How to Become a Neonatal (NICU) Nurse

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Written by Ayana Dunn, BSN, RN Content Writer, IntelyCare
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Reviewed by Morganne Skinner, BSN, RN Content Writer, IntelyCare
NICU nurse caring for newborn

Are you drawn to pediatrics or critical care? Do you love infants? Are you interested in helping people through their first days of parenthood? If so, becoming a neonatal nurse and working in the neonatal intensive care unit (NICU) could be a great fit for you. (“Neonate” is Latin for “infant.”) Let’s take a look at how to become a NICU nurse, the workplace environments, duties for this job, salary outlook, and NICU nurse schooling.

What Is a Neonatal Nurse?

A neonatal nurse is a nurse who specializes in the care of newborns. They care for infants across the acuity spectrum of healthy and low-risk to critically ill and high-risk in the NICU.

What Is a NICU Nurse?

Some newborns spend days or months in the NICU if they’re born with an infection, low birthweight, or other complications. A NICU nurse specializes in the care of these newborns that have varying levels of acuity.

Neonatal Nurse vs. NICU Nurse

There’s a difference between a neonatal nurse and a NICU nurse. All NICU nurses are neonatal nurses, but not all neonatal nurses are NICU nurses. Both work with newborns, but NICU nurses specialize in babies needing acute medical attention requiring an intensive care unit.

For example, a neonatal nurse can be found in labor and delivery units attending to healthy babies, or babies with complications that are not deemed life threatening. NICU nurses always work with critically ill and often premature babies who need extra support while they develop enough to survive without medical intervention.

Where Do Neonatal Nurses Work?

These nurses primarily work in hospitals and children’s hospitals. Neonatal nurse work environments are divided into four levels of care based on rising acuity. Each subsequent level has the capabilities of the previous levels. Labor and delivery nurses work within the first level, while NICU nurses work in the second level and beyond.

  • Level 1: Care of newborns born full-term with no health complications
  • Level 2: Care of newborns born at or after 32 weeks’ gestation recovering from health complications requiring medication, feeding support, or ventilators
  • Level 3: Care of newborns before 32 weeks’ gestation, and babies with severe health complications requiring ventilation regardless of their gestational age
  • Level 4: Care of newborns born at or before 24 weeks’ gestation in need of major surgery due to a genetic or acquired condition

What Do Neonatal Nurses Do?

When learning how to become a NICU nurse, you’ll find that nurses who work with infants perform many of the same tasks as nurses who work with adults. Assessment, monitoring, providing hands-on care, collaborating with other healthcare team members, creating care plans, and providing education are all part of NICU nurse duties.

In neonatal nursing, the nurse works closely with the patient’s family, such as the parents or primary caregivers. They also include the parents closely in their care plans. Neonatal nurses promote closeness between the infant and the parents, assist parents in coping with separation, and support the parents’ caregiving.

These are some common neonatal nurse responsibilities in the NICU:

  • Obtaining patient’s weights and measurements
  • Monitoring newborn’s vital signs
  • Administering IV fluids and medications
  • Providing newborn care education and emotional support to parents
  • Performing a newborn physical assessment
  • Screening for genetic, hormonal, metabolic, and other disorders
  • Changing and administering feeding tubes
  • Monitoring for changes in health status
  • Performing intubations

For more insight into the duties of this role, check out our sample neonatal nurse resume and sample NICU nurse resume.

How to Become a NICU Nurse: 7 Steps

Understanding the NICU nurse education requirements is essential for those aspiring to work as a neonatal nurse. It involves several key steps:

1. Complete Your Nursing Education

One of the first steps on the path of how to become a NICU nurse is earning a nursing degree. You can pursue an associate’s degree in nursing (ADN) or bachelor’s of science in nursing (BSN) nursing program. Because the latter is a more involved degree, a BSN may provide you with more career development opportunities.

2. Pass the NCLEX

Pass the National Council Licensure Examination (NCLEX). It’s a variable-length computerized adaptive test that screens your readiness to work as a nurse. If you fail to pass the NCLEX on the first try, explore our comprehensive guide on retaking it.

3. Obtain Nursing Licensure

Complete all the state-specific requirements and then submit your RN license application to your state board of nursing. Remember, different states have different requirements. Your application will be reviewed, and if everything is in order, your license will be issued.

4. Gain Clinical Experience

Work as a registered nurse to build essential clinical skills and experience. Many nurses begin their careers in medical-surgical units, offering them the chance to acquire new skills and care for patients with a wide array of conditions. In addition to labor and delivery, other relevant specialties that can help you prepare to work as a neonatal nurse include:

5. Pursue Neonatal Nurse Certification or NICU Nurse Certification

Your journey to becoming a neonatal nurse working in the NICU may involve obtaining certification. The National Certification Corporation (NCC) offers several different certifications for registered nurses:

No matter what specific certifications for NICU nurses you may choose to focus on, it’s recommended that all neonatal nurses obtain certification in:

6. Keep Advancing With Continuing Education

Stay updated on advancements in NICU nursing by attending conferences, taking continuing education courses, and joining professional organizations, such as the National Association of Neonatal Nurses (NANN) and the Association of Women, Health Obstetric and Neonatal Nurses (AWHONN). Continuous learning ensures you stay knowledgeable in this evolving field.

7. Pursue Additional Education

You can choose to pursue advanced education by obtaining a master’s of science in nursing (MSN) or a doctor of nursing practice (DNP) degree and becoming a nurse practitioner.

How Long Does It Take to Become a Neonatal Nurse?

Neonatal nursing is an entry-level nursing career, so it takes the same amount of time to become a neonatal nurse as it does to become a RN. On average, you’re looking at two to four years.

The time frame will vary depending on your degree choice and how long it takes for you to become a RN. Additionally, if you choose to begin your nursing career in another specialty before making the switch to neonatal nursing, it may take you longer.

Note that some hospitals offer NICU programs to new grads, while others require at least a year of experience.

NICU Nursing Skills to Develop

Obviously, you will need to obtain clinical knowledge of newborns’ anatomy, vital signs, and reflexes, which are all unique to their age group. What’s normal for newborns isn’t the case for other developmental stages, as your NICU nurse schooling will teach you.

You’ll also need to develop soft skills. Although there is overlap between the nursing skills needed in other specialties, such as critical thinking, tailoring your skill set to this unique specialty is an important part of how to become a NICU nurse.

Empathy and Compassion

Imagine how the parents are feeling. Having a newborn admitted to a NICU is an incredibly stressful experience on top of the emotional vulnerability that accompanies new parenthood. Neonatal nurses are important sources of empathy, knowledge, and support throughout this time.

Desire to Nurture

Unlike older patients, babies need interaction and to be held to foster healthy emotional development. This is a specialty where you must genuinely want to spend time with your patients.

Excellent Communication

You’ll rely on strong, effective communication skills to explain to frazzled parents complex medical procedures and the reasons why they’re necessary. You must also employ nonverbal communication to sooth patients and facilitate healthy emotional development.

Ability to Remain Calm and Focused

This trait is necessary to be able to work with parents, as well as with babies. Infants can sense the emotions of people around them.

How Much Does a NICU Nurse Make?

The average NICU nurse salary is approximately $84,308 per year. NICU nurse pay can vary significantly based on geographic location, facility in which you work, and your years of experience. In comparison, the average neonatal nurse salary is around $75,000 per year.

For those with geographic flexibility, it’s worth considering nursing positions in states known for offering some of the most competitive RN salaries, such as:

Ready to Pursue Neonatal Nursing?

Now that you know how to become a NICU nurse, it’s time to start applying. Discover how IntelyCare can help match you with the best-fitting nursing jobs.