Roxanne R. Stahl, MSN, APRN, NNP-BC
Neonatal Nurse Practitioner
The Monroe Carell Jr. Children's Hospital at Gateway Medical Center
The Neonatal Nurse Practitioners (NNPs) working at Gateway care for all newborns; primarily in the NICU and attend 60% of all deliveries. NICUs rely on the neonatal APRN to play a vital role in caring for critically ill neonates. As a healthcare provider on an interprofessional team, a NNP participates in a wide variety of complex patient care activities that both acute and chronic care. The practice is multifaceted and includes integration of research, education, practice, and management with a high degree of autonomy. Advanced health assessment skills, critical decision-making, diagnostic reasoning, and advanced clinical competencies are also important aspects of the neonatal APRN role. Procedures performed include endotracheal intubation, ventilator management, arterial puncture, umbilical line and chest tube placement, needle aspiration of the chest, suprapubic bladder tap and lumbar puncture. As front line providers, NNPs interact with families building rapport and facilitating ongoing communication at a stressful time in a family's life; when their baby is ill.
Gateway is a community hospital in Clarksville, Tennessee, with its own unique challenges. There is one NNP staffed 24/7 to provide newborn care and emergency airway and IV access up to age 2 as needed. A Vanderbilt Neonatologist provides care during the day and on-call after hours. Consequently, the NNP must be able to function autonomously and be able to resuscitate critically ill neonates at a moment's notice. We frequently have one, or two (twins) resuscitations/admissions with the NNP as team leader with minimal support. Gateway NICU transfers patients needing more complex care, long term ventilator management, or a higher level of care to Vanderbilt. Working in a smaller town, the healthcare professional needs to develop meaningful relationships with families, staff, administration to provide the best of care to patients.
I have been a nurse for 32 years and a NNP for 22 of those years. I graduated from the MSN/NNP program at the University of Colorado Health Science Center and moved to Nashville for employment. I have enjoyed working at Vanderbilt and the last 15 years at Gateway in conjunction with Vanderbilt. I currently serve on the National Association of Neonatal Nurse Practitioners (NANNP) Council. I have written many policies, papers and recommendations in this capacity and mentored many students. I have written my first text book chapter on Case Based Learning: Pathophysiology of the newborn which showcases 5 case studies on HEENT. I received a scholarship to attend Nurses in Washington Internship (NIWI) in March of this year where I will learn about the making of healthcare policy and travel to "the hill" to see legislation at work. I also belong to Middle Tennessee Association of Nurse Practitioners (MTANP), AANP, NANN, and Medical Reserve Corps.
I am married and have a 17 acre horse property in Kentucky. I ride almost every day and often trailer to parks, usually to ride with other nurses! My husband is a videographer and owner of CCPROVideo. He and I are planning a wedding for my stepdaughter this summer which will include a reception at our barn; she is a PhD of Healthcare ethics from St Louis University and Masters of Divinity from Vanderbilt and works as faculty at Michigan State University. Her sister is a Printmaker with her MFA from Edmonton Canada and is currently the artist in residency at Granville Island, Vancouver Canada.