How To Become A Neonatal Nurse (NICU)

What Is A Neonatal Nurse (NICU)?

A neonatal nurse is a nurse that works specifically with newborn babies. The first hours of a newborn child’s life can be essential and there are so many things that could go wrong. The neonatal nurse is responsible for the care of the baby as well as his or her mother and cares for healthy as well as sickly babies in their first few hours and days in this world.

Nature Of The Work/Duties

There are three levels of neonatal nursing with different tasks involved. At the first level of neonatal nursing you will be required to look after all of the healthy babies that are born and ensure that nothing goes wrong in their first hours of life. The second level of neonatal nursing involves looking after premature babies and babies who for some reasons get sick after birth. The last level is the most intensive and requires the highest degree of personal strength of character as it involves taking care of babies that are severely ill or born with serious conditions. This is one of the more heartbreaking aspects of neonatal nursing and a nurse working at level 3 needs to be prepared to deal with loss on a relatively frequent basis throughout her career.


Neonatal NurseBased on the levels mentioned above we can split the locations in which neonatal nurses are employed into two categories:

  • Neonatal intensive care units, or
  • Mother-baby or newborn nurseries taking care of healthy newborns

You will either work in an area where you are dealing with health babies or in an area where you are dealing with mildly to severely sick babies. Many hospitals have maternity wards, which is where you will be employed if you choose to work in a hospital as a neonatal nurse. There are also a number of other settings where you could be employed such as special maternity hospitals that specialize in this line of work. Employment options are good but, as it is a popular area to work in, the competition can be relatively stiff for a position.

Neonatal Nurse (NICU) Requirements

Although you will definitely need an RN license, apart from this requirement there are very few other stipulations for neonatal nurses. To a large degree the requirements depend on the facility that you plan to work in. some facilities require that you have experience as an RN once you have graduated from an RN program. In these cases you may find it helpful to work as an RN in just about any setting for about a year before reapplying for a job as a neonatal nurse. Other institutes will hire you straights after you leave your RN school. This usually depends on the demand for neonatal nurses at a facility as compared to the number of nurses available. This is one of the easier nursing specialties to become involved in as the requirements are not stringent.

Personality Traits

The personality traits for a neonatal nurse are as follows:

  • You must have excellent people skills for dealing with your patients, the families of your patients, and the colleagues that you will work with such as the obstetrician.
  • You must have empathy so that you can show your patients and their families that you understand their situation and that you are part of their world.
  • You should also have a clear and intelligent understanding of the needs of newborns.
  • You should not have a personality that is easily clouded by your emotions.
  • Because of the many health care professionals involved in birth you need to be able to work well with a team.
  • You must also have excellent and quick critical thinking skills and an ability to work under pressure.

Educational Requirements

The first step in terms of your education is to become an RN. To do this you will need to attend an RN degree program. The two more popular degree programs are the associate’s degree in nursing and the bachelor’s degree in nursing. Both of these will allow you to sit the NCLEX-RN examination (which is the national licensing exams for RNs) and get your license. After that you can return to graduate school and earn a master’s degree which will allow you to be a neonatal nurse practitioner. In between degrees you should get some experience as a neonatal nurse so that you can decide whether or not it is, in fact, the course of action that you would like to take in terms of furthering your career form that point.


To be a neonatal nurse you need an RN license. In order to get an RN license the following steps must be taken:

  • Firstly you need to attend an RN program. These programs are offered by universities and colleges and last for 2 to 4 years depending on the degree that you work towards.
  • Once you have graduated from the program you will need to apply to your state board of nursing for licensure. Note that different states have different licensing laws, so you will need to look into those carefully before applying.
  • Once you application is accepted you will have to set a date to write the NCLEX-RN examination. Passing this examination will earn you RN licensure.
  • The license needs to be renewed periodically and depending on the license renewal requirements of your state.

How To Become A Neonatal Nurse (NICU)

Training, Advancement And Other Qualifications

To maintain your NR license you will need to do a certain number of continuing education at set intervals in order to maintain it. Once you have met all of the necessary requirements for being a neonatal nurse it is a good idea to focus all of the continuing education that you do from thereon out on neonatal aspects. Some states require that your continuing education is done in very specific areas, but in those states where you can choose your continuing education credits it is always a good idea to focus on the area of nursing that you have chosen to specialize in which is, in this case, neonatal nursing. You have to these credits anyway so it is in your best interests to choose credits that will boost your skills and confidence level in your job.

Source An Accredited Education Program

When you do your RN training it is essential that you do it through a program that is accredited. If the program is not accredited you will waste your time and money as you will be required to do the program again from scratch. There are a number of ways to check accreditation:

  • Find out where current nurses did their training as they cannot be RNs unless the school they trained at was accredited.
  • Enquire with your state board of nursing and have a look through the list of accredited schools that they provide you with.
  • The school itself should be open and forthcoming about this information, but be wary because there are false schools (especially ones that offer online training) that may blatantly lie about their accreditation status.

Earn Your Associate’s Degree

An associate’s degree is the lowest level of education that you need in order to be an RN by writing the RN examination. To obtain an associate’s degree you will firstly need to find a school in your area that offers an associate’s degree program in nursing. Once again your state board of nursing is a great resource to turn to if you want to find a list of accredited schools. Consider the options. Some schools will be more expensive than others; some will be further away, and so on. Choose your top options and apply for the associate’s degree program. Then you simply have to work hard and complete the course to earn your associate’s degree. These degrees take a few years to complete. This degree allows you to write the NCLEX-RN exam.

Obtain Your Licensure

There are no additional licensing requirements to being a neonatal nurse other than the RN license, but it will make things easier for you if you have a nurse practitioner license. To get a nurse practitioner license you will have to return to school and get your master’s degree in nursing. You can do you master’s degree with a focus on neonatal nursing and all topics related to babies. This will make you, at the end of your course, a neonatal nurse practitioner. This is essentially a higher position and you may be eligible to earn more money if you have this advanced qualification. Requirements for nurse practitioner training and certification vary from state to state and it will be up to you to research the requirements for your particular state.

Online/Distance Education Programs

To a certain degree you can become a neonatal nurse through online study. However, when you consider the basic education requirements that you need, in other words, your RN qualification, it should become apparent to you that the degree cannot be complete entirely online. This is because the degree consists of two main parts:

  • A theory section which is made up of textbook knowledge that you will need to learn.
  • A clinical practice section which requires that you get hands-on training in a health care setting.

This second aspect of the training program cannot be done online. Most online courses will inform you that you need to make your own efforts to complete the clinical coursework yourself. Any course claiming otherwise should be treated with deep suspicion. Some online courses have agreements with healthcare facilities, and these are the better options to choose.

Job Outlook

The health care industry in general and the nursing industry in particular, are on the increase in terms of the number of jobs that are available. While other industries suffer due to economic hardships, the medical industry stays strong. Increases in the number of RN jobs that will be available are expected to be huge over the next year. In addition RNs that have a specialization in neonatal nursing will be able to benefit from the fact that there has been an increase in the number of premature babies born, the number of multiple births that have occurred and an increase in fertility treatments, all which lead to the conclusion that there is a growing number of babies that need your skill and your care.


A neonatal nurse can earn between $46,166 and $100,755 a year. If you add the potential bonus that they can receive a year of $0.00 – $10,122 it brings the total to $45,207 – $113,531. Your level of education can affect how much you are paid as a neonatal nurse:

  • A Master of Science in Nursing (MSN) will earn you $64,053 – $101,699 a year.
  • A Bachelor’s Degree will earn you $30,521 – $76,562 a year.
  • A Bachelor of Science in Nursing (BSN) will earn you $38,884 – $81,389 a year.
  • A Master of Science in Nursing (MSN), Neonatal Nurse Practitioner will earn you $70,000 – $86,110 a year.

Popular cities that pay well are:

  • Denver, Colorado
  • Houston, Texas
  • Dallas, Texas
  • Nashville, Tennessee
  • Philadelphia, Pennsylvania
  • Seattle, Washington
  • Pittsburgh, Pennsylvania

The main thing to remember about being a neonatal nurse is that working with children is great, but the tragedies, when they occur (and they will), will hit you a lot harder than if you are working with adults. Consequently strength of character is required for this line of work and, if you feel that you do not have the required strength of character, you should consider an alternative line of work. Another important thing to remember is that you can work in NICU if you do not have certification, but becoming a neonatal nurse practitioner will improve your career and you salary and earn you a higher degree of respect.

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