A groundbreaking nursing role in St. Vincent Medical Center’s Maternity Center has been gaining attention throughout the nursing community. Our facility sees over 6500 deliveries per year. Our reputation of providing excellent nursing care for our high risk mothers has lead to a natural increase high risk newborns. Although our level III neonatal intensive care unit (NICU) cares for the least stable of the newborns, we developed a new nursing role in order to care for those newborns that fell on the line between stable and unstable. These patients could be at the highest risk for falling through the cracks if they are not monitored more closely, but, they may not need the critical care of the NICU. We also believe that, when possible, newborns should remain with their families as we are a family-centered care facility that promotes bonding through rooming-in. Our facility decided to look at the newborn population we were seeing, and see if we could decrease the number of admissions to the NICU for less invasive situations. This would benefit the family and the facility, bringing with it cost-savings that are necessary in health care today. This discussion led to the development of the newborn triage (NBT) role in 2000. In this role, a nurse would provide an extra layer of care to our at-risk newborns 24 hours a day. In developing this role, we recognized that we would have to educate nurses to ensure the safety of the patients. The NBT nurses are nurses throughout the perinatal department, including postpartum, NICU, and L&D nurses, who have gone through didactic and orientation to the role. The NBT nurse is notified of any at-risk newborn, often prior to birth, and writes the newborns’ information on a constantly changing list. The NBT nurse does not have a specific assignment, but follows all at-risk newborn not admitted to NICU, communicating with the nurses caring for those patients, assisting with newborn care, and acting as a liaison between nurses and pediatricians, decreasing the number of unnecessary calls to pediatricians. The NBT nurse has also become an educator to both the families and the nurses. With the NBT role, we have absolved many barriers between pediatricians and staff nurses by increasing skill level, improving communication, and developing greater trust. We are able to work in collaboration as members of the same team. Since the development of this groundbreaking role, we have had pediatricians comment that they feel more comfortable with the care their patients are receiving. Nurse satisfaction level has increased since nurses know that there is someone available if they need assistance with one of their newborns but are unsure of whether the pediatrician needs to be notified. In allowing our at-risk newborns to room in with their families, we not only increased our family satisfaction, we have also allowed our NICU to focus on caring for the least stable of the newborns as their acuity levels continue to rise, with our high-risk patient population.