If nursing is your passion and you love working with babies, becoming a neonatal nurse may be an ideal career choice. Caring for premature babies and critically ill infants, a neonatal nurse works in a hospital in a neonatal intensive care unit, also known as a NICU. A high level of experience and special certifications are required for this fast-paced position.

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It takes four years to become a neonatal nurse plus practical experience in a residency.

What Is a Neonatal Nurse?

Although "neonatal" is another word for newborn, a neonatal nurse manages the care of babies until they are released from the hospital. The education and experience required to become one of the nurses who works with babies depends on the NICU level. A level II NICU is equipped to care for babies who need short-term care and don’t require long-term life support. Babies with more serious medical issues or who need artificial ventilation are cared for in a level III NICU, and a level IV NICU is reserved for babies with the most serious of conditions.

Consider the Degree Options

The academic journey of a neonatal nurse begins with earning a degree as a registered nurse. Given the competitive nature of the field, a Bachelor of Science in Nursing, or BSN, is recommended for this position. This degree program combines academic classes with clinical skill sessions and clinical observation.

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Look at the Curriculum

You can expect to spend four years working on your BSN. You’ll take classes like biology, anatomy and physiology, pharmacology and fundamentals of nursing. Practical education will teach you skills about providing oxygen therapy, starting an IV, giving injections, taking vital signs and chest tube care. Clinical rotations will expose you to various nursing specialties like intensive care, obstetrics, general medicine, surgery and pediatrics.

Practical Experience Is Critical

It can be difficult to break into neonatal nursing. Gaining practical experience in pediatric nursing in advance of graduating from nursing school can give you a head start. Some clinics or hospitals offer externships for nursing students to help them develop an interest in specialized or advanced-care nursing. Seeking an externship, shadowing a neonatal nurse or volunteering in a pediatric clinic will help you network with other professionals and gain valuable insight.

Finishing Your Registered Nurse Degree

You will be licensed as a registered nurse after successful completion of the National Council Licensure Examination for registered nurses. Expect to spend one to two months studying for the exam. If you don’t pass the NCLEX the first time, you can retake it in 45 days.

Pursue a Neonatal Nurse Residency

Hospitals with a Level III NICU or above often offer residencies for nursing graduates who are interested in working in neonatology. If you want to become a neonatal nurse, apply for a nursing residency at a medical facility that provides neonatal classes in this specialty. You will have to have a BSN to be eligible for a neonatal nursing residency.

Become Experienced as a Nurse

You’ll need to work in the field prior to seeking certification as a neonatal nurse. You may be able to secure a position in a clinical or hospital setting to provide relevant experience. Once you have substantial work experience in nursing, you can pursue advanced certification.

Attain Certification as a Neonatal Nurse

There are a variety of certifications available to nurses who are interested in working in neonatal nursing.

The American Association of Critical Care Nursing offers a specialization in neonatal care. To become eligible to take this exam, you’ll need 1,750 hours of neonatal nursing experience within the past two years. You may also take the exam if you have been an RN for five years with a minimum of 2,000 hours of experience in neonatal nursing.

You can become a registered nurse certified in neonatal intensive care by taking a test offered by the National Certification Corporation. Eligibility for this exam includes proof of 2,000 hours as a registered nurse along with specialty experience in neonatal nursing.

Look at Additional Specialty Certifications

Other preparation and certification that’s recommended for a neonatal nurse includes basic life support, neonatal resuscitation and advanced cardiovascular life support. You may be able to take these certification classes at your local hospital or online.

Continuing Education Is a Must

In order to maintain your certification as a neonatal nurse, you’ll need to complete relevant continuing education. Each certification specialty has varying requirements. You can expect to spend between 10 and 100 hours every three years to maintain your certification.

What Does a Neonatal Nurse Do?

A neonatal nurse treats premature and critically ill newborn babies in a specialized intensive care unit. Feeding, monitoring vital signs and operating medical equipment like a ventilator are common duties of this position. Some neonatal nurses transport patients, work on surgical teams or focus on cardiac care. In addition to taking care of their patients, a neonatal nurse provides support and education for families and caregivers.

Advantages of Being a Neonatal Nurse

Neonatal nurses develop close relationships with patients and their families. When a critically ill baby becomes well enough to go home with his parents, the job satisfaction for a neonatal nurse is high. Nursing jobs provide scheduling flexibility, and experienced nurses can find a job with ease.

Challenges of Being a Neonatal Nurse

Burnout is common for neonatal nurses. Shifts may be as long as 12 hours, and the work can be mentally and physically exhausting. The constant sound of patient alarms can be overwhelming. Your tiny patients are struggling to survive and sometimes, the outcome is far from positive. In addition to caring for patients, a neonatal nurse is connected to their families. When a patient dies, the heartbreak can be difficult to manage.

What Do Nurses Get Paid?

In 2017, the Bureau of Labor Statistics reported that the average salary of a registered nurse was $73,550. Government and hospital settings paid slightly more. A neonatal nurse with specialized certifications and experience can expect to earn substantially more. States reporting the highest wages include California, New York, Texas, Florida and Pennsylvania.

Set Your Sights on Career Advancement

Once you’re an experienced neonatal nurse, you may want to pursue other related job opportunities. Positions include a neonatal transporter, neonatal critical care clinical nurse specialist or a neonatal nurse practitioner. In addition to professional challenge, you can increase your earning potential with these positions.

Neonatal Nurse Practitioner

A neonatal nurse practitioner provides advanced care for premature babies and infants who are sick or are in need of special care. Often present at high-risk births, a neonatal nurse practitioner serves as the leader of other neonatal nurses. This position requires a Master of Science in Nursing and certification as a neonatal nurse practitioner.

Neonatal Clinical Nurse Specialist

If you’re interested in developing new advances in neonatal care and serving as a leader in the NICU, you may want to consider becoming a neonatal clinical nurse specialist. A Master of Science in Nursing degree and board certification in advanced neonatal nursing care is required for this position.

Neonatal Transporter

Since Level IV NICU facilities are scarce, the need to transport critically ill infants is common. A neonatal transporter is specially certified to provide intensive care for neonates during helicopter or ambulance transport. Previous experience as a neonatal nurse and certification by the National Certification Corporation is required for this position.

Job Security is Certain

Becoming a registered nurse will assure you plentiful job opportunities. A 15 percent growth in available nursing positions is expected between now and 2026. An experienced neonatal nurse with a BSN and specialized certifications is in even higher demand.

About the Author

Dr. Kelly Meier earned her doctorate from Minnesota State Mankato in Educational Leadership. She is the author and co-author of 12 books and serves as a consultant in K-12 and higher education. Dr. Meier is is a regular contributor for The Equity Network and has worked in education for more than 30 years.