A Neonatal Nurse Practitioner (NNP) is an advanced practice nurse registered nurse who is masters’ prepared. He/she is prepared to practice across the continuum, providing primary, acute, chronic and critical care to neonates, newborns and infants in neonatal intensive care (NICU), emergency rooms, delivery rooms or specialty clinics with a holistic approach. They may also conduct research, act as consultants, or provide education to staff and family members.
The role of the Nurse Practitioner was born in Quebec in the early 1990’s. Despite the practice existing in other provinces and the United States it was a struggle to develop the practice in Quebec. Several changes had to occur within the law such as bill 90 and modification of article 36.1 (Loi sur les infirmieres et infirmiers du Quebec). These changes came about in the early 2001 – 2003, roughly 10 years after the initiative at the Montreal Children’s Hospital. Shortly thereafter McGill University opened the first Neonatal Nurse Practitioner program in 2004.
The Montreal Children was the driving force behind the development of the practice in Quebec. More specifically the NICU, which at the time was looking at how to improve patient care by providing more continuity of care and eliminating gaps in communication. The result was the NNP role. The development of the role was a combined effort from nursing and the medical team. Within a two-year period, three nurses completed training with the medical team, which provided both didactic and clinical training. Several meetings and discussions were had with the Order of Nurses during the training period and once practiced was established with their full support. It was not until 1994 with the blessing of the College of Physician that we became a pilot project. The practice of NP at the time was limited to the Montreal Children with permission from the CMDP and the hospital board having approved the practice. It was not until 1998 that the three NP after recognition of their homegrown program by Stony Brook University completed their Master’ degree and went on to be board certified in the United States.
It was at that point that I became involved with the Order of Nurses and the College of Physician to develop the guidelines for the educational programs and the rules and regulations for the practice of the neonatal nurse practitioners. The work took almost two years before completion with the first licensing exam becoming available in 2006.
The McGill Neonatal Nurse Practitioner Program has to date successfully graduated 23 nurses, which are currently practicing in Quebec many of whom have become affiliates with the university. Now, there are eight students in the program with an estimated graduation time of 2021. The program has had three five-year accreditations. Quebec has six Neonatal Intensive Care in which Neonatal Nurse Practitioners may practice, four of which are located in Montreal.