal obstruction, measure weight and length and take chest X-rays if needed. 

  • Recording observations and documenting a baby’s care

A neonatal nurse records various observations about the baby, such as weight and height, and documents any changes to the baby’s care plan. The other nurses then share these recordings to ensure they don’t overlook any information. 

  • Initiating appropriate basic resuscitation

In an emergency, a neonatal nurse will first assess the infant’s airway, breathing and heart rate. They’ll provide oxygen or perform cardiopulmonary resuscitation (CPR) if necessary. 

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Additionally, neonatal nurses evaluate whether the baby needs immediate medical attention and treatment. They should be able to quickly react to the emergency if anything goes wrong. A pediatrician may not be available at all times, so neonatal nurses must be trained in these emergency medical skills.

  • Troubleshooting and maintaining NICU equipment

Neonatal nurses are often tasked with troubleshooting and maintaining equipment in an NICU. This equipment includes monitors, ventilators, incubators, baby warmers, baths, scales and mobile carts. 

One way that neonatal nurses maintain equipment is by completing routine checks to ensure they are functioning properly. This requires proper training and knowledge of NICU equipment. Neonatal nurses need to know how to address any problems that arise with these machines to minimize risk to their young wards and keep patients safe.

  • Educating new parents on basic infant care

Knowing what to do when your baby is born can be difficult for a new parent. What should you feed them? How often should you change their diaper?

Neonatal nurses are highly skilled in infant care and have the knowledge to answer any questions parents may have during the first year of their child’s life. They can also offer support if problems or concerns arise along the way, such as breastfeeding issues or jaundice.

The different stages in neonatal care

Neonatal nurses can provide different levels of care depending on the severity of a baby’s condition at birth and how critical their health situation is. Hospitals provide four levels of neonatal care.

  • Level I: Well newborn nursery

These units provide care and evaluation for healthy newborn babies – for example, infants who can maintain their body temperature and breathe on their own. Level I nurseries also have the facilities to stabilize infants born at 35-37 weeks, as well as infants who are ill or born before 35 weeks before they are transferred to a unit that can provide a higher level of care.

  • Level II: Special care nursery

Special care nurseries have all the capabilities of Level I nurseries. They provide care for babies born at 32 weeks or older and who weigh 3.3 pounds or more. These infants may have non-urgent health problems. Babies who need oxygen via a ventilator for a brief period of time will also receive care here. If they need breathing assistance for longer than 24 hours, they will be moved to a higher level of care. 

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In addition, infants who have recovered from the NICU will be moved to a Level II nursery for additional monitoring before they are able to be sent home with their parents.

  • Level III: Neonatal intensive care unit (NICU)

Level III facilities have the same requirements for care providers as Level I and II facilities. In addition, these units provide care for:

  • Babies born before 32 weeks and who weigh less than 3.3 pounds
  • Critically ill babies of any age or weight
  • Babies who require breathing equipment to help them stay alive
  • Babies in need of surgery

These units also offer prompt access to a full range of pediatric medical subspecialists, including surgeons, anesthesiologists and ophthalmologists.

  • Level IV: Regional NICU

Level IV facilities provide all the capabilities of Level I, II and III units, offering the highest level of care for babies who may require specialized surgeries for birth defects and other disorders. Regional NICUs have a full range of pediatric medical subspecialists on site.

Wrapping up

Neonatal care is a highly specialized field of medicine. While many infants today survive conditions that would have been fatal in years past, medical advances are fragile, and stillbirths and infant deaths do occur.  

New parents need to know what steps they can take during pregnancy and after birth to improve their child’s chances of survival. With neonatal care available, even premature babies born at just 23 weeks can grow up to lead healthy lives.

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