Neonatal Nursing Week is September 14-20, celebrating the dedication and hard work of neonatal nurses who provide essential care to their tiniest patients.
Neonatal nursing is a subspeciality of nursing that provides care to newborns born with health abnormalities such as prematurity, congenital disabilities, infections, and other types of health problems. The neonatal field is broad, and there’s so much that people don’t know about these nurses who work hard to keep critically ill babies alive and well.
What Do Neonatal Nurses Do?
These nurses work in nurseries to ensure that newborn babies who are ill are stable and monitored. Neonatal nurses train to provide neonatal resuscitation if necessary. Still, their primary responsibilities are to perform typical nursing duties, test newborns’ cognitive skills, and help mothers during and after the birth of their child.
Depending on the severity of care, neonatal nurses can work with a spectrum of newborns who require different amounts of care, from premature newborns (premies) who are moderately ill to high-risk infants who require incubators, ventilators, surgery, or other types of critical care.
Neonatal nurses can also work in settings other than hospitals, providing in-home care to critically ill infants in communities. However, hospitals are often the most common setting.
Neonatal nurses is a diverse field with several opportunities for nurses to learn on the job. Read on to learn facts about neonatal nurses you didn’t know about.
Not All Neonatal Nurses Work in the NICU
Neonatal nurses can work in the neonatal intensive care unit (NICU), but they also care for healthy babies.
Different levels of neonatal nursing exist. Level III, or NICU nursing, is what people usually think of when they think of neonatal nursing. These nurses work with critically ill newborns with congenital problems or who are extremely premature, and they specialize in working with premature babies.
Level II nurses work in special care nurseries for babies born at 32 weeks gestation who are moderately ill or have returned from the NICU and need additional care. Level I nurses care for healthy babies born at 35 to 37 weeks gestation and care for these newborns as needed.
Although these levels play a different role, all neonatal nurses are crucial in assisting newborns during their pivotal first moments.
Neonatal Nurses Care for Babies as Tiny as Two Pounds
Premies that arrive at the NICU can be as low as two to three pounds, with extremely premature babies (micropremies) weighing less than 1.75 pounds.
Although any baby born before the 37th week of pregnancy is considered premature, the earlier a baby is born, the more susceptible they are to infection and other illnesses since their organs aren’t fully developed yet.
NICU nurses use special equipment to keep newborns alive and ensure their patients are healthy enough to be released. NICU newborns also receive on-the-clock care from bedside nurses and other specialists to check out what happens with each infant.
These nurses also work closely with the parents of premies to reassure them of any concerns and update them on their child’s health.
NICU Cares for More Than Just Premature Babies
One of the most common reasons a baby is in the NICU is prematurity, but there are other reasons why babies— including full-term ones— can be admitted to the NICU.
Some reasons why newborns require NICU assistance can be conditions of the heart and lungs, such as an abnormal breathing pattern, slow heart rate, or respiratory distress syndrome.
Infections pose a severe risk to infants, including sepsis, bacterial meningitis, and diseases transmitted from the mother. These can endanger newborns who are already vulnerable to the outside world. Illnesses such as anemia, feeding problems, hypoglycemia, and withdrawal from alcohol or narcotics are also life-threatening dangers to a baby’s health that require NICU support.
We generally don’t study the classics of philosophy in nursing school. Unless we encountered philosophy in high school, a previous time in college, or out of personal interest, we nurses may not frequently think about Socrates, Plato, and Aristotle, let alone Heidegger, Kant, and the rest.
Nurses aren’t alone. Even though philosophy could be argued to be the underpinning of civilization, not many people spend much energy trying to understand it. We know it’s essential, but it’s not easy reading, and we have a lot of other things to do, like managing our careers, planning our next vacation, paying bills, and raising our families.
However, certain philosophical questions and statements are part of the popular consciousness, and sometimes, a brief reflection can yield some valuable gold for our life’s journey.
The Unexamined Life
The statement that “an unexamined life is not worth living” has been attributed to Socrates for thousands of years. While the exact wording is sometimes slightly different, the general idea is there: if we don’t look deeply at our lives and consider our motivations for what we do and the truth of who we are, life may not hold as much meaning as it could otherwise. Whether that examined life is not worth living is a matter of opinion, but we get Socrates’s point.
If you take a good look at your nursing life, what do you see? What gold is there to mine from your experiences, and what has being a nurse brought you? Have your original motivations remained with you, or have your experiences significantly changed how you view your career?
This is not to say that you can’t simply go to work each day, do your job, and come home to your family. There’s nothing wrong with doing your job well and enjoying the rest of your life. You probably work pretty darn hard, and you deserve enjoyable and restful time away from work.
Not everyone is predisposed to philosophical reflection. But when we realize the potential value in taking a deeper look at what we do and why we do it, sometimes we’re led down a path that bears the fruit of what Socrates was getting at.
A Precious Gem
Taking the above statements to heart, there’s much to say for periodically pausing to reflect on your nursing journey.
You could visualize your career as a precious gemstone expertly cut into multiple facets, be it a diamond, a ruby, a tourmaline, etc. Holding your faceted nursing career up to the light, what do you see? Consider these questions as a place to begin:
What were my original motivations for becoming a nurse?
What has changed for me since I first graduated? Do I see my career differently?
Is there something I’ve always wanted to do in my career that I haven’t yet accomplished?
How do my colleagues perceive me? What do they see and experience when interacting with me?
What impact do I have on patients? How do they experience and perceive me?
What have I learned about myself in the course of my career? Has anything about me fundamentally changed based on my experiences as a nurse?
Does my work as a nurse hold enough meaning for me?
What would I tell my younger self if you could message the nursing student or new grad I once was?
The precious gem of your nursing career has many facets; depending on how you hold it up to the light, you will see different things. If you take the time to examine your life and career, you may discover things about yourself that you’ve never realized. Focused self-examination has the power to reveal a great deal.
To Examine or Not to Examine
There are no rules about how introspective anyone has to be. Life in the 21st century is complicated, and as mentioned earlier in this article, we have a lot of other things to do just to keep afloat. If you’re raising children, have aging parents, or are feeling your own aging process, there’s plenty demanding your attention.
You probably work hard, have many responsibilities, and always have a lot to think about and do. There’s no need to take a deep dive into your deeper motivations and desires, but if you do for a moment, there may be some valuable insights about you, your life, and your identity as a nurse.
Is an unexamined (nursing) life worth living? You don’t need Socrates to tell you — you know the answer that works for you.
In the 21st century, several holistic approaches to medicine have become increasingly popular among clinicians and patients. One such approach continuing to gain steam is functional medicine.
But what exactly is functional medicine, and what does it have to offer patients looking to dive deeper, as well as providers and clinicians who want to help their patients improve their overall health and well-being?
Putting Out the Fire
Hally Brooke, NBCHWC, FMCHC, CPT, is the Founder and CEO of Live Nourished Coaching, a nationwide health coaching agency. As a Certified Functional Medicine Nutrition Counselor and a Nationally Board-Certified Health and Wellness Coach, Ms. Brooke brings a nuanced, expert perspective to understanding functional medicine’s role.
When asked to define functional medicine, Ms. Brooke begins, “Functional medicine is root cause medicine, which means we go after the true root of the symptoms instead of slapping a Band-Aid on the symptom.”
She continues, “Consider eczema or psoriasis — these are both symptoms of inflammation, a root cause of almost every chronic disease. But inflammation itself is actually only a secondary root cause — something lit that fire in the first place.”
She explains further, “Inflammatory root causes include food intolerances, intestinal permeability, toxicity, mold exposure, or infection. If you treat the skin with a steroid, the problem will go away only as long as you use the topical ointment. If you treat the root cause of the inflammation causing the problem, it goes away forever. Treating the symptoms is like turning off the fire alarm and leaving the house ablaze. Treating the root cause actually puts out the fire.”
Brooke further differentiates functional medicine from mainstream medicine: “Functional medicine looks at the whole person—body, mind, and spirit—and emphasizes the importance of personalized care and lifestyle changes.”
“Functional medicine differs from mainstream medical practice in several key ways,” Brooke offers, and she breaks it down for us in this way:
Root Cause Focus: Instead of just treating symptoms, functional medicine aims to find and address the underlying causes of illness.
Personalized Care: Treatment plans are tailored to the individual’s unique genetic, environmental, and lifestyle factors and are focused on lifestyle change, not prescription medication.
Holistic Approach: It considers the whole person, including physical, emotional, and spiritual aspects, and how they interact.
Prevention and Wellness: There is a strong emphasis on preventive care and promoting overall wellness, not just disease management.
What About Nutrition?
“Functional nutrition is an approach to diet and nutrition that emphasizes whole, nutrient-dense foods and considers each individual’s unique needs,” Brooke shares. “It looks at how food affects the body on a biochemical level and aims to support optimal health.”
“Our current approaches to nutrition often fail us because they can be too generalized and don’t take into account individual differences. Many mainstream diets focus on calorie counting or macronutrient ratios without considering food quality, nutrient density, and how different foods interact with our unique bodies.”
Barriers to a Functional Approach
While functional medicine may sound great to many of us, providers might see this practice as a barrier.
Discussing why providers might be hesitant, Ms. Brooke explains, “Conventional medical appointments are often short, making it hard to delve into complex, root-cause investigations.”
She adds, “Meanwhile, many providers aren’t trained in functional medicine principles during their medical education, let alone being trained in nutrition, which is a key fundamental of functional medicine.”
“Most western doctors would say, for example, that nutrition has nothing to do with Hashimoto’s Disease, but by changing a person’s diet, we can completely reverse Hashimoto’s in many cases.”
In terms of the medical culture, Brooke observes, “The traditional medical model focuses more on acute care and managing symptoms, which can lead to skepticism towards approaches that are perceived as less evidence-based or more time-consuming.”
The Benefits to Patients
When considering how patients can benefit from a functional approach, Brooke states, “Patients can experience numerous benefits from a functional approach, including:
Improved Health: by addressing root causes, patients often see more significant and lasting improvements
Personalized Treatment: Care plans are tailored to individual needs and lifestyles, taking their whole being into account, leading to more effective and relevant interventions
Empowerment: Patients learn more about their health and how to manage it, resulting in greater self-efficacy and well-being. Instead of the doctor being the end-all-be-all, it’s the patient taking their health into their own hands, guided by the provider.
Prevention: Functional medicine often helps prevent future health issues by promoting overall wellness and balance.”
Nurses, Functional Medicine, and the Future
Brooke advises nurses wanting to be trained in functional medicine basics: “There are multiple pathways for nurses to get involved in functional medicine. Nurses can partner with a health coach to create a collaborative care model or become certified functional medicine health coaches themselves.
She continues, “There are many courses and certifications in functional medicine that nurses can take to enhance their practice. Nurses can also apply functional medicine principles in their current roles by incorporating holistic assessments, personalized care plans, and lifestyle counseling.”
Brooke adds, “HI believes health coaching and functional medicine are the future of healthcare because they address the limitations of the traditional medical model by preventing disease and promoting wellness, rather than just treating illness. They also provide more individualized, patient-centered care, which itself leads to better outcomes.”
“Finally,” Brooke concludes, “healthcoaching and functional medicine consider all aspects of a person’s life and health, fostering a more comprehensive and effective approach to care. They empower patients to take an active role in their health, which can lead to more sustainable health improvements and overall well-being.”
Growing up in a household where the medical field was ever-present, the sight of my mom, a nurse, coming home from her shifts at the hospital and the stories my aunt shared from her nursing career filled our family gatherings. Nursing felt like a natural path for me to follow. My older brother and I, deeply influenced by these strong women and our Nicaraguan heritage, embraced the calling to carry forward the values they instilled in us.
After earning my Bachelor of Science in Nursing (BSN) from the Goldfarb School of Nursing in St. Louis, Missouri, I began my career at Barnes-Jewish Hospital in St. Louis, working in the oncology unit. Starting a nursing career during the COVID-19 pandemic, especially in an oncology unit with immunocompromised patients, was a test of resilience. The challenges were always present, but I was fortunate to have incredibly supportive coworkers who guided me through those tough times.
As a first-generation American, my Nicaraguan heritage profoundly influences how I care for patients, with a focus on family and community support. This background has instilled a sense of warmth and personal connection, ensuring every patient feels seen and cared for. These principles guide me daily from my early days on an oncology unit to my current role.
Two years into my time at Barnes-Jewish, I became interested in exploring the country beyond my hometown of St. Louis and growing from new experiences as a nurse. I began travel nursing contracts, first in Atlanta, Georgia, and then in Dallas, Texas. These opportunities opened my eyes to the diverse challenges and cultures within different hospitals and specialty care areas. This time was rewarding and enriching, though it came with its own set of difficulties, such as adapting to new environments. Despite these challenges, I always found support among my coworkers, and together, we managed to provide the best care possible for our patients.
After these contracts, like many nurses, I started to feel uncomfortable with the rigidity around hospital shift scheduling and wanted more control over my schedule. A year ago, I discovered ShiftMed, a platform that allows me to choose when, where, and how often I work, providing the ultimate flexibility. This approach helps manage burnout and maintain a healthy work-life balance. With ShiftMed, I can easily plan my schedule around personal events and travel. For instance, I can take a week off to visit Chicago or plan a two-week trip to the Philippines without any hassle or waiting to see if my request for time off was approved.
I work three 12-hour nursing shifts a week with ShiftMed at SSM Health in St. Louis. The platform’s flexibility means I can shift my workdays around my personal life, ensuring I don’t miss out on important events with family and friends. This control over my schedule has allowed me to travel more and buy my first home, which I just started moving into—a milestone I am incredibly excited about. I typically pick all my shifts a month in advance, allowing me to plan my life with certainty and ease.
Friends, family, and colleagues often ask me about working for ShiftMed, and I am curious how it all works. Many think it sounds too good to be true. They’re often surprised at the level of control and flexibility I have over my schedule. The scheduling platform lets me view available shifts well in advance and select those that best align with my life. This flexibility is a game-changer for managing the unpredictable demands of a nursing career. It also helps me prevent burnout, as I can adjust my schedule to ensure I get the breaks I need.
Recently, I had a family emergency and had to cancel a shift at the last minute, something I never do. The support and empathy I received during this time reaffirmed my decision to work with them. They understand that life can be unpredictable and are accommodating when emergencies arise. I was also able to embrace this flexibility when my grandmother fell ill, needing more of my time and attention. ShiftMed allowed me to adjust my schedule without the stress and guilt that typically accompany such personal challenges.
I’m also able to work across different hospital departments. I typically pick med-surg shifts but occasionally end up working in other units. This has allowed me to connect with numerous colleagues across various units at SSM Health. I have formed strong relationships with many staff members, and it’s heartwarming to be greeted wherever I go in the hospital. This sense of community and recognition is something I cherish deeply.
I am grateful for the growth and opportunities I’ve experienced throughout my career. This flexible approach to work has allowed me to balance my professional aspirations with my personal life, ensuring I provide the best care for my patients while living a fulfilling life outside of work.
If you’re a nursing school student, you might be thinking about what to specialize in if you don’t want to become a general registered nurse. Or, if you’re a nurse in the workplace, you might think it’s time for a career change.
Whatever your current situation, nursing is a broad field with many different specialties to fit your lifestyle.
Even if you’re happy where you are, read on to learn more about unique nursing specialties that might surprise you.
5 Specialties to Consider
Flight Nursing
Yes, some nurses work on flights! Similar to nurse paramedics, flight nurses are trained to care for patients during emergency air transport. They administer pre-hospital care onboard helicopters and airplanes and work with physicians and paramedics during in-flight destinations.
Flight nurses must work in high-pressure situations with patients in critical conditions. Their tasks include resuscitation, triage, administering IV drips, and monitoring vital signs so that the patient is well enough to be safely deplaned.
You’ll find these nurses in civilian or military environments. Examples of places flight nurses work include hospitals, private medical transport companies, and the Air Force. The Air & Surface Transport Nurses Association (ASTNA) provides more information for nurses who work in transport nursing.
Nurse Entrepreneur
Nurse entrepreneurs work for themselves, taking on all the risk and responsibility of running their own businesses. The specific nature of their work varies depending on their specialization and area of expertise. These nurses can manage their own agencies, coach clients through telehealth, sell their own scrubs, and pursue other business ventures related to the field of nursing.
Many nurses start out as full-time employees with a side hustle and eventually grow into their businesses full-time. Others prefer to work on their own early in their careers.
There’s no right or wrong way to be an entrepreneur. In fact, nurses have gone on to careers in art, blogging, and public speaking.
Certified midwives provide care during pregnancy, childbirth, and the postpartum period. They help expectant mothers navigate the pregnancy process and find safe delivery services in rural and urban areas. They also coach families on life after childbirth and care for infants after their first 28 days.
Midwives work in hospitals, clinics, private and public office settings, homes, and birth centers. Their care includes counseling on gynecologic health and discussions of family planning topics such as birth control. Midwives also conduct physical examinations, prescribe medications, and order diagnostic tests like labs or ultrasounds.
These nurses work one-on-one with the family or pregnant person, listening to their needs and reassuring them based on their concerns. The American College of Nurse-Midwives (ACNM) has more information on midwifery and their roles in society.
Legal Nurse Consultant
These nurses work in the legal field, interpreting medical information for attorneys. They also act as expert medical witnesses in malpractice, personal injury, or workers’ compensation cases.
Legal nurse consultants in this field can be valuable since they are experts in medical terminology. Litigation teams need someone to interpret complex medical information they may not understand. In courtrooms, these consultants can also explain medical details to jury members who aren’t well-versed in the subject.
Given their skills, legal nurse consultants can work at law firms, insurance companies, consulting firms, and consultant agencies or even become self-employed with their practice.
Like legal nurse consultants, forensic nurses also work in a field you wouldn’t expect— the criminal justice system. Their skills, however, are very much needed as they provide care to sexual assault, violence, and assault victims in criminal cases.
Forensic nurses perform roles that include collecting data and recording evidence, photographing injuries, interviewing patients and their families, and treating victims in physical pain. They also act as intermediaries between patients, families, law enforcement, and doctors.
Since this career is fast-paced and patient-facing, forensic nurses are expected to foster trust and understanding with the victim and assist the forensic team with any information needed for conviction. These nurses work in hospitals and emergency rooms, but they can also be found in laboratories and law courts.
In the busy world of healthcare, a group of hidden heroes emerges with specialized care and unwavering dedication: meet the unsung champions of psychiatric-mental health (PMH) nursing. These caregivers play a crucial role in shaping compassionate mental healthcare.
We spoke with Angela Amar, PhD, RN, FAAN, the Dean and Erline Perkins McGriff Professor at the New York University Rory Meyers College of Nursing. Dean Amar is a PMH nurse with expertise in gender-based violence and discusses the roles of PMH and forensic nursing.
Please talk about your career path and how you became a PMH nurse.
I became a nurse because I liked science and helping people. I’ve always been intrigued by human behavior. Even as a child, I remember watching people interact and wondering why they did the things they did. Psychiatric nursing provides a window into understanding human behavior and the tools and skills to help people. This skill has been very useful as a nurse administrator.
Please talk about what a psychiatric-mental health nurse does.
Psychiatric mental health nurses (PMH) provide nursing care for patients with psychiatric illnesses and symptoms. PMH nurses provide comprehensive care to individuals, groups, families, and communities who are affected by mental illness and substance abuse.
How do you become a psychiatric-mental health nurse?
All nurses receive education and clinical experience in assessing, diagnosing, caring for, and treating mental health and substance disorders. Working in a mental health unit or facility will allow a nurse to learn more psychiatric skills. To become a psychiatric/mental health nurse practitioner, one must complete a graduate education program and become licensed and certified.
You have expertise in gender-based violence and forensic nursing. What is forensic nursing?
The International Association of Forensic Nurses (IAFN) defines forensic nursing as “…the practice of nursing globally when health and legal systems interact” (IAFN). Forensic nurses are often described as the link between the health care and criminal justice systems. Establishing this linkage between health care and the criminal justice system is essential to providing the comprehensive care victims and offenders of violent crimes need. Specifically, forensic nurses provide specialized health care and expertise to meet the needs of victims and offenders of violence. Specialized health care may include evaluation, identification, and treatment of injuries, collection of biological and physical evidence, legal documentation of injuries, and, sometimes, participation in legal court proceedings.
Can you talk about the field where this expertise is useful?
Forensic nurses practice in various settings with a diverse group of victims and offenders. Many forensic nurses work as part of interdisciplinary teams that investigate abuse or neglect situations with adults and children, as well as teams involved in prevention efforts. Forensic nurses in critical and emergency care and psychiatric nursing routinely interact with individuals who have experienced violence and its consequences. These nurses provide physical care while attending to the collection of evidence and documentation for legal proceedings.
Forensic nurses may work with individuals in prisons and jails’ medical, psychiatric, and evaluation units. Psychiatric nurses work with victims and offenders. Other areas of forensic nursing practice include death investigation, mass disaster care/investigation, and legal nurse consulting. Examples of potential employers include hospitals, community health care sites, law enforcement, coroner’s offices, and the military; potential roles are nurse coroner and forensic nurse examiner.
What types of conditions do forensic nurses manage?
The earliest and most recognized role in forensic nursing in the United States is that of the sexual assault nurse examiner (SANE). The purpose of SANE programs is to provide victims of sexual assault with health care, forensic assessment, evidence collection, forensic documentation, and court testimony. Other roles include death investigation, child, elder, and intimate partner violence investigation, corrections nursing, and legal nurse consultant.
What are the challenges of forensic nursing?
Forensic nurses are exposed to the savagery of violence and crime and the difficult aftermath survivors experience on a daily basis. Self-care and fortitude are important, as is working in a community and on a team that can provide support. As a newer specialty within nursing, the roles are not always understood, and many nurses have created roles for themselves in systems that did not initially see the need.
What are the most critical skills for forensic nurses?
Unfortunately, too many people in our society experience violence and crime as victims and offenders, as well as affected family members, friends, or significant others. Forensic nurses are ready to help them and demonstrate caring, capability, and compassion. Excellent interpersonal and communication skills are essential, as is knowledge of the dynamics of violence and crime.
What makes being a forensic nurse so unique?
Forensic nursing is an innovative and evolving nursing specialty that addresses healthcare issues with a medico-legal component. In responding to the societal and health care needs created by increasing criminal violence, forensic nursing programs provide nurses with the necessary skills for specialized health care and expertise to meet the needs of victims and offenders of violence. Violence and crime are major issues affecting our society. Nurses provide care to victims and offenders of violence in a variety of settings, often without specialized training.
Are there evidence-based guidelines forensic nurses must follow?
All nurses follow evidence-based practice guidelines. This also pertains to SANEs and the other forensic roles.
You’re a leading scholar in gender-based violence and have influenced the direction of campus policy nationally. Can you talk about these policies and their role in nationwide campuses?
My research examines help-seeking behavior, specifically in college students who have experienced sexual or relationship violence. Many young adults do not report violence and often do not receive follow-up care for the physical and psychological effects. My research examined factors influencing help-seeking behavior at the individual, relational, and community levels. Specifically, we explored how friends can be more effective in promoting help-seeking and how campus policies may inhibit or promote help-seeking.
You just finished your first year as the Dean of New York University Rory Meyers College of Nursing and Erline Perkins McGriff Professor of Nursing. How did the year go, and what are you looking forward to in your second year?
It’s been a great year. NYU Meyers is a vibrant community in a dynamic and global university in one of the world’s greatest cities. The faculty and staff are talented and engaged, and the students are smart and stellar. NYU Meyers has always had an eye on the future and is a trend-setting and change-making institution. I am excited by the possibilities of continuing to lead the nation, expand our global footprint, and continue with innovative research and teaching while promoting a learning organization where everyone thrives and grows.
