L. Wellman, D. Stevens, Ann L. Wilson
Apr 1, 1981
Neonatal nurse clinician programs have been developed in part to meet the needs for clinical management skills and technical expertise usually provided by pediatric house officers. The question as to whether patient care can be effectively delivered by nurses has not been fully answered. Neonatologists became actively involved in neonatal care in South Dakota in 1978. Con-comitantly, a nurse clinician training program was developed which included over 300 hours of didactic teaching, six weeks of applied clincial experience and a 34 week preceptorship in a tertiary nursery. Neonatal clinicians were taught to manage the transport and daily care of seriously ill neonates. The mortality for the unit fell from 20% in 1977 to 5.5% for the 1st 9 months of 1980. In addition, there were no fluctuations in mortality associated with housestaff rotation. Nurse clinicians now perform nearly 60% of all procedures. Neonatologists, in concert with nurse clinicians, can provide care at a level which compares favorably with other tertiary care centers. This care provides a high level of consistency and continuity not obtainable in the usual housestaff program. Neonatal clinicians are an effective alternative for situations in which there are an insufficient number of pediatric house officers.