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How to Become a Neonatal Intensive Care Nurse

An in-depth look at the duties, responsibilities, schooling, requirements, certifications, job outlook, and salary expectations for today’s NICU Nurses

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Neonatal ICU Nurses care for some of the most fragile patients within our healthcare system—critically ill or endangered newborns.

They work with premature infants, all the way up to two-year-old children. To be good at what they do NICU Nurses must possess strong communication skills, patience, compassion, and emotional fortitude.

The role of the Neonatal ICU Nurse is not an easy one, and it’s not for everyone. These nursing professionals must endure both extreme highs and lows on a daily basis. It’s a highly specialized medical field that requires strength, compassion, and a specific set of skills that prepare you for the demands of the ICU. With that said, many NICU Nurses love their jobs. It’s a rewarding profession that can offer endless opportunities for professional growth and gratification.

NICU Nurses are also amongst the highest paid nurses in the country.

(Click here to see our full list of the highest paying nursing jobs in the US).

Continue reading our Neonatal Nursing career guide if you’re interested in specializing in this field. We will cover how to become a Neonatal Intensive Care Nurse as well as the specific duties, responsibilities, and salary* expectations for this important profession.

NICU Nursing Defined

What Is a Neonatal Intensive Care Nurse?

Neonatal Intensive Care Nurses care for children during the most vulnerable phase of their lives, with a special focus on ill or premature infants. They monitor the infant’s conditions, check for signs of distress, and administer medication, along with other forms of basic care, like changing diapers and feeding.

Additionally, they act as a support system for parents and families of critically ill children, premature babies , and newborns, which can be extremely demanding from an emotional standpoint. They deal with a variety of problems including prematurity, birth defects, infection, cardiac malformation, and surgical problems.

Labor and Delivery Nurses, Neonatal Nurses, and Pediatric Nurses also work with babies and small children, at times very ill ones, but the work of the NICU Nurse stands apart for obvious reasons. The “intensive care” component of to the job title denotes the high-risk nature of their patient group, as well as the pressure involved in caring for them.

Neonatal ICU Nurse: Job Description

What Does a Neonatal Intensive Care Nurse Do?

For a Neonatal Intensive Care Nurse, no two days are ever the same. From treating full-term infants with brain injuries, to neonatal infants suffering from maternal drug use, these nurses see it all. In this highly specialized field, every function of their job can make a world of difference. For example, performing a blood transfusion for a newborn can save their life and, for a parent, a kind gesture or even a smile can have an immeasurable affect.

Because of the vital and delicate nature of their work, NICU Nurses must wear multiple hats. Their duties run the gamut from the smallest of tasks to the most critical, from changing diapers to resuscitation, along with everything in-between. Consulting and coordinating with team members, providing nutritional assessment and IV therapy, monitoring and adjusting equipment and vital signs, preparing records, and even discharge planning are all among their day-to-day responsibilities.

NICU Nursing: Job Responsibilities

Neonatal nurse treating a newborn

Some of the typical day-to-day responsibilities of a Neonatal Intensive Care nurse can include any of the following tasks:

  • Caring for infants transitioning to extra uterine life
  • Providing age and culturally appropriate care to patient
  • Consulting and coordinating with health care team members to assess, plan, implement, and evaluate patient care plans
  • Providing nutritional assessment and specialized feedings
  • Changing dressings, inserting catheters, starting IVs
  • Providing arterial and intravenous therapy
  • Monitoring and adjusting specialized equipment used on patients, such as incubators and ventilators
  • Preparing and administering records and prescribed medications
  • Monitoring vital signs and initiating corrective action whenever the patient displays adverse symptomatology
  • Assisting treating physician during examination, treatment, and procedures, which can include life-saving situations
  • Instructing and educating patient’s family
  • Recording all care information concisely, accurately, and completely, in a timely manner, in the appropriate format and on the appropriate forms
  • Performing other position-related duties as assigned, depending on assignment setting

NICU Nursing Jobs

Where Do Neonatal Intensive Care Nurses Work?

Neonatal Intensive Care Nurses work around the clock and every day in hospital NICU environments. It’s a somewhat physically demanding job that requires walking, bending, stretching, and standing for long periods. They often face hazards from exposure to chemicals and infectious diseases and must frequently utilize their fine motor skills and visual acuity.

Neonatal ICU Nursing School & Certification

What Training Is Required to Become a Neonatal Intensive Care Nurse?

In addition to their responsibilities as Registered Nurses (RNs), Neonatal Intensive Care Nurses require a specific set of skills to care for the most fragile lives – preterm and newborn babies.

Because of the depth and breadth of their job requirements, the path to becoming a Neonatal ICU Nurse requires intensive education and work experience. To become licensed Registered Nurses, prospects must complete an associates degree or bachelor’s degree and pass the NCLEX-RN examination. This is followed by a period of supervised clinical experience. Some NICUs also require prior experience in infant care, such as pediatrics, or nursing experience in a level III NICU. Then, to become an Advanced Practice Registered Nurse (APRN), you must earn wither your nursing master’s or doctoral degree.

Here is a closer look at the necessary steps to becoming a Neonatal Intensive Care Nurse:

1. Earn Your BSN Degree

It all starts with earning an accredited nursing degree. Your BSN degree combines the fundamentals of nursing theory with actual hands-on clinical practice to develop knowledge of different medical procedures.

2. Pass the NCLEX-RN Certification Examination

Upon earning your bachelor’s degree and passing the National Council Licensure Examination (NCLEX) to gain your RN license.

(Click here to read our NCLEX-RN Exam Review & Study Guide).

3. Earn Your MSN Degree

After passing the National Council Licensure Examination (NCLEX) and attaining your RN license, you must then pursue your Master of Science in Nursing (MSN) degree, with a specialty in pediatric care (preferred).

4. NICU Nursing Certification

After working in a neonatal unit and receiving a graduate degree, many aspiring NICU nurses will pursue further licensing to validate their knowledge and solidify their standing. Certification can be obtained for Neonatal Intensive Care Nursing through the National Certification Corporation.

NICU Nursing School

Students looking at computers

The four important competency areas for NICU Nursing includes general assessment, physiology and pathophysiology, pharmacology and professional practice.

Organizations, like the National Association of Neonatal Nurses, assist members in obtaining continuing nursing education (CNE) credits and maintaining their certification. The Association of Critical Care Nurses (AACN) also offers a national certification for nurses interested in being certified in NICUs, cardiac care units, ICUs, trauma units or critical care transport.

The specialized nature of Neonatal ICU nursing requires a specialized set of skills, and rather than medical surgical nursing, hiring managers may prefer to see experience in certain areas such as:

  • Pediatric Nursing
  • Pediatric Intensive Care Nursing
  • Maternal-Child Nursing
  • Well Baby Nursing
  • Labor and Delivery Nursing

Furthermore, candidates should strongly consider obtaining specialty certifications, including:

  • Neonatal Resuscitation Program(NRP)
  • Pediatric Advanced Life Support (PALS)
  • S.T.A.B.L.E. Program

Neonatal Intensive Care Nursing Salaries

How Much Do NICU Nurses Make?

According to ZipRecruiter, the average salary* for NICU nurses is about $102,000 per year (or $49.00 per hour).

NICU Nurses in the highest pay brackets can earn up to $142,000 per year.

The highest paying states for Neonatal Intensive Care Nurses include New York, Massachusetts, Washington, New Hampshire, and Hawaii.

Job Outlook for Neonatal Intensive Care Nurses

Although the U.S. Bureau of Labor Statistics does not report the specific job outlook projections for NICU Nurses, they do report that overall employment for nurse practitioners is projected to increase by 45% from 2019 to 2029, which is much faster than the average for all occupations (4%).

Much of this growth will result from an increase in the incidents of prematurity, along with advances in technology.

Neonatal Intensive Care Nursing Career

Are you ready to start your career as a NICU Nurse?

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If you’re the type of individual who can juggle a wide range of responsibilities and is as comfortable working with the smallest of infants as you are with working with their families, the role of a Neonatal Intensive Care Nurse cold suit you well.

If this sounds like you, rise up to the challenge and begin your career journey by earning your BSN degree at Eagle Gate College.