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Caring for the Tiniest Patients: Neonatal Nurse Career Overview

Neonatal nurse

Have you always seen yourself working with babies? Are you looking for a nursing specialty that allows you to make a difference in the lives of the tiniest and most vulnerable patients? Neonatal nursing may be the perfect career for you. 

The world of neonatal nursing offers nurses one of the most rewarding and challenging career trajectories. It requires unique skills, expertise, education, and training. Still, once you start practicing, nothing compares to the satisfaction of knowing the critical role you played in the lives of the babies and families you care for. 

In this guide, we’ll give you a complete overview of neonatal nursing, including the education and training required, the job description and work settings, the challenges and rewards of the job, as well as career opportunities and salary expectations. Whether you’re a nursing student exploring your options or a Registered Nurse looking to switch specialties, you’ll find all the valuable information about neonatal nursing you need.

Let’s get started.

What Is a Neonatal Nurse?

Neonatal nurses are Registered Nurses who specialize in caring for newborn infants, particularly those who are premature, critically ill, or have other medical conditions that require specialized care. These RNs work in neonatal intensive care units (NICUs), where they provide around-the-clock supervision to newborns needing medical attention.

Neonatal nursing is a vital field of healthcare. Premature birth rates have been increasing in recent years, with the CDC reporting that in 2021, preterm birth affected about 1 of every ten infants born in the United States. Babies born too early (especially before 32 weeks) have higher rates of death and disability. 

However, with medical advances, more babies are surviving birth and requiring specialized care to improve their chances of survival and long-term health outcomes. And Neonatal Nurses provide that specialized critical care that helps more and more infants survive and lead healthy lives.

They work closely with other healthcare professionals, such as neonatologists, pediatricians, and respiratory therapists, to ensure that each infant receives the best care.

What Does a Neonatal Nurse Do?

what does a neonatal nurse do?

Neonatal RNs have many duties and responsibilities that revolve around caring for critically ill or premature infants. Their role also encompasses providing support and education to parents and family members. Let’s take a look at more key duties that you can expect to find in a Neonatal Nurse’s job description:

  • Assess newborns’ physical, behavioral, and developmental progress to ensure babies are meeting age-appropriate milestones.
  • Administer medications, fluids, and nutrition as prescribed by physicians. When doing so, Neonatal RNs must pay the most attention to correct dosages and any adverse reactions.
  • Perform medical procedures such as inserting IVs, performing blood draws, and inserting feeding tubes to manage infants’ medical conditions.
  • Maintain accurate and detailed records of newborns’ medical history, treatment plans, and progress to ensure continuity of care.
  • Recognize and manage respiratory distress, cardiac arrest, or sepsis emergencies.
  • Provide emotional support to parents and families during stressful and challenging times.
  • Educate parents on how to care for their newborns, including feeding, bathing, and monitoring their health.
  • Collaborate with healthcare professionals. Neonatal nurses work closely with neonatologists, pediatricians, respiratory therapists, and other healthcare professionals to provide comprehensive care to newborns.
  • Participate in clinical research: Some Neonatal Nurses may choose to participate in clinical research studies to improve neonatal care and develop new treatments. 

While these are some of their key responsibilities, every day could bring something different as every little patient is unique and requires particular attention. 

How to Become a Neonatal (NICU) Nurse?

how to become a neonatal nurse

Becoming a Neonatal Nurse takes two to four years as the minimum educational requirement is RN licensure, and you can obtain an RN degree in either two years with an ADN or four with a BSN. If you want to advance your career, you can become a Neonatal Nurse Practitioner. 

But let’s not get ahead of ourselves. In this section, we’ll be taking a closer look at every step on your way to becoming a Neonatal Nurse. 

Step 1: Obtain a Degree in Nursing

Enrolling in an accredited nursing program is the first step to becoming a Neonatal Nurse. You could pursue different types of nursing programs, but the most popular are an Associate’s Degree in Nursing and Bachelor’s Degree in Nursing. 

The ADN program is typically a two-year degree program that provides prospective learners with a foundation in nursing. This program includes clinical rotations in various healthcare settings but may not include a specific rotation in neonatal nursing.

The BSN program is a four-year degree program that provides students with a significantly more comprehensive education in nursing. Ultimately, this is the most significant benefit of a BSN program over an ADN program: you’ll come out on the other side better prepared and with a more extensive set of skills and knowledge to tackle the challenges of a nursing career.

However, the advantages of enrolling in a BSN degree go even further than enhanced clinical skills. Many hospitals already require nurses to hold a BSN degree or at least strongly prefer it. Having a Bachelor’s can open up more job opportunities for RNs and significantly increases their earning potential. 

Find out more benefits of getting a BSN Degree in Nursing

The BSN program offered by Nightingale College is an exceptional choice for aspiring RNs seeking a quality nursing education. Our program is carefully designed to prepare you to become a highly skilled nurse who will have a tremendously positive impact on the health and well-being of your future patients. You can complete the program in as few as 32 months. Moreover, the BSN degree follows a blended format, with online didactic instruction and on-ground supervised field experience, making it a flexible and convenient option that takes your busy schedule into consideration. 

While ADN programs provide a solid foundation for nursing practice and may be a more cost-effective option for some students, earning a BSN degree can offer significant career opportunities, increased earning potential, and stronger clinical skills. If you started as an ADN nurse and want to advance your education later in your career, you can do so through a bridge RN-to-BSN program. 

Nightingale College’s RN-to-BSN program is top-of-the-line in this category. It’s a 100% online program which makes it extremely career friendly: you can pursue an advanced degree while maintaining an active professional life. Our curriculum is designed to challenge you to reach a higher level of critical thinking and problem-solving. Ultimately, it will make you a better nurse, and everyone - you, your patients, and the entire healthcare system - stand to benefit from that. 

Step 2: Obtain a Registered Nurse License

After completing a nursing program from an accredited institution, one more step before you are a full-fledged nurse: obtaining an RN license. The license is a legal requirement and is necessary for RNs to be able to perform their job duties.

Nursing graduates must pass the National Council Licensure Examination (NCLEX-RN) to gain their license. 

The NCLEX-RN exam consists of multiple-choice questions that cover a wide arrange or topics. It is a comprehensive examination that determines your preparedness to take on this critical role.

Once you pass the NCLEX-RN exam, you can apply for an RN license from the nursing board in the state where you want to practice. The application process may vary slightly by state, so make sure you meet all the requirements before applying for licensure. 

Once that is out of the way, you get your nursing license and bragging rights. You’ve worked hard through nursing school, so it’s time to celebrate your accomplishments. 

Step 3: Gain Nursing Experience

However, the real work is just starting. 

To work in a neonatal intensive care unit (NICU), RNs typically need at least two years of experience working in a hospital setting. Nurses can gain experience in critical care, pediatric nursing, or other related areas during this time. Getting hands-on experience is crucial for nurses because it allows them to develop the necessary skills and knowledge to provide specialized care to critically ill newborns in the NICU. 

By gaining experience in a hospital setting, RNs can become more confident in their abilities, interact with more professionals and build a stronger foundation for their practice. 

Step 4: Obtain Neonatal Nurse Certification

While not mandatory, getting certified as a nurse can be a great step forward for your career. 

Certification demonstrates a nurse’s expertise and specialized knowledge in their chosen field. It increases their credibility and enhances their professional reputation, leading to more job opportunities, career advancement, and higher salaries. It’s also a great way to develop your skills and knowledge through continuing education and training.

Neonatal Nurses interested in becoming certified can do so through the American Association of Critical Care Nurses (AACN). 

CCRN (Neonatal) certification is a specialty certification for nurses who provide care to newborn patients experiencing acute or critical illnesses. To qualify for it, you need to meet specific criteria: 

  • Hold an unencumbered RN or advanced practice registered nurse (APRN) license.
  • Have two years experience as an RN or an APRN, with 1,750 hours of direct acute or critical care for neonatal patients
  • Or five years experience as an RN or an APRN, with a minimum of 2,000 hours caring for acutely or critically ill neonates. 

Another certification option for Neonatal RNs is available through the National Certification Corporation (NCC). The NCC offers more certificates that could pique your interest, such as Neonatal Intensive Care Nursing, Inpatient Obstetric Nursing, Low Risk Neonatal Nursing, Neonatal Nurse Practitioner. Eligibility credentials include: 

  • Current licensure as an RN in the U.S. or Canada.
  • 24 months of specialty experience comprised of a minimum of 2000 hours 
  • Employment in the specialty sometime in the last 24 months.

Make sure to check more specific requirements for each certification before you apply, and always stay on top of the game through continuing education

Step 5: Pursue Advanced Education

Suppose you’re interested in leadership roles or want to enhance your skills and knowledge in neonatal nursing to the highest level. In that case, you can pursue advanced education, such as a Master’s or Doctor of Nursing Practice (DNP) degree. 

With an MSN degree under your belt, you could pursue a career as a Neonatal Nurse Practitioner. It’s an advanced practice nurse degree with a higher level of responsibility and more autonomy

Advanced education opens up opportunities for leadership roles, research, and teaching, so if you want to contribute to advancements in the field of neonatal nursing, this is the way to go.  

What Is the Salary of a Neonatal Nurse?

neonatal nurse salary

According to data from Payscale, as of April 2023, the average annual wage for Neonatal Nurses was $75,460. However, this salary can vary depending on several factors, such as location, years of experience, and level of education.

In urban areas or specialized hospitals, neonatal nurses may earn higher salaries than in general hospitals. Also, neonatal nurses who work in neonatal intensive care units (NICUs) or other specialized units may earn higher wages. Additionally, Neonatal RNs who have earned a Bachelor of Science in Nursing degree and obtained certification in neonatal nursing may earn higher salaries than those with less education and experience. 

Find more in our presentation of all neonatal nurse salaries by state, across the US.

Neonatal Nurse Practitioner Salary

Neonatal Nurse Practitioners (NNPs) are among the highest-paid nurses. According to data gathered from Payscale, on average, an NNP can earn around $114,674 a year. However, it’s essential to know that factors such as education and training requirements, job demand in your area, and potential salary might impact your earning potential. 

Where Do NICU Nurses Work? 

Neonatal nurses work in various settings, primarily in hospitals and healthcare facilities with neonatal intensive care units (NICUs). 

NICUs are typically organized into different levels based on the level of care needed by the newborns. Here’s a breakdown of the different levels of neonatal nursing: 

Level I

Level II

Level III

Level IV

Basic Care Nursery

Special Care Nursery

Neonatal Intensive Care Unit

Regional NICU

Provide care to healthy newborns who require routine monitoring and observation but do not require intensive medical intervention.

Provide care to newborns who are moderately ill or premature, but do not require the highest level of medical intervention.

May administer medications, provide oxygen therapy, and monitor the newborn's vital signs.

Provide care to critically ill or premature newborns who require the highest level of medical intervention.

May perform complex medical procedures, such as intubation, administer intravenous medications and nutrition, and monitor the newborn's vital signs around the clock.

Provide the highest level of medical care to newborns with the most complex medical conditions.

Neonatal nurses in a level IV NICU work with a team of specialized healthcare professionals, such as neonatologists and pediatric surgeons.

What Skills Are Most Important to Neonatal Nurses?

Neonatal nursing is a highly specialized field that requires a unique set of skills and knowledge. Some of the most critical skills for neonatal nurses include the following:

  • Attention to Detail: Neonatal nurses must be highly detail-oriented and able to accurately monitor and record vital signs, administer medications, and perform other medical procedures with precision.
  • Critical Thinking: Neonatal nurses must be able to assess newborns’ conditions quickly and accurately, which requires great clinical skills and lots of critical thinking. 
  • Communication: Efficient communication is the cornerstone of any nursing job. Given that they have to collaborate with other healthcare professionals and often interact with the baby’s family, Neonatal RNs must be able to provide clear information about the newborn’s condition, treatment options, and care plan.
  • Neonatal nurses must be compassionate and empathetic, providing emotional support to parents and families during difficult and stressful times.
  • Patience and Resilience: The field of neonatal nursing can be emotionally and physically demanding, requiring nurses to be patient, resilient, and able to handle high-stress situations.

Are You Ready to Become a Neonatal Nurse?

become a neonatal nurse

If you’re passionate about caring for newborns and want to make a meaningful difference in their lives, becoming a Neonatal Nurse could be the perfect career path for you. So, are you ready to become one and join the ranks of the most dedicated and compassionate healthcare professionals?

Enroll in Nightingale College’s BSN program today! The tiniest patients require the biggest heart - and that’s you!

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