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Neonatal Intensive Care Nurse (NICU)

Neonatal intensive care (NICU) nurses care for infants who are premature (born prior to 32 weeks) or have critical conditions requiring high level constant monitoring. There are four levels of neonatal critical care. Level I (well care), Level II (special care), but in levels III and level IV, life-sustaining treatment is delivered by NICU nurses and an entire team of neonatal practitioners. These infants are in incubators, need oxygen support, may have feeding tubes and IV medication drips, or are critically ill. NICU nurses closely monitor their small patients while providing emotional support and education to their parents.

Education Requirements

All nurse specialty areas require an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree and successfully pass the state’s NCLEX-RN exam. Some hospitals prefer you to have a BSN but may accept an ADN.

How to advance/career pathway

Neonatal intensive care nurses must be BCLS certified but also need Neonatal Resuscitation Program (NRP) certification.  Many places prefer you have one to two years of experience in neonatal care, pediatrics or OB. You can apply for your CCRN in (Neonatal) from the AACN after completing the required clinical hours in either two or five years.

You can also advance by getting an MSN or doctoral degree with a neonatal intensive care focus as a Clinical Nurse Specialist (CNS) or as a Neonatal Nurse Practitioner (NNP).

RESPONSIBILITIES

  • Assess and monitor neonatal patients for changes in temperature, ventilation, cardiac and renal status
  • Administer tube feeding, IV medications, dressing changes, catheter care, and prevent skin breakdown
  • Attend rounds with the neonatal intensive care team and report patient status or needs
  • Provide family reassurance and newborn teaching

MOST COMMON CASES

  • Anemia
  • Apnea
  • Bradycardia
  • Bronchopulmonary dysplasia (BPD)
  • Hydrocephalus
  • Intraventricular hemorrhage (IVH)
  • Jaundice
  • Necrotizing enterocolitis (NEC)
  • Patent ductus arteriosus (PDA)
  • Periventricular leukomalacia (PVL)
  • Prematurity
  • Infant respiratory distress syndrome (RDS)
  • Retinopathy of prematurity (ROP)
  • Sepsis
  • Transient tachypnea of the newborn (TTN)

How to become a

Neonatal Intensive Care Nurse (NICU)

  1. Complete an ADN or BSN program in nursing
  2. Pass the NCLEX-RN exam and apply for your RN license
  3. Have one to two years of experience working as an RN in pediatrics or OB
  4. Apply to work in a Neonatal intensive care unit
  5. Apply for your CCRN (Neonatal) after completing the required clinical hours

Specialty Groups and Communities

National Association of Neonatal Nurses (NANN) 

  • Mission: “NANN is committed to developing and delivering the tools and connections you need to advance your career and evolve the profession.”
  • Cost: $130, annually.
  • Perks: Connect with fellow APRNs, attend the annual NANNP Business Meeting to learn about advanced neonatal nursing practice, access to join the American Association of Nurse Practitioners (AANP) with $10 off of your membership, and more.

American Nurses Credentialing Center (ANCC) 

  • Mission
  • Cost: $52-78, annually.
  • Perks: Free CEU hours, discounts on certification, NTI Conference registration and AACN Store products, and more.

The Pros

  • Challenging, advanced learning opportunities with complicated infant conditions
  • Develop close relationships with neonatal intensive care patients and families. 
  • Rewarding to see the recovery of patients from life-threatening conditions
  • Work collaboratively with the neonatal intensive care team

The Cons

  • Focus on neonatal intensive care patients limits experiences with less intense medical cases
  • Stressful since patients may unexpectedly do poorly
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Personality Traits

  • Dexterous and careful with small-sized equipment
  • Optimistic and empathetic
  • Observant of small changes in vital signs or body temperature
  • Clear communicator to the infant’s family
  • Organized and meticulous
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Average Salary

Neonatal Intensive Care (NICU) nurses typically make between $45k - $101k, with a median salary of $64,473. For the most up-to-date salary information, check out Salary Explorer.

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Certifications

American Academy of Pediatrics (AAP) 

  • The Neonatal Resuscitation Program (NRP)

American Nurses Credentialing Center (ANCC) 

  • CCRN (Neonatal)
  • CCRN-K (Neonatal) for nurse supervisors 

National Certification Corporation (NCC)

  • Neonatal Intensive Care Nursing (RNC-NIC)
  • NCC has additional certifications for RNs and NPs.
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Work Setting

Hospitals or emergency transport

Interested in learning more about what it’s like to be a Neonatal Intensive Care Nurse? We spoke to one to find out. Read What Does a Neonatal Intensive Care Nurse Do?