In this episode of Voices from the Nursing Frontline, host Dr. Lisa Beasley is joined by Dr. Tosha Harris, a neonatal nurse practitioner and assistant professor in the College of Nursing at the University of Tennessee Health Science Center. Dr. Harris offers an inside look at the realities of neonatal intensive care, emphasizing that the NICU is not a nursery, but a high-acuity environment where precision, vigilance, and teamwork are essential. She describes the immense responsibility of caring for patients who may weigh as little as one to two pounds and explains how NICU clinicians develop a “micro-assessment” mindset—detecting subtle changes that can prevent life-threatening crises. The conversation explores the balance between speed and accuracy, the technical skills neonatal nurse practitioners must master without hesitation, and the critical role of communication across interdisciplinary teams and with families. Dr. Harris also highlights trauma-informed, family-centered advocacy, stressing the importance of presence, empathy, and intentional communication during one of the most overwhelming experiences a family can face. As a national leader in neonatal nursing, Dr. Harris addresses workforce challenges, scope-of-practice concerns, and the growing demand for neonatal advanced practice nurses. She underscores the need to protect and strengthen the neonatal nursing pipeline while preparing the next generation not only to practice, but to lead. This episode is a powerful reminder of the skill, compassion, and advocacy that define neonatal nursing—and why these clinicians are indispensable to babies, families, and the future of healthcare.