What is Neonatology?
Neonatology ?is a pediatric discipline that focuses on the medical care of newborn infants, particularly those who are sick or preterm. It’s a hospital-based specialty that’s most commonly used in neonatal intensive care units (NICUs). Premature babies, low birth weight babies, intrauterine growth restriction babies, congenital abnormalities (birth defects), sepsis, pulmonary hypoplasia babies, and birth asphyxia babies are the main patients of neonatologists.
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Historical Developments
Despite the fact that high newborn death rates were acknowledged by the medical profession as early as the 1860s, breakthroughs in current neonatal intensive care have resulted in a dramatic drop in infant mortality in the modern period. This has been accomplished through a combination of technology advancements, greater infant physiology understanding, improved sanitary standards, and the creation of specialist neonatal critical care facilities. In the mid-nineteenth century, infant care was in its infancy and was dominated by obstetricians; but, in the early 1900s, pediatricians began to play a more direct role in neonatal care. Dr. Alexander Schaffer invented the term neonatology in 1960. In 1975, the American Board of Pediatrics developed an official neonatology sub-board certification.
Georg von Ruehl, a Russian physician, invented a crude incubator in 1835, consisting of two nestling metal tubs encircling a layer of heated water. By the mid-1850s, the Moscow Foundling Hospital was using similar “warming baths” on a regular basis to assist preterm children. In 1857, Jean-Louis-Paul Denuce was the first to disclose his own identical incubator design in medical literature, and he was the first physician to demonstrate its efficacy in the maintenance of premature newborns. By 1931, Dr. A Robert Bauer had incorporated more complex enhancements to the incubator, including humidity control and oxygen supply, as well as heating capabilities, which contributed to enhanced neonatal survival.
With the introduction of mechanical breathing for newborns in the 1950s, neonatal care skyrocketed, enabling for survival at ever-lower birth weights.
Dr. Virginia Apgar, an anesthesiologist, invented the Apgar score in 1952, which is used for a systematic assessment of babies soon after birth to guide subsequent resuscitation efforts if necessary.
In 1965, Yale-Newhaven Hospital in Connecticut opened the first specialized newborn intensive care unit (NICU). Premature and critically unwell newborns were cared for in nurseries without specialized resuscitation equipment prior to the advent of the NICU.
Dr. Jerold Lucey proved in 1968 that preterm hyperbilirubinemia (a kind of newborn jaundice) may be successfully treated with artificial blue light. As a result, phototherapy became widely used, and it is today a standard treatment for newborn jaundice.
The introduction of pulmonary surfactant replacement treatment in the 1980s increased the survival of extremely preterm newborns while also lowering chronic lung disease, one of the problems of mechanical ventilation, in less severely premature infants.
Academic Training
A neonatologist is a physician (MD or DO) who specializes in neonatology in the United States. To become a neonatologist, a physician must first finish training as a pediatrician, then a fellowship in neonatology (which lasts three years in the United States). Most, but not all, neonatologists in the United States are board certified by the American Board of Pediatrics or the American Osteopathic Board of Pediatrics in the specialty of Pediatrics and the sub-specialty of Neonatal-Perinatal Medicine. Most nations currently have similar post-graduate training programmed in neonatology, which is a subspecialty of pediatrics.
In the United Kingdom, a physician interested in becoming a neonatologist would participate in an eight-year pediatric specialist training programme after graduating from medical school and completing the two-year foundation course. The remaining two to three years would be devoted to specialty training in neonatology.
Nurse practitioners who specialize in newborn care are known as Neonatal Nurse Practitioners (NNPs). They are considered providers, and they frequently share NICU care responsibilities with resident physicians. Within their scope of practice, as specified by governing legislation and the hospital where they work, they can treat, plan, prescribe, diagnose, and conduct operations.
Newborn nursing is a nursing specialization that focuses on neonatal care.
Spectrum of Care
Neonatalists specialize on the treatment of babies who require hospitalization in the Neonatal Intensive Care Unit, rather than specializing on a specific organ system (NICU). They may also serve as general pediatricians, evaluating and caring for newborns at the hospital where they work. To better assess long-term results, certain neonatologists, particularly those in university institutions who do clinical and fundamental scientific research, may monitor newborns for months or even years following release from the hospital.
The newborn is making several adjustments to life outside of the womb, and its physiological systems, such as the immune system, are still developing. The following diseases are of importance during the newborn period:
Compensation
Pediatric neonatologists make a lot more money than ordinary pediatricians. In 2018, the average pediatrician income in the United States was between $221,000 and $264,000, while the average neonatologist compensation was between $299,000 and $355,000.
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Hospital Costs
One of the most prevalent reasons for hospitalization is premature delivery. From 2003 to 2011, the average hospital expenses for maternal and neonatal surgical treatments were the lowest in the United States. In 2012, maternal or neonatal hospitalizations accounted for the majority of hospitalizations among babies, adults aged 18–44, and Medicaid recipients.
The number of neonatal stays (births) in the United States varied around 4.0 million between 2000 and 2012, peaking at 4.3 million in 2006. In 2012, maternal and neonatal hospitalizations accounted for 27% of all hospital stays in the United States. The average hospital charges, on the other hand, remained the lowest among the three types of hospital stays (medical, surgical, or maternal and neonatal). In 2012, the average cost of a maternal/neonatal hospital stay was $4,300 (compared to $8,500 for medical stays and $21,200 for surgical stays).
A growing number of programmes focusing on infant care collaboration are being launched all around the world, which is encouraging. A few significant examples are the International Neonatal Consortium, Newborn Care International, and the Global Newborn Society. The purpose is to standardize and manage neonatal care while also coordinating research initiatives.
Neonatal Nurse
Neonatal nurses provide care for preterm or unwell newborn newborns. A newborn infant may be affected by a variety of ailments that need medical attention.
Working Life
Premature newborns face unique challenges, such as breathing issues or dietary requirements, which can be life threatening. You’ll be an important member of the team that ensures that treatment is delivered quickly and correctly.
In acute hospitals, you’ll be on call 24 hours a day, seven days a week. You’ll rotate between shifts in the critical care, high dependency, and special care infant units. Some nurses work in the community, where they provide follow-up care and assistance to newborns and their families who have recently been discharged from the hospital.
You’ll be given a variety of jobs to do, including:
You’ll collaborate with a variety of people, including pediatricians, nutritionists, midwives, and other pediatric nurses. You’ll also play a vital part in assisting the baby’s parents during a time when they are both nervous and concerned.
Becoming a neonatal nurse has its own set of prerequisites and training.
To work as a neonatal nurse, you must be a certified adult nurse, child nurse, or midwife. Some companies may need experience or understanding of newborn nursing difficulties, such as grief management or related areas, such as breast feeding. You’ll be encouraged to pursue professional growth after six months of relevant experience. Typically, this will entail particular training modules on various elements of newborn nursing. Your firm and local institutions collaborate to provide these services. They might be available online, allowing for distant study.
Must have Skills
Being extremely organized, adaptable, and able to priorities properly will be essential if you are responsible for newborns with a variety of health issues. You’ll also be keenly aware of your surroundings, capable of assessing patients and deciding on the best course of action. You’ll also need empathy and compassion for the newborns’ family.
Career Development
You could choose to pursue a career in management, education, research, or advanced practice. Working as a nursing consultant is also a possibility.
Pay and Conditions
Your typical work week will be roughly 37.5 hours, depending on your shift schedule, which may encompass nights, early mornings, evenings, weekends, and holidays. As a neonatal nurse, you’ll be paid according to the Agenda for Change (AFC) pay scale, with band 5 being the most common starting point.
In addition, you’ll have access to our excellent pension plan and health-care discounts, as well as at least 27 days of annual leave plus holidays.