title: Developing a neonatal workforce: role evolution and retention of advanced neonatal nurse practitioners.
abstract: BACKGROUND
  Over the past decade more than 120 advanced neonatal nurse practitioners (ANNPs) have graduated from the Southampton based ANNP programme.
  
  
  OBJECTIVE
  To determine the scope of practice and evolving role of ANNPs and to identify factors that may affect future recruitment and retention.
  
  
  METHODS
  An open ended structured questionnaire on clinical role, working arrangements, retention and attrition, continuing education, and professional development was sent to 95 ANNPs.
  
  
  RESULTS
  A response rate of 83% was achieved. There was an attrition rate of 14%, with most ANNPs remaining in their original seconding unit. Factors considered to be important for role satisfaction included a well defined role, working within a team of ANNPs, appropriate remuneration, and evidence of unit support for both role definition and continuing professional development.
  
  
  CONCLUSIONS
  Although ANNPs are expensive to both train and employ, this evidence suggests that there is a good return on the investment in terms of retention to the unit and the specialty. Their role incorporates many features of advanced nursing practice as well as providing "value added" neonatal care by merging traditional medical and nursing roles and crossing professional boundaries. In 2004 the manpower challenges for neonatal units will be even more acute; these data confirm that there are effective options available but they require long term strategic planning and investment.
authors.affiliation: Division of Child Health, School of Nursing and Midwifery, University of Southampton, Southampton, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Smith
authors.forename: M A
authors.initials: MA
authors.lastname: Hall
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002322:Career Mobility; D004509:Education, Nursing, Continuing; D004739:England; D005260:Female; D005381:Financing, Organized; D006767:Hospitals, District / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D017283:Neonatal Nursing / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000458:organization & administration* / Q000523:psychology / Q000600:supply & distribution; D024802:Nurse's Role; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011364:Professional Practice; D015397:Program Evaluation; D012456:Salaries and Fringe Benefits; D013192:Staff Development