How to Become a Neonatal NurseEdited by Nancy Lynn Swezey, BSN, RN, CNOR
Neonatal nursing is a great career path for medical professionals who want to make a difference in the lives of entire families. Neonatal nurses care for newborn infants. A neonatal nurse might address complications of prematurity, acute infection, congenital defects, and surgery. Because neonatal nurses work primarily with some of the most vulnerable patients, they’re required to attain strict credentials.
The first step to becoming a neonatal nurse is to acquire the appropriate level of education. In order to qualify as a registered nurse (RN), candidates will have to complete an associate degree, bachelor’s degree, or higher. These degrees must be earned from an accredited nursing program. Many employers now require RNs to have a minimum of a Bachelor of Science in Nursing (BSN) to be hired. After passing the licensing exam for RNs, the National Council Licensure Examination (NCLEX), candidates can apply to work in a Neonatal Intensive Care Unit (NICU), thereby entering the field of neonatal nursing. For a more advanced scope of practice, a nurse can become a neonatal nurse practitioner (NNP). This requires a master’s degree or doctoral degree, additional clinical training, and board certification.
What Is a Neonatal Nurse?
A neonatal nurse is a registered nurse who specializes in working with newborn patients. This type of work usually takes place in a Neonatal Intensive Care Unit, where premature or sick babies are given intensive medical care. Neonatal nurses care for premature babies who have not reached full development within the womb, babies of addicted mothers who are withdrawing from opiates and other narcotics, neonates with infections, sepsis, respiratory diseases, or congenital defects. Aspiring neonatal nurses may want to seek out a nursing school that offers clinical practicum placements within a nursery or NICU. This allows the nurse to train in the specialty as a student.
Neonatal nurse practitioners are essentially neonatal nurses with a broader scope of practice and greater responsibility. They are referred to as advanced-practice nurses, and many of their responsibilities overlap with those of physicians. A neonatal nurse practitioner works with doctors and other nurses to provide direct care to the infants in a NICU, writing orders, creating treatment plans and overseeing outcomes, performing small procedures, and managing medication regimes.
What Does a Neonatal Nurse Do?
Neonatal nurses care for premature and often fragile neonates. While the word “neonatal” itself refers to the first few weeks of a baby’s life, neonatal nurses often care for babies long after they have surpassed that time frame, if such extended care is warranted. This time period depends on the severity of an infant’s condition and on his or her response to treatment. Longer NICU stays may be due to very and extreme premature birth (less than 32 and 28 weeks of gestation, respectively), sepsis, profound birth defects, and cardiac issues. Neonates requiring care are admitted to the NICU immediately after birth. In most facilities, neonates who return to the hospital after discharge from birth will go to a pediatric unit if care is required.
A typical neonatal nurse’s day might be spent administering medication,feeding neonates, and educating new mothers. As with any nursing career, the neonatal nurse experiences emergencies and must perform life-saving measures. Before working in this field, it is important for any aspiring neonatal nurse to considering the precarious condition of this patient population.
Where Can a Neonatal Nurse Work?
Working as a neonatal nurse can involve practicing in a variety of different settings. One of the most common workplaces is a NICU, which is a separate ward within a hospital. The neonatal population is often categorized by levels of acuity and care needs within the NICU, as some neonatal patients have much greater need for treatment and oversight than others. Roles in these facilities represent some of the most sought-after positions in the field. Neonatal nurses working in a NICU may fill the role of staff nurse, nurse manager, or clinical specialist, depending on their education, experience, and interests.
However, not all neonatal nurses work in hospitals. Some neonates may require nursing care that doesn’t warrant a hospital stay. Neonatal nurses can work with these patients within the home and community. The ongoing advice and guidance of a medical professional are indispensable to families who find themselves in this situation. Neonatal nurses can serve as experts for at-home care to follow up with any treatment plans for NICU babies after discharge. In other situations, new parents may seek out neonatal nursing care to guide them through the process of early parenthood, even with healthy neonates.
Neonatal nurses are responsible for providing care and treatment for vulnerable babies, usually in a hospital setting. Prospective neonatal nurses should consider that a NICU can be a stressful work environment.
According to a 2013 study in JAMA Pediatrics journal, nearly one-third of infants in NICUs are understaffed. For this reason, many NICU’s offer overtime to nurses and require higher patient to nurse ratios. This may be especially true for the neonatal nurse practitioner, who has greater responsibility and oversight of NICU patients. For many NICU nurses, an affinity for this unique patient population mitigates much of the work-related stress.
For neonatal nurses working in the community or in patients' homes, a different set of skills may be necessary. Home and community neonatal nurses provide direct care, but their work may involve more patient parent education than the NICU nurse's work. Positive rapport, patience, and interpersonal communication skills will be indispensable for neonatal nurses in a non-hospital setting.
Career Outlook and Demand
Neonatal nurses are usually in high demand due to understaffing in NICUs. Contributing factors to the demand for neonatal nurses are advances in life-saving medical technology for neonates and the increased use of fertility treatments, which may contribute to neonatal health complications. In addition, registered nurse employment is expected to grow 15% between 2016 and 2026, according to the Bureau of Labor Statistics.
Neonatal nurse jobs can also lead to further career opportunities. Experienced neonatal nurses can apply for positions as developmental care specialists, clinical care specialists, nurse managers, or neonatal nurse practitioners. With these opportunities in mind, prospective nurses can approach their careers with a mindset of continuous growth and expansion.
It’s also important to consider the level of compensation one can expect in the neonatal nursing field. According to PayScale, the median neonatal registered nurse pay in the United States is $30.30 per hour or $61,352 per year for salaried employees. Neonatal nurse practitioners can expect a higher level of pay commensurate with their higher education. The median neonatal nurse practitioner wage is $53.10 per hour or $98,559 for salaried workers. These are country-wide medians, though income for nurses is greatly dependent on state, institution and community. For example, nurses in urban areas tend to have a higher salary than rural nurses.
Neonatal nursing requires a minimum of an associate degree in nursing (ADN). Obtaining a bachelor’s degree in nursing may give prospective nurses more employment opportunities and increased income.
A graduate program is required to achieve a higher level of responsibility as a neonatal nurse practitioner. In addition to a master’s or doctoral degree, candidates benefit from obtaining neonatal certification from the Neonatal Intensive Care Nursing Certification Corporation. This certification requires applicants to have a current RN license and at least 24 months of experience in the field.
Applying to Nursing School
There are many considerations for prospective neonatal nurses to explore when choosing a nursing school.
A valid nursing program is accredited by the Accreditation Commission for Education in Nursing (ACEN) or by the Commission on Collegiate Nursing Education (CCNE). Nursing programs prepare graduates to work as registered nurses. Applicants should also look for a school that will provide them with guidance to help them pass the National Council Licensure Examination (NCLEX), which is necessary for licensure.
Upon qualifying as a registered nurse, neonatal nursing applicants can seek out positions in the NICU. This will allow them to gain the necessary training to have a career in neonatal nursing.
Neonatal nurses can benefit from continuing education. Neonatal nurses have the option of pursuing master's or doctoral level clinical education to expand their scope of practice as neonatal nurse practitioners (NNPs). In addition to the option of graduate education, there are abundant resources for pursuing continuing education as an RN. States and employers require contact hours and clinical education credits in order for nurses to stay current in the ever-evolving health sciences. These education requirements can teach nurses about the latest developments in their field and ensure that they are eligible for renewed licensure in the future.
In order to become a neonatal nurse, a candidate must meet the minimum educational requirements for all nurses. At a minimum, this entails earning an associate degree in nursing, although the standards of practice for nursing increasingly favor a BSN. Graduates require licensure to work as a registered nurse, after which they can begin applying for careers in neonatal nursing. Licensure involves passing the NCLEX and registering with the state in which the nurse practices.
After gaining experience, neonatal RNs can apply for certification as a Critical Care Registered Nurse in neonatal care (CCRN [neonatal]).Many neonatal nurses opt to enroll in a graduate nursing program in order to work at a higher level of responsibility. Graduate level clinical nursing programs require both didactic and clinical experience in the candidate’s respective specialty. Upon graduating with a master’s or doctoral degree, candidates must obtain licensure to work as neonatal nurse practitioners (NNPs).
Frequently Asked Questions
How Long Does It Take to Become a Neonatal Nurse?
There are three main steps to becoming a neonatal nurse. First, an individual must graduate from nursing school with at least an associate degree. Of course, a higher level of education may be rewarded with a higher salary or more promotional opportunities. The second step involves passing an exam known as the National Council Licensure Examination, or NCLEX-RN. This is the official examination that will grant an individual the licensure necessary to work as a registered nurse.
How Do I Specialize in Neonatal Nursing?
All registered professional nurses undergo general nursing education, the dictates of which are determined by accrediting authorities for all nursing curriculum. Although there are required foundational clinical practicum with all patient populations, many nursing schools allow students to request specialization for a portion of their training. If the nursing student establishes a good rapport with an employer during clinical training, this may foster options for employment upon graduation. Work experience is the main source of specialization in neonatal care, often with the aid of continuing education credits. However, some colleges and universities offer nursing programs with an emphasis on neonatal care. Where available, these programs are the best way for candidates to prepare for a career in the field.