Nursing Care of Surgical Neonates in the Neonatal Intensive Care Unit: A Narrative Review.

Surgical neonates represent one of the most vulnerable populations in the NICU due to physiologic immaturity, limited compensatory reserves, and exposure to perioperative stress. Although advances in neonatal surgery, anesthesia, and intensive care have improved survival, outcomes remain closely linked to the quality and consistency of nursing care. Nurses play a critical role in physiologic stabilization, prevention of complications, early recognition of deterioration, and delivery of family-centered care throughout the perioperative course. This narrative review synthesizes current evidence on the nursing care of surgical neonates, focusing on essential domains including monitoring and documentation, thermoregulation, respiratory and nutritional support, infection prevention, pain assessment, parental counseling, nurse-led education, and nursing leadership. The review also examines the influence of nurse-to-bed ratios on patient safety, particularly in low- and middle-income countries where workforce shortages remain common. Strengthening nursing capacity, leadership, and structured communication with families is essential to improving safety and outcomes for surgical neonates.