Munson Medical Center in Traverse City, Michigan houses a 22-bed level 3 NICU staffed by 2 full-time clinical neonatologists and 4.5 neonatal nurse practitioners. This is the only NICU in the northern lower peninsula, serving a referral region spanning 150 miles. The NNP functions collaboratively with the supervising Neonatologists to coordinate the patient care needs of the high-risk newborn population. The NNP collaboratively manages well and critically ill infants using a family-centered approach to patient care. The majority of patients are born at Munson Medical Center, but some are transported in from the region, either by the neonatal transport team or through the emergency department after discharge home. Our neonatal program services well newborns (0-2 per day) and NICU patients (levels 2 and 3) with a total average daily census 12-14. Neonatal nurse practitioner shifts are 24 hours in-house, with 3 shifts every 2 weeks constituting full time employment. Neonatologist support is readily available 24/7, but neonatologists do not reside in-house. The NICU at Munson Medical Center hosts a robust neonatal transport team, which you will lead. Accompanied by a NICU RN, respiratory therapist, and EMS team, you will provide regional support spanning a 150-mile radius, reached by ambulance, helicopter, or fixed wing airplane. The NICU cares for all gestational ages. HFOV, HFJV, conventional volume and pressure ventilation, bubble CPAP, high flow nasal cannula, and NIPPV are available. Gentle ventilation strategies including INSURE surfactant administration are targeted. Management of central lines (UVC, UAC, PICCs) with continuous infusions for pressor support, sedation, or prostaglandins is expected. Bedside retinopathy of prematurity eye exams are completed at Munson by an experienced local ophthalmologist, with capability for in-house laser photocoagulation or anti-VEGF injections. Standard diagnostic services available include MRI, CT scan, GI contrast studies, ultrasound, x-ray, echocardiogram, EKG, continuous EEG with real-time neurology interpretation. Commonly encountered procedures include intubation, surfactant administration, needle decompression, chest tube placement, IV access (PIV, PICC, UVC, UAC), arterial blood sampling, blood transfusions, lumbar punctures, and resuscitation. Daily multidisciplinary rounds with the patient's family, NNP, Neonatologist, pharmacist, respiratory therapist, nutritionist, dietitian, lactation consultant, and social worker promote a collegial team, with a family-centered approach. As of this posting, pediatric surgical services, ECMO, inhaled nitric oxide therapy, and therapeutic hypothermia are NOT available at Munson Medical Center and require transfer to a level 4 NICU (DeVos Children's Hospital or University of Michigan). SPECIFIC DUTIES 30 Conducts comprehensive physical assessments of patients. 30 Establishes medical diagnosis for common short-term or chronic health problems. 30 Orders and Interprets laboratory tests and performs diagnostic and invasive and noninvasive procedures. 30 Noninvasive tests that can be ordered and interpreted independently or in collaboration with the neonatologist or his/her designee include X-ray-chest, abdomen, skeletal. Noninvasive and invasive tests ordered by the NNP in collaboration with the neonatologist or his/her designee: MRI, EEG, EKG, and ECHO cardiogram, Hearing Screening, GI studies: UGI, BE, swallow study, GU studies: VCUG, Ultrasonography, CAT scan. 30 Invasive procedures that can be ordered and performed by the NNP with consultation as necessary with the neonatologist or his/her designee include arterial puncture, suprapubic bladder tap, chest tube placement and removal, endotracheal intubation, lumbar puncture, needle thoracentesis, umbilical and arterial catheterization and removal, percutaneous central venous catheter placement and removal, venipuncture, exchange transfusion and partial exchange transfusions, peripheral artery catheterization and removal. 30 The NNP may prescribe medications in collaboration with the neonatologist. 30 The NNP may prescribe the following therapeutic treatments: Respiratory therapy utilizing nasal cannula, nasal CPAP, Ventilation-initiation of initial settings, adjusting settings based on blood gases and x-rays for conventional ventilators, volume ventilators, and HFOV and HFJV. Inhalation treatments, chest physiotherapy, suctioning. 30 Initiation and adjustment of fluid requirements, parenteral and enteral nutrition, placement of OG and NG tubes 30 Urinary Catheterization 30 Blood Transfusions 30 Phototherapy 30 Suture Removal 30 Makes patient referrals to appropriate physicians or other health care providers. 30 Provision of emergency care 30 The NNP may perform CPR and initiate and manage resuscitative measures, including medications, laboratory tests, and therapeutic/corrective measures as listed above until the neonatologist or designee is available. The neonatologist is responsible for discontinuing resuscitative measures if the infant does not respond to therapy. 30 Performs other duties and responsibilities as assigned. EHR 30 Oracle Health Qualifications 30 Education / Training: 30 Nurse Practitioner: 30 Licensed Registered Nurse in the State of Michigan 30 Certified as Family Nurse Practitioner with the American Nurses Association 30 Work Experience: 30 Neonatal transport experience preferred. 30 Certification, Licensure, Registration: 30 Current BLS certification 30 Current NRP certification 30 NRP instructor status is encouraged. Completed advanced training program and is certified by NCC as a neonatal nurse practitioner Candidate must apply for and be granted appropriate clinical privileges through MMC's normal credentialing processes before rendering services.