What is Neonatal Nurse in 2023

What is Neonatal Nurse in 2023

Everything You Need to Know About Neonatal Nurse 

Currently, the country is experiencing high birth rates, ultimately leading to an increased demand for neonatal nursing services. Neonatal nursing is a specialty in nursing that focuses on providing primary care services to newborn infants born with various health rate complications ranging from premature births, surgical problems, congenital disabilities, and cardiac malformations. Neonatal Intensive Care Unit (NICU) nurses, also referred to as neonatal nurses or NICU RNs, provide neonatal intensive care services in acute health care settings such as neonatal intensive care units.


Although the neonatal period is the first month of life, neonatal nurses offer primary care to newborn babies shortly after birth and provide care services for newborns with long-term health complications. The most common nursing professions in neonatal nursing are neonatal nurses and neonatal nurse practitioners. Even though the two nursing professions perform similar roles, there is some difference between the two. Neonatal nurses are registered nurses who have the skills and knowledge needed to care for newborns. Neonatal nurse practitioners are advanced practice nurses who offer specialized neonatal intensive care. They work within the neonatal intensive care unit. 


To become a neonatal nurse, you earn an undergraduate degree and obtain a registered nurse practicing license. However, registered nurses aspiring to become neonatal nurse practitioners must earn a graduate degree, preferably a DNP degree. There is more to NICU nurses. This article explores the various aspects of neonatal nurses, including: 


  1. Responsibilities of a neonatal nurse 
  2. Skills and qualification required in neonatal nursing 
  3. What to expect from a career in neonatal nursing 
  4. Salary and benefits for neonatal nurses

Responsibilities of A Neonatal Nurse 

The primary motive for neonatal nurses is to make a difference in the lives of newborn infants and their families. It will be more satisfying to hear from the infant’s families that you made a difference in their lives when they were almost giving up. The registered nurses act as the voice to the sickest and smallest patients by providing general patient care and intensive care services. 


Neonatal nurses and neonatal nurse practitioners mostly work within the neonatal intensive care unit providing intensive care to infants with life-threatening medical conditions. However, the roles differ significantly as neonatal nurse practitioners can perform specialized care services that NICU RNs cannot perform. 

What Does a Neonatal Nurse Do? 

Currently, close to 50,000 cases of low-birth-weight infants are reported in the United States annually, leading to high demand for NICU services. Unlike in the last decades, the survival rates for vulnerable infants are currently ten times better, thanks to the technological advances in the medical field and efforts of neonatal nursing specialists and physicians. But what do neonatal nurses do to make a difference in the lives of infants and their families? Neonatal nurses work closely with infants and their parents to provide care for their newborn babies. They act as a bridge between nurse practitioners and physicians providing care for the infant. They feed and clean the babies on behalf of their parents. 


Neonatal nurses are often found in hospital facilities. Nevertheless, they work in community outpatient centers and clinics, offering follow-up care services to vulnerable infants once they leave the hospitals. Knowing the medical conditions for infants can be quite challenging. However, with the expertise of neonatal nurses, diagnosing illnesses can be quite easy. The neonatal nurses observe the behaviors of the newborns to determine any abnormalities in their behaviors. 


They watch the vital signs and blood circulation issues closely. Infants born with chronic conditions or born prematurely are given round-the-clock in neonatal intensive care units by NICU nurses since they require level III care. The level III care patients must always be isolated to prevent infections. The NICU nurse performs various tests to evaluate the existence of health problems. They also help the infants with vital functions, administer medications prescribed by physicians, and monitor their health progress.  


What Is the Difference Between a Neonatal Nurse and A Neonatal Nurse Practitioner? 

Neonatal nurses must have completed a nursing degree program and satisfactorily passed the NCLEX-RN examination needed to become a registered nurse. On the other hand, a neonatal nurse practitioner is an APRN who has earned a graduate-level nursing program, passed the nurse practitioner examination, and gained at least two years of hands-on experience in neonatal care. Neonatal nurses usually provide care to their assigned babies. 


A neonatal nurse implements the treatment plans ordered by a nurse practitioner or physician. They constantly monitor the vital signs, administer medications, provide post-surgical care, and deliver phototherapy. Neonatal nurse practitioners work under a physician. They diagnose conditions, order lab tests, perform invasive nursing procedures, and evaluate medical treatments. They might change the infant’s treatment plan if need be. 

What Is It Like to Work as A Neonatal Nurse? 

Newborn care is one of the toughest but most rewarding nursing jobs. The nursing profession calls for individuals who are passionate about infants. Neonatal nurses work under pressure as slight nursing errors might lead to life-threatening situations. Working in a fast-paced environment such as that of the NICU requires commitment and adept skills. The neonatal nurse job requires effective communication between the neonatal nurses and the infant’s parents. Although the neonatal nurse job is quite involved, most nurses report high-level career satisfaction. 

Skills and Qualification Required in Neonatal Nursing 

Neonatal nursing is a highly specialized nursing field that requires nurse practitioners to possess advanced nurse practicing skills. A neonatal nurse is responsible for newborn infants with a wide range of health complications. It is important for nurse practitioners, especially those providing neonatal care services, to be flexible, highly organized, and emphatic individuals to ensure effective care for neonatal patients. Neonatal nursing involves interprofessional collaboration between neonatal nurses, neonatal nurse practitioners, and physicians to provide quality care. 

What Skills Are Needed to Become a Neonatal Nurse? 

A NICU nurse is entrusted with the care of the smallest and most vulnerable patients in the country. The nursing skills of nurse practitioners and registered nurses providing neonatal care should be on point. Additionally, neonatal nursing requires long working hours and high commitment levels to ensure effective care for newborn babies, particularly those in the neonatal intensive care unit. Below are some of the skills you need to become a neonatal nurse: 


  • Attention to Detail: Newborns undergo rapid development, which might lead to life-threatening conditions. Neonatal nurses need to have a solid knowledge of every development stage to help identify minor deviations. The minor deviations typically signify major health issues. NICU nurses provide critical care to newborn babies, especially premature babies. Having strong attention to detail skills will ensure effective care minimizing medical errors such as mal administered drugs. 
  • Communication Skills: Verbal communication is a vital aspect of the nursing profession. Therefore, aspiring neonatal nurses must have adept communication skills to talk to patients’ families, including updating them on the infant’s medical progress and coaching the parents on home care practices. The information provided by a NICU nurse is always critical to the newborn’s health, more so after discharge. 
  • Decision-Making Skills: NICU nurses provide care to the most vulnerable newborns who require round-the-clock medical attention. The infants in NICU are highly susceptible to infections and diseases. The NICU nurse should assess the baby’s health situation and make prompt decisions to improve its well-being. 
  • Multitasking Skills: In the NICU, there is no such thing as one-task-at-a-time, as NICU nurses are always busy doing several tasks at a go. The to-do list for nurse practitioners can change within no time. Being able to handle multiple tasks simultaneously is the stamp of authenticity in nursing. 

What Are Personality Traits Useful in A Neonatal Nurse? 

Neonatal nurses should be able to perform their tasks while navigating through various emotional situations. The nurse needs exceptional personality traits to be able to provide care to newborn infants. Some of the personality traits include: 


  • Empathy: Neonatal nurses should empathize with critically ill infants, their parents, and other family members. 
  • Resilience: Not all newborn patients make it while undergoing treatment in NICU. NICU nurses need to remain calm no matter the situation. In case of loss of life, the nurse should be able to cope with the situation and return to work ready to make a difference in other patients’ lives.
  • Compassion: To effectively working in the neonatal nursing field, a neonatal nurse practitioner must have strong compassion for little helpless babies. 
  • Caring: Neonatal nurses should be caring enough to ensure effective care. They should also understand the situation of the infant and parent. 

What Kind of Education Does a Neonatal Nurse Need? 

A neonatal nurse must earn at least an AND or BSN degree and registered nursing certification. Additionally, they must be certified in neonatal resuscitation specialty. Those working in NICU must obtain NICU practicing certificates. On the other hand, neonatal nurse practitioners must earn a minimum of two-year clinical experience in a NICU setting. They also need to earn an advanced degree in nursing, preferably a doctor of nursing practice degree. 

What to Expect from A Career in Neonatal Nursing 

Neonatal nursing is among the most in-demand nursing professions in the United States’ job market. Neonatal nurses perform several roles related to care for neonatal patients. Aspiring neonatal nurses should have higher expectations as it is one of the most involving careers. As a neonatal nurse or neonatal nurse practitioner, you should expect to make a difference in parents’ and newborn infants’ lives. Neonatal nurses work in various health care settings, including hospitals, clinics, and community outpatient centers. NICU nurses providing level III care services to critically ill infants should expect to work in a neonatal intensive care unit. 

Since neonatal care services, particularly neonatal intensive care services, are provided around the clock, aspiring neonatal nurses should expect to work longer hours than other nurse practitioners. Mostly, NICU nurses work in 12-hour shifts while level II nursery neonatal nurse practitioners work in 8-10 hour shifts since their patients need less neonatal intensive care. The neonatal nurses will also be providing follow-up and home care for high-risk infants. The aspiring neonatal nurse should expect varied salaries. Registered nurses earn relatively lower amounts than advanced nurse practitioners. 

What Are Neonatal Nursing Career Options? 

Neonatal nursing is one of the nursing subspecialties with several career opportunities. The career opportunities are specific to either registered nurses or nurse practitioners. As you progress your career and education levels, you might unlock a new world of physicians’ opportunities. Some of the career opportunities available in neonatal nursing include: 


  • Staff Nurses 


Staff nurses are the most common profession in neonatal nursing. Staff nurses provide specialized care to acutely ill newborns. They help in the delivery of premature infants to ensure the safety of the infant and the mother. They assist mothers with breastfeeding processes. The staff nurses also provide care to acutely ill infants receiving IV medications or those on ventilators. 


  • Neonatal Nurse Practitioners


Neonatal nurse practitioners are highly skilled neonatal nurses who work closely with physicians and other registered nurses to provide neonatal intensive care to babies in the NICU. To practice as a neonatal nurse practitioner, a registered nurse must attain a terminal degree in nursing. The doctoral program trains and prepares the advanced nurse practitioners to provide intensive care to infant patients. They are required to share their knowledge and experience with an interprofessional team as they take care of critically ill newborns. 


  • Neonatal Nurse 


The primary profession in neonatal nursing is that of neonatal nurses. The neonatal nurses provide general care to infants, especially level II nursery patients who don’t require neonatal intensive care. They administer medications, observe vital signs, monitor patients’ health progress, and conduct follow-up procedures to already discharged infants. 


  • Developmental Care Specialists 


Developmental care specialists are nurse practitioners who provide direct care to patients by evaluating the infants’ development needs. Infants develop rapidly, hence the need for highly specialized development care nurses. They collaborate with other neonatal nurses to build a comprehensive treatment plan for each baby’s development stage. They use their knowledge to identify vulnerable infants’ needs and advocate for developing and implementing responsive initiatives. They work closely with pediatric nurses to monitor the infants’ progress during their later stages of development. 


  • Clinical Nurse Specialists 


These are advanced practice nurses who support neonatal nursing staff with direct care services. They provide educational programs needed by neonatal nursing staff to learn various clinical skills. 


  • NICU Travel Nurse 


The NICU travel nurses provide critical care services to critically ill infants and premature newborns in a health facility’s neonatal intensive care unit. The travel nurses formulate treatment care plans for neonatal patients. They regularly evaluate the effectiveness of the care plans and make adjustments as required. They administer medications, perform neonatal medical procedures, provide health education, and comfort families during the tempting period. 


  • Nurse Managers 


Neonatal nurse practitioners with high leadership and administrative skills might work in a hospital setting as nurse managers. The nurse managers act as administrators of the NICU, ensuring its environment is safe and has the resource needed for intensive care. 


  • Nursing Assistants 


Nursing assistants are vital professionals in neonatal nursing. The nursing assistants stock neonatal nurses with the necessary supplies they need in a NICU. Also, they are responsible for picking test results from laboratories and medications from the pharmacy. 

What Is a Typical Day Like for A Neonatal Nurse? 

Neonatal nurses are some of the busiest nursing professions in the health care sector. They typically day entail long working shifts, which compels them to work for a maximum of 12 hours a day. Despite the long working hours, neonatal nursing responsibilities come with satisfaction levels as each working shift involves impacting infants and their family’s lives.


A typical day begins with attending to a few neonatal patients, especially those within NICU. The NICU nurses get briefed on the patient’s progress and notified of any variations in their health, as the nurses always strive to care for infants they have previously looked after. This helps develop a personal touch with the baby’s family and better understand its medical conditions. The first step is to ensure the baby’s resuscitation equipment or other NICU equipment are set correctly. Nurse practitioners evaluate the patient’s health conditions by observing vital signs and striving to determine behavior changes. 


Other daily tasks include bathing the child and preparing them for parent visits. Neonatal always check on the parent’s sheet to determine the visiting time and help prepare the infants, especially those in NICU, for visitation. They prepare and check the patient’s medications and administer the medications as prescribed by the physician. The nurses also check and manage intravenous fluids and infusion, recording observations, and documenting their observations in each infant’s file. 


The neonatal nurse always ensures that the sheets are clean and change the baby’s nappies all the time. They spend most of their time sitting and the baby’s sides and always open for alarms and other emergencies. A change in their heart rate can trigger the alarms. Also, a drop in oxygen saturation might require immediate action. Although the daily activities might be challenging, the task comes with many rewarding experiences. 

What Is the Current Job Market for Neonatal Nurses? 

The neonatal nursing field is among the nursing subspecialties with a promising job outlook. Bureau of Labor Statistics projects neonatal nurses’ employment rate to grow by 26% in the current decade. The organization also expects the NICUs to expand their services due to technological trends disrupting the healthcare industry. This signifies improved health outcomes for vulnerable infant patients, especially those born prematurely and critically ill patients. With this, the demand for NICU nurses will keep growing for the foreseeable future. Not all babies are born healthy. Not every newborn is delivered on time. This demonstrates that now that later generations have reached the parenting age, there may be increased demand for specialized care services. 


Currently, there is a worrying trend in neonatal nursing. The health sector is witnessing an increased retirement rate of the current neonatal nurses. Hospitals are in a rush to replace highly experienced nurses near retirement with a new workforce, leading to a higher demand for neonatal nurses and neonatal nurse practitioners. If you are considering pursuing a career in neonatal nursing, then this is the right time. Enroll in a nursing degree program and earn your practicing certification.

Salary and Benefits for Neonatal Nurses 

Neonatal nurses are highly paid advanced practice nurses due to their specialized care services. The salaries for neonatal nurses depend on various factors, including educational levels, years of working experience, job location, employer, among other factors. The demand for neonatal nursing caregivers is immensely high, with most health care organizations striving to replace the nurse practitioners nearing their retirement ages. 

Before applying for any neonatal nursing job, it is always imperative to consider the positions’ salaries and benefits. This will determine whether the remuneration package meets your personal needs and career objectives. Notably, neonatal nurse practitioners earn relatively higher salaries than the registered nurses practicing within the subspecialty. Hence, those intending to grow their wages should consider advancing their education.

What Benefits Do Neonatal Nurses Get? 

Neonatal nursing is both a challenging and rewarding career option for aspiring nurses. Even though the most rewarding thing about neonatal nursing jobs is impacting the lives of newborn babies and their families, NICU nurses enjoy many other rewards. The rewards and benefits are always additional remuneration packages to the baseline salaries. If you doubt neonatal nurses’ earning potential, some of the outlined benefits below will help change your mind. 


  • Medical Insurance Cover 


The nursing profession is a high-risk profession as both registered nurses and nurse practitioners are always at great risk of hospital-acquired illness. Various employers offer neonatal nurses a wide range of health insurance plans to cover medical costs. The insurance plans cover the medical expenses for hospital-acquired conditions and illnesses acquired outside the working hours. In some cases, your employers might provide health coverage for your family. 


  • Over-Time Bonus 


working overtime is an effective way of growing your earnings and salaries. NICU nurses typically work 12 hours a day. Any additional work hours beyond the twelve-hour shift are considered overtime. Neonatal intensive care nurses are always paid for the extra working hours in terms of bonuses and other incentives. 


  • Paid Vacation 


To the complexity of neonatal intensive care, it is always vital for neonatal nurses to take working leave once in a while. While on annual leaves, some employers, especially those in the private sector, offer their neonatal nursing employees paid vacations. What could be more rewarding than traveling around the country to enjoy a full paid vacation? 


  • Malpractice Insurance 


NICU nurses provide intensive care to the smallest and most vulnerable members of the community. Medical errors could have several ethical and legal implications. NICU nurses are always at high risk of malpractice. While looking for a new neonatal nurse job, consider health institutions with malpractice insurance. Larger institutions often provide malpractice insurance coverage due to their high financial implications. 


  • Continuing Education Reimbursement 


Neonatal nurses wishing to advance their undergraduate degrees are always given education off days separate from the normal paid time off. Interestingly, most employers fully fund the continuing education programs for the NICU nurses, while others reimburse the neonatal nurses’ funds to finance their continuing education programs. 

How Many Hours Does a Neonatal Nurse Work Per Day? 

Neonatal nurses spend most of their time taking care of neonatal patients. Most NICU nurses, including pediatric nurse practitioners and travel nurses, work 12-hour shifts per day. However, those offering level II care, such as clinical nurse specialists, have flexible working schedules consisting of 8-10 hours working shifts. 

What Kind of Salary Do Neonatal Nurses Make? 

Although neonatal nurses’ salaries vary depending on their education and experience, neonatal nurses make an average salary of $73,880. This translates to an average hourly wage of $49. Entry-level registered nurses practicing in the neonatal nursing field earn a salary of $50,891. The wages rise with increased years of working experience due to the promising career outlook for neonatal nurses.

In Summary 

Neonatal nurses provide care services to newborn babies experiencing health complications such as premature birth, congenital disabilities, and infections. They improve ill infants’ well-being by evaluating their health condition, performing tests, developing treatment plans, and monitoring the newborn’s progress. They also educate parents on how to take care of their newborns after discharge from the NICU. They work closely with neonatal nurse practitioners and physicians to provide direct care to neonatal patients. In addition to delivering direct care to newborn infants, the nurses support women during labor and after labor. 

Neonatal nurses work in birthing rooms and nurseries within hospital facilities. The nurseries for ill infants are always categorized into level II and level III. Level II nurseries house patients with less critical conditions, while level III nurseries house critically ill patients, including premature infants. Others work within homes providing follow-up services to the already discharged patients. Neonatal nurse practitioners and neonatal nurses vary in several aspects. NNPs are required to earn an advanced nursing degree, whereas NICU-RNs must complete undergraduate nursing degrees. 


Currently, neonatal nurses earn an average salary of $73,880. However, the wages vary due to several factors, including education levels, years of working experience, job location, and employer. The neonatal nurse requires several skills and personal attributes to be effective in their nursing practice. Some of the skills and personal attributes include good communication skills, attention to detail, resiliency, empathy, multitasking skills, and quick decision-making skills.


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