If you’re interested in entering the growing field of healthcare, NICU nursing can be a rewarding career option. While there are numerous types of nurses, specially trained neonatal intensive care unit (NICU) nurses help care for infants who are born prematurely or experience health issues just after their timely arrival.
Working with sensitive newborns requires resilience, keen observation, and appropriate accreditation.
In this short guide, we’ll go over the steps for how to become a NICU nurse. We’ll also review the career options you’ll access upon entering the profession and the NICU nurse requirements.
Step 1: Understand the Role
Neonatal nurses help care for newborn infants between their birth and their discharge from the hospital. Babies may remain hospitalized for conditions including:1
- Birth defects including cardiac malformation
- Premature birth
- Surgical issues
In these cases, they can end up in NICU units, where specially trained NICU nurses provide around-the-clock observation and nursing care. In some cases, NICU nurses also provide aftercare in home settings for children up to two years of age.
No matter where they work, NICU nurses must remain sensitive to the needs of children and their families to perform dual roles:
- Infant observation and nursing care – NICU nurses help feed newborn infants, administer medications, and monitor their vital signs. Very small infants may not have the ability to cry, so neonatal nurses must develop expert skills for observing and keeping track of their patients’ progress.
- Communicating between all parties – Neonatal nurses also serve as crucial intermediaries between physicians, specialists, and babies’ families. They need to communicate information and concerns with sensitivity and care.
Kinds of Neonatal Nurses
Is there a difference between a neonatal nurse and a NICU nurse?
The short answer is that all NICU nurses work with infants and are therefore neonatal nurses. On the other hand, not all neonatal nurses work in intensive care units. However, this takes a bit more explanation.
There are several different levels of neonatal care:2
- Level I: Hospitals have nurseries for newborns who are born with no medical issues. Neonatal nurses working in these units are by definition not NICU nurses.
- Level II: NICU units care for newborns who need additional support, whether due to premature birth, infection, or other medical issues.
- Level III: Higher-level NICU units are staffed with nurses, doctors, and equipment that facilitate the care of premature babies who are very small or very sick.
- Level IV: There are also regional NICUs with specialized equipment that may not be available at local hospitals.
Nurses working at level II, III, and IV NICUs require different levels of training and preparation.
NICU Hours and Payment
Infant patients require consistency of care, which means the neonatal nurses often work long shifts of eight to twelve hours.3 Depending on the length of your shifts, you can expect to work four to five days per week.
How much is a NICU nurse salary?
- In the U.S., the average nursing salary is $42,000 per year.
- However, according to Nurse Journal, the median salary for neonatal nurses is much higher, at $64,074.4
- Where you live impacts how much you make. For example, in California—the highest-ranked state for nursing salaries—the median income for nurses is $106,950. In South Dakota, it’s less than half that.
- Traveling nurses can move between high-paying assignments. On average, they can make $100,000 per year.
Beyond your starting salary, there’s always room for growth as a NICU nurse. After beginning your first job, you can pursue further study. In time, you could become a nurse practitioner or get trained in high-paying advanced nursing skills.
Step 2: Earn a Nursing Degree
If NICU nursing sounds like the right career for you, the next step is completing the correct training. There are several potential degrees to prepare yourself for a career in nursing.
- Associate’s Degree in Nursing (ADN) – After completing high school, you can obtain an ADN in as little as two years of full-time study. However, keep in mind that some employers may require you to enroll in a BSN program to continue your education as you begin work.
- Bachelor of Science in Nursing (BSN) – Completing a four-year bachelor’s degree can give you deeper training. You may also have an advantage when studying for the NCLEX exam (which we’ll discuss more in the next section) and applying for jobs.
- Master of Science in Nursing (MSN) – If you already have a bachelor’s degree in another field, it may be possible to complete a two-year master’s degree in nursing. Likewise, some nurses with BSNs choose to pursue advanced study in preparation for careers as nurse practitioners or advanced nurses.
Your undergraduate or graduate study will include coursework that prepares you to sit for certification as a registered nurse.
Step 3: Pass the NCLEX exam
Beyond completing a degree in nursing, you’ll need to pass the National Council Licensure Examination-Registered Nurse (NCLEX-RN) to receive your nursing license.
This test assesses your ability to deal with a wide range of patients and situations (not just infants and children). It consists of 75-265 questions, and you must answer at least 75% accurately to pass the exam.
Are you wondering how to study for NCLEX exam?
While your education should prepare you well, there are plenty of guidebooks and test prep support services available to ensure your success.
Step 4: Get Experience
Next, it’s time to acquire experience working with infants.5
- Some NICU units may be willing to hire recent graduates with a strong interest in neonatal care, although others will require evidence of past experience working with infants and children.
- If you’re unable to find a job in a NICU, it could be helpful to begin your career in pediatric nursing or labor-and-delivery nursing.
As you gain clinical experience working with infants and children, you’ll amass the necessary experience you need to sit for certification as a NICU nurse.
You’ll need two years of clinical experience before you can qualify for specialized NICU certification.
In the interim, it’s helpful to train and apply for the following certifications, which are also common NICU nurse requirements:
- Basic Life Support (BLS) – Offered through the American Heart Association, BLS certification indicates that you’ve undergone specialized training to administer CPR and other cardiovascular life support for infants, children, and adults.6
- Advanced Cardiovascular Care Life Support (ACLS) – As a neonatal nurse, you’ll need to do more than administer CPR—you’ll also need to use sound judgment to formulate a response and communicate with a team. Building on the skills of the BCLS certificate, the ACLS indicates your preparedness to recognize and respond to respiratory and cardiac emergencies.7
- Neonatal Resuscitation Program (NRP) – The American Pediatric Association also offers a specialized course and certification specifically for resuscitating infants. It includes eleven lessons and concludes with an exam.
Step 5: Pass a Neonatal Certification Exam
After working as a nurse and acquiring experience with infant care, you’ll eventually be ready to pursue specialized certification as a NICU nurse.
There are two potential options:
- The American Association of Critical Care Nurses offers a Critical Nare Registered Nurse-Neonatal (CCRN-Neonatal) certificate. To apply, you’ll need 1,750 hours of experience caring for acutely and critically ill infants within two years. You’ll also need to pass an exam that tests clinical judgment and professional ethics.8
- The National Certification Corporation offers a different certificate, the RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC®). Similar to the CCRN exam, you’ll need two years of clinical experience. However, in this case, the 2,000 required hours of experience can combine education, research, administration, and patient care.9
To find the best fit for your career goals and experience, look at local job listings for NICU nurses. That way, you can determine which certification is preferred in your area.
Another potential factor is your current role. If you have fewer hours directly caring for critically ill infants but a surplus of other experience, it may be easier to qualify for an RNC-NIC® certificate.
Once you’re certified, you’ll have a better chance of obtaining full-time roles in NICU units.
As your career progresses, it’s also possible to become a neonatal nurse practitioner (NNP) within a NICU unit. That would require you to study for an MSN or Nurse Practitioner Degree (NDP).
Finding Your Ideal Job as a NICU Nurse
After years of study, work, and dedication, you can pursue your dream job as a NICU nurse.
For some, the ideal position is close to home. However, because NICU nurses have such specialized skills, they’re in high demand. That opens up the possibility for exciting career paths.
For example, if you’re interested in travel nursing jobs, you could potentially increase your income while living in different climates, states, and cities throughout the U.S.
Whether your priority is stability or variety, the perfect NICU nurse job is out there.
Traveling With Host Healthcare
How can you get started as a traveling NICU nurse?
Here at Host Healthcare, we’re one of the leading travel healthcare companies. We make it our mission to connect talented healthcare providers with the right jobs throughout the U.S. When you apply as a travel NICU nurse, we’ll match you with a recruiter who can help you find your next dream job and locale on your journey as a NICU nurse.
- National Association of Neonatal Nurses. Is a Career in Neonatal Nursing Right for You? http://nann.org/professional-development/what-is-neonatal-nursing
- Rocky Mountain Hospital. Understanding NICU Levels. https://rockymountainhospitalforchildren.com/health-education/neonatal-intensive-care-unit-levels.dot
- Career Trend. What Are the Working Hours for a Neonatal Nurse? https://careertrend.com/facts-5642963-working-hours-neonatal-nurse-.html
- Nurse Journal. Neonatal Nurse Careers and Salary Outlook. https://nursejournal.org/careers/neonatal-nurse/#:~:text=Neonatal%20nurse%20salary%20data%20varies,made%20an%20average%20of%20%2482%2C492.
- Noodle. Pursuing a Career as a Neonatal Nurse. https://www.noodle.com/articles/pursuing-a-career-as-a-neonatal-nurse-everything-you-need-to-know#:~:text=To%20become%20a%20NICU%20RN,of%20years%20of%20clinical%20experience.
- AHA. BLS Training. https://cpr.heart.org/en/cpr-courses-and-kits/healthcare-professional/basic-life-support-bls-training
- AHA. ACLS Training. https://cpr.heart.org/en/cpr-courses-and-kits/healthcare-professional/acls
- AACN. CCRN (Neonatal). https://www.aacn.org/certification/get-certified/ccrn-neo
- NCC. Neonatal Intensive Care Nursing. https://www.nccwebsite.org/certification-exams/details/5/neonatal-intensive-care-nursing