Neonatal intensive care unit (NICU) nurses deliver specialized care to infants who have been born prematurely or suffer from problems such as birth defects, low birth weight, or other severe illnesses. These infants can be fragile. They require the skilled hands-on touch and knowledge of expertly trained NICU nurses who can gently guide them towards recovery. NICU nurses support parents by showing them how to handle, feed, and communicate with their newborns. They assist young mothers to learn lactation techniques and encourage fathers to take an active role.
There are four levels of acuity NICU nurses’ work; each one has different responsibilities. When NICU nurses care for infants with mild deficits, the goal is to “feed and grow” the baby. Higher levels of acuity require closer observation using cardiac monitoring, respiratory support, and feeding tubes to provide nutrition. NICU nurses who work with severely premature infants must balance needed hands-on care while limiting overstimulation.
NICU nurses often receive advanced training to improve their skills in neonatal care. There are a slew of certifications they can obtain. Some become advanced practice registered nurses (APRNs) either as neonatal nurse practitioners (NNPs) or clinical nurse specialists (CNSs) specializing in neonatal intensive care.
All NICU nurses must scrub before caring for their patients to reduce infection. Depending on the acuity level, age, and strict feeding schedule, NICU nurses care for one to three babies at a time, usually during a 12-hour shift.
NICU nurses provide specialized care based on the level of care for the infant.
Level 1: Well newborns only need basic care.
Level 2: Special care of early-born infants born before 32 weeks with low weight and mild health problems. Nurses may provide IV antibiotics, phototherapy, and other support.
Level 3: Life support for infants born before 32 weeks of gestation, weighing less than 1500g, or who have severe medical/surgical conditions. These neonates require assisted ventilation, cardiopulmonary monitoring, lab work tracking, temperature monitoring, and may require advanced imaging scans.
Level 4: Require regional NICU designated facilities possessing a comprehensive medical team capable of providing surgical care of complex medical and surgical conditions 24 hours a day. Local hospitals transfer their sickest patients here. In addition, level 4 centers can provide advanced respiratory support such as extracorporeal membrane oxygenation and perform complex surgeries. These babies may or may not be premature but have severe medical or surgical needs. They receive all the care in level 3 plus may need the care of two nurses at a time.
NICU nurses may also go to the OR directly to admit a new infant and meet the parents after a C-section or emergency delivery.
NICU nurses must be able to assess and monitor neonatal patients accurately for subtle changes in their cardiac, respiratory, renal status, and temperature since these infants can be significantly affected. Tube feedings, IV medications, and blood transfusions are all administered more frequently in small volumes to prevent fluid overload or other complications.
NICU nurses run and monitor specialized equipment such as incubators, phototherapy machines, or infant warmers. They provide dressing changes, catheter care, and observe their young patients for any skin breakdown.
