What Is a Neonatal Nurse?

Nurse Types / Neonatal Nurse

According to the National Association of Neonatal Nurses, approximately 40,000 low birth weight infants are born annually in the United States. Due to the advances in medicine, along with physicians and nurses who care for vulnerable babies, survival rates are 10 times better than they were 15 years ago. 

Though there has been significant progress, there are still a lot of infants born who need special care and attention within the Neonatal Intensive Care Unit (NICU). Enter the neonatal nurse!

In this post, we will explore the following: 

• What is neonatal nursing?
• What does a neonatal nurse do?
• What is it like to work as a neonatal nurse?
• What is the difference between a neonatal and NICU nurse?
• What are the career opportunities for a neonatal nurse?
• How do you become a neonatal nurse?
• How do you change your specialty to become a neonatal nurse?
• How much does a neonatal nurse make?

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What is neonatal nursing?

The neonatal period is the first month of an infant’s life. Neonatal nursing is a specialty within nursing that cares for newborn infants with issues such as prematurity, low birthweight, congenital disabilities, cardiac problems, infection and sepsis. In general, neonatal nursing refers to care for patients experiencing issues right after birth. 

It also involves helping infants who experience long-term problems specific to prematurity or illness after birth. Sometimes, neonatal nurses can care for infants until they are two years old. 

What does a neonatal nurse do?

Neonatal nurses provide essential and often life-saving care for infants. Some of their job duties include: 

• Providing round the clock care for infants immediately after birth
• Checking the health of infants suffering from birth complications
• Performing tests and evaluating results 
• Educating new parents on caring for their infant
• Operating and maintaining the equipment in the NICU
• Discussing with parents or guardians various procedures 

What is it like to work as a neonatal nurse?

Though many nursing specialties overlap, there are some specific ways that neonatal nursing differs from other types of specialties. The primary way that neonatal nursing differs involves the relative level of stress they work under. 

Their patients are often in critical condition and need constant attention, similar to an ICU nurse. The nurse-to-patient ratios are generally lower. In other words, you work with fewer patients than other nurses do. 

Another factor that’s different is the size of the patient. Since you’re dealing with patients that are often significantly undersized, you have to be meticulous with how you administer medication. Many NICUs require two RNs to verify medications, even for something benign like multivitamins.

Sandy Chiem, RN, a neonatal nurse, said, “It is incredibly easy to accidentally give a premature infant an adult dose of a medication because it literally comes down to a few zeros sometimes.”

One of the primary goals of neonatal nurses is to see the patients reach weight goals. You are there to help them gain the necessary weight for them to go home and enjoy the care and comfort of their loved ones. 

But weight is “only one small piece of the puzzle,” according to Chiem.

Other benchmarks neonatal nurses use include adequate weight gain, being off respiratory support, adequate thermoregulation outside of the isolette, 5-7 days apneic/bradycardic event free, and ability to bottle or breastfeed without the assistance of a nasogastric feeding tube.

Neonatal nurses need to have emotional composure. You will see many infants who never make it past your care. It’s essential to have a toolkit of self-help routines and coping mechanisms to weather those storms.

You’ll also work with the same baby for the entirety of their stay. This promotes continuity of care and better outcomes.

Most importantly, the NICU is also family centered.

“You are supporting families through some of the hardest days of their lives,” Chiem said. “Not only do we support the baby but a huge part of what we do is work with parents, whether that be providing emotional support or education.”

How do you become a neonatal nurse?

Step 1: Obtain a nursing degree

The first step to becoming a neonatal nurse is to meet the educational requirements. You must complete either an ADN or BSN. You can finish an associate program in two years at a community college. A bachelor’s degree requires two years of general education and two years of upper-division nursing units. 

Step 2: Get licensed

After you receive your degree, the next step is to get licensed. As a nursing graduate, you must take the NCLEX-RN exam administered by the National Council of State Boards of Nursing. Individuals who pass this exam are set to become registered nurses through their state of residence. 

Step 3: Training and certification

Once you pass the NCLEX-RN exam, you have a few options for receiving certification as a neonatal nurse. The National Certification Corporation provides an RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC).

Candidates must have an active RN license, 24 months of specialized experience as an RN, and a passing score on an eligibility exam to obtain this credential. This must be renewed every three years.

There is also the American Association of Critical-Care Nurses, which provides the CCRN (Neonatal) specialty certification. You can also apply for specialized NICU certifications:

• Neonatal Neuro-Intensive Care (C-NNIC)
• Neonatal Pediatric Transport (C-NPT®)
• Care of the Extremely Low Birth Weight Neonate (C-ELBW)

After you receive certification, you will have an opportunity to join a NICU team as a neonatal nurse. You also need to pay attention to continuing education requirements specific to the state in which you practice. 

How do you change your specialty to become a neonatal nurse?

If you are already working as a nurse and want to try and change roles, there are a few ways to do this. The first step is to shadow a nurse in the NICU department. You can ask your supervisor to shadow another nurse. While shadowing, it’s crucial to network with the other nurses on the unit. Get a feel for the unit and the people who work on it.

By networking, you can gain insight into the open positions as well. Once you learn of an opening, it’s all about timing. You don’t want to switch roles as a new nurse.

How much does a neonatal nurse make?

A neonatal nurse’s salary depends on many factors. Some of these factors include location, experience and education. According to data from Incredible Health, the average salary for Neonatal Critical Care Nurses is $88,160 – an hourly rate of $42. This is about 6% higher than a the average registered nurse’s median wage.

Here’s a breakdown of the neonatal nurse salary in comparison to other nursing positions.

• Charge nurse – $64,935
• Pediatric nurse – $59,084
• Labor and deliver nurse – $99,043

If you recently received certification and are looking for a job, we can help you here at Incredible Health. Just sign up and we will send you job opportunities! 

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What is the difference between a neonatal and a NICU nurse?

The neonatal and NICU nurse are the same role. NICU nurses are simply neonatal nurses who work in the NICU. The NICU is the neonatal intensive care unit.

What are the career opportunities for a neonatal nurse?

There are many different opportunities for neonatal nurses within this specialty. Below you will find a list of typical roles. 

Staff nurses

These nurses assist with specialized care for severely to mildly ill newborns. You could see yourself caring for an infant who is using a ventilator or helping a new mom with breastfeeding.  

Clinical nurse specialists

This is an advanced practice registered nurse who equips the nursing staff with educational programs to ensure they provide up-to-date, evidence-based care. 

Nurse managers

In this role, the nurses provide administrative leadership to the staff to ensure that policies and procedures are followed for optimal patient care. 

Developmental care specialists

These nurses have specifically studied developmental care for sick and preterm infants. They help the team with developmental needs and goals of newborn babies, such as weight gain. 

Neonatal nurse practitioners (NNPs)

This role is staffed by advanced practice registered nurses who coordinate with physicians and other nurses to provide critical care to NICU infants. 

What is the salary and career outlook for neonatal nurses?

The average salary for a neonatal nurse is $88,160. That is higher than the annual average salary for all RNs of $82,750.

The career outlook for RNs is expected to grow by 6% between 2021 and 2031.

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