Neonatal Nurse Practitioners Bring Expert Care to Communities Across Texas

A term mother arrives for a planned induction at a community hospital west of Houston. The team expects a routine delivery until the call comes that she has abruptly hemorrhaged. It requires expertise, immediate action and a coordinated response as soon as the newborn is delivered. 

Texas Children’s Neonatal Nurse Practitioner (NNP) Courtney Jones is the advanced practice clinician on site. She steps in to stabilize the newborn, begin ventilation, place central access if needed, and determine whether the baby might require cooling or transfer. 

“You’re there for the critical first steps,” she says. “Things change quickly, and you’re helping parents understand what’s happening while making sure the baby gets exactly what they need.” 

Scenarios like this happen regularly but, at our partner hospitals, Texas Children’s expertise is already in the room. For NNPs, it’s an opportunity to practice at a high level, respond confidently during emergent deliveries and ensure that families in community settings receive the same standard of care they would expect in the Texas Medical Center, without leaving their local hospital. 

Extending Texas Children’s Care into Communities 

Since 2003, the Texas Children’s Hospital Community Initiatives (CI) program has brought neonatal, pediatric and maternal-fetal expertise to hospitals across Greater Houston and beyond. Today, the program supports 12 partner hospitals, ensuring families receive the same high standards of care they would expect from Texas Children’s, without leaving their communities. 

Neonatal Nurse Practitioners lead neonatal resuscitation, stabilize newborns, place lines and collaborate closely with hospital teams. Families are often surprised to learn that the clinician caring for their newborn in a Houston Methodist or CHI St. Luke’s facility is a Texas Children’s provider. 

“When they realize I work at Texas Children’s, parents are frequently grateful to have the level of care they associate with our reputation,” says Natalie Stephens, an FNP working in our CI program. “Knowing a Texas Children’s clinician is caring for their newborn brings a sense of reassurance because the same evidence-based guidelines and collaborative model guide their baby’s care.” 

Neonatal Nurse Practitioners: Autonomy, Expertise and Trust 

Community-hospital-based NNPs practice with a high level of autonomy, supported by the Baylor College of Medicine Guidelines for Newborn Care and close collaboration with neonatologists. 

“Those guidelines direct us to make sure that we’re all delivering consistent care to our patients,” says Courtney. “That kind of continuity makes it very easy to practice medicine correctly and to do a great job.” 

If a newborn needs highly specialized or surgical care, teams coordinate transfers to Texas Children’s Level IV NICUs at our Main, The Woodlands or North Austin campuses. This approach supports our system’s commitment to providing the right care in the right place for every child.   

“At night, you’re the one in-house,” Courtney says. “You have a backup physician on call, but you are the person immediately available to save that baby’s life. You have to have confidence and some years of experience.” 

For many, this combination of independence and structure creates deeply satisfying work. Smaller Level II–III NICUs — often 8 to 20 beds — allow long-term relationships to form. Families remember their NNPs years, sometimes decades, later. That connection is part of what makes the work extraordinary. 

“It’s very rewarding when you see a baby that was once 550 grams come back walking and talking and living a completely normal and great life,” Courtney says. “It always makes my heart so happy.” 

Teamwork That Drives Better Care 

Community sites are small enough to function like close-knit units, which opens opportunities for shared decision-making and meaningful communication with nursing, respiratory therapy, pediatrics and care management. 

Courtney explains how this teamwork plays out daily: “Around 9:30 or 10 each morning, the physician, myself, the bedside nurse, the charge nurse, the respiratory therapist and the dietitian all round together. We review the exam and the plan, and everybody adds input.” 

That collaborative approach continues throughout the day, whether it involves supporting new mothers or addressing urgent changes in a newborn’s status.  

Community Settings That Fit a Variety of Lifestyles 

Texas Children’s Community Initiatives program offers Neonatal Nurse Practitioners the chance to practice in environments that match different lifestyles — whether that’s the university-driven pace of College Station or the suburban convenience of West Houston and Fort Bend County. 

College Station is a growing area with a strong sense of community, supported by Texas A&M University and family-friendly neighborhoods. Sharon Fassino, Community Initiatives APP and an NNP, shares that many staff value the experience of a smaller unit, the lack of major metro traffic and the way the NICU team becomes “like a family” in a region surrounded by small towns and rural communities. Our NNPs also have opportunities to serve as clinical instructors or guest educators at local programs. 

While large parts of Fort Bend County remain rural or semi-rural, Sugar Land is a suburban city. Shaped by decades of Houston’s expansion, it’s one of the fastest-growing counties in the U.S. Courtney appreciates living about 30 minutes from her partner hospital west of Houston and practicing at a high level without spending hours in traffic — something many NNPs working in community hospitals value. 

Across all CI locations, NNPs work in Level III environments where they play a central leadership role, especially during night shifts. Physicians live nearby and remain on call, but the onsite practitioner guides care during critical moments. As Sharon notes, this requires confidence and strong L&D experience, yet it offers meaningful autonomy and the ability to make a visible impact within communities. 

Whether someone thrives in a tight-knit college town or appreciates the convenience of suburban living and working, Texas Children’s offers multiple environments where experienced NNPs can grow, lead and shape exceptional neonatal care close to home. 

Supported, Connected and Equipped to Grow 

Although community NNPs work outside the medical center, they remain closely connected to Texas Children’s: 

• Shared clinical standards: All providers follow annually updated guidelines. 

• Hands-on proficiency: Skills labs in our Simulation Center support continued competency. 

• Regular communication: The CI team meets monthly and leaders visit each site. 

• Meaningful involvement: NNPs participate in QAPI committees, chart reviews and site-level initiatives. 

• Professional growth: Opportunities exist to join projects, present at conferences or pursue additional degrees such as the DNP. 

Many NNPs choose community hospitals because the work blends advanced neonatal practice with a manageable, predictable rhythm. Practicing close to home while working at a high level makes a difference — professionally and personally. 

Shape the Future of Neonatal Care in Communities Across Texas 

Texas Children’s is seeking dedicated, experienced Neonatal Nurse Practitioners who want to bring advanced neonatal care where it’s needed most: into communities across Texas. 

If you’re looking for autonomy, connection and meaningful impact, explore current Neonatal Nurse Practitioner opportunities and join a team that brings expert, compassionate neonatal care closer to home for families across our state.