NNP Enrollment Gap: Insights From NICU Nurses

BACKGROUND: Despite a critical nationwide need, the Neonatal Nurse Practitioner (NNP) workforce is rapidly declining because of decreased enrollment in NNP programs, compounded by an aging workforce. Neonatal intensive care unit (NICU) nurses are the only professionals eligible to enter NNP education, yet there is limited research on their intentions and barriers to pursuing advanced education. PURPOSE: This study aimed to explore NICU nurses' intentions to pursue advanced practice nursing education and identify perceived barriers. METHODS: This cross-sectional study used random sampling and surveys distributed through NANN and social media to assess NICU nurses' intentions, perceptions of the NNP role, barriers to graduate school, and program preferences. Quantitative data were analyzed with R version 4.4.0, and qualitative responses were categorized thematically. RESULTS: A total of 531 participants completed the survey. Most respondents were younger than 40 years, with a mean of 7.6 years of NICU nursing experience. A majority (77.8%) indicated they intended to return to school. The main obstacles identified included finances, work-life balance, autonomy, responsibility, and interest in other roles. The most common response was a desire for better work-life balance. IMPLICATIONS FOR PRACTICE AND RESEARCH: This study highlights the need for more flexible NNP programs to support nurses returning to school and addressing concerns about work-life balance. With declining NNP graduates, the specialized care in NICUs may be at risk if other specialties fill the gap, potentially affecting outcomes for fragile infants.