Neonatal Intensive Care Nurse
What is a Neonatal Intensive Care Nurse?
A Neonatal Intensive Care Nurse specializes in the care of neonates (newborns) 28 days old or less typically in a Neonatal Intensive Care Unit (NICU) in an acute care hospital. A Neonatal Intensive Care Nurse most commonly provides evidence based nursing care using advanced technologies and monitoring to deliver advanced care to newborns that will allow the premature or sick newborn to mature in a monitored environment. The NICU nurse is responsible for teaching parents and families about what is happening with the newborn and how the family can help care for the infant. The Neonatal Intensive Care Nurse works closely with neonatologists – physicians who specialize in the care of newborns.
Quick Facts about Neonatal Intensive Care Nurses:
The Bureau of Labor Statistics does not track the Neonatal Intensive Care Nurse role, so the data below is based on the closely related Registered Nurse role:
- 2015 Median Pay ( for a Neonatal Intensive Care Nurse, according to PayScale.com)
- Number of Jobs in 2014
- Job Prospects from 2014-2024
- Much faster than average
- Projected Employment in 2024
- Areas of Growth for Neonatal Intensive Care Nurses specifically
- Primarily in Level II, III, or IV Neonatal Intensive care Units
Figure 1: Accessed online from Bureau of Labor Statistics July 2016
What does a Neonatal Intensive Care Nurse do?
The NICU Nurse role is designed to provide advanced nursing care that improves patient outcomes for premature or unhealthy newborn infants. Depending on state-specific scope of practice, a Neonatal Intensive Care Nurse will do some or all of the following:
- Take nursing histories from families;
- Review the prenatal months and delivery of the newborn;
- Perform in-depth physical exam of the neonate;
- Analyze and monitor results of tests;
- Diagnose nursing problems based on the history, exam and testing;
- Create plans of care for patients and families based on the neonate’s problems and nursing diagnoses;
- Administer and monitor medication and treatments based on the plan of care;
- Evaluate the infant’s response to prescribed medications and treatments;
- Set up and monitor equipment specific to neonatal intensive care (cardiac monitors, apnea monitors, ventilators, etc.);
- Teach and collaborate with families about the findings and plan of care;
- Collaborate with and educate other members of the healthcare team.
Where do Neonatal Intensive Care Nurses work?
Historically, very premature or sick newborns died at birth. With developments in technology and prenatal care, the need for NICU nurses has increased. The care of normal newborns is now typically done by maternity nurses as the full term infants room in with the mother. This leaves primarily the sick and preterm infants to be cared for in the neonatal units.
In the United States, neonatal nurses can work in any of four levels of nurseries in the acute care setting:
- Level I nurseries are for those infants born at 34 weeks gestation or later and who are relatively healthy.
- Level II nurseries are for those newborns who may require extra time and attention before going home in a few days or weeks. These nurseries are often found in smaller hospitals.
- Level III nurseries are for those newborns who require technological and medical interventions (for example, respiratory support) that are not available in the first two levels of care. This level of nursery is typically found in large medical centers, children’s hospitals and teaching facilities.
- Level IV nurseries are for those newborns who require Level III services plus surgical or transport care. As with the Level III nursery, this level of nursery is typically found in large medical centers, children’s hospitals and teaching facilities.
The US Bureau of Labor Statistics (BLS) does not keep statistics specific to employment of Neonatal Intensive Care Nurses. Although NICU Nurses are a small subset of all Registered Nurses, in May 2015, the BLS showed the following as employment of Registered Nurses by state:
Figure 2: Accessed online from Bureau of Labor Statistics July 2016
What qualities should a Neonatal Intensive Care Nurse have to be successful?
The Neonatal Intensive Care Nurse will be working primarily with infants and their families. This fact leads to the need for a unique skill set including:
- Solid basic nursing skills;
- An exceptional understanding of normal and abnormal growth and development during the first 2 months of life;
- An ability to talk to worried families and translate medical terminology and sometimes terrifying technology into a language that a stressed family can understand;
- Understanding of the stress that a parent will experience with a sick infant and the ability to deal with that stress in a calm but authoritative manner;
- Exceptional critical thinking and problem solving skills;
- High skills with technology;
- Attention to detail since small changes in an infant can have catastrophic results.
How much can I expect to earn as a Neonatal Intensive Care Nurse?
The Neonatal Intensive Care Nurse can expect to earn a good living. Salaries will vary depending on specialization, location, experience and education. As of July 2016, the median annual wage was $60,507. Median salaries for NICU roles vary widely depending on education and role. Obviously, the neonatologist (the physician) is the highest paid. The neonatologist has spent the most in terms of time and money to earn the degree. However, the Neonatal Nurse practitioner and Case Manager also earn very good salaries and the NICU Registered Nurse has a salary in line with other RN salaries:
Figure 3: Accessed online at www.payscale.com July 2016
Of course, wages vary widely by state, cost of living, and need. Experience of the Neonatal Intensive Care Nurse has a large impact on salary with a $25,000 per year increase from the entry level through 20 years’ experience:
Figure 4: Accessed online at www.payscale.com July 2016
What are the job prospects for a Neonatal Intensive Care Nurse?
The need for Neonatal Intensive Care Nurses will continue to grow through 2024 with an expected 14% increase in the next several years. Job prospects for NICU Nurses are excellent over the next 10 years as Millenials marry and begin to have children. Technology continues to advance enabling healthcare practitioners to keep many more infants alive and thriving who would surely have died in the past.
How can I become a Neonatal Intensive Care Nurse?
A Neonatal Intensive Care Nurse must be a Registered Nurse with at least an Associate’s or Bachelor’s degree in nursing. Many hiring facilities require that the NICU Nurse will have at least one to two years of pediatric or medical surgical nursing experience in an acute care environment. Many facilities require that the nurse be certified in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS).
A Neonatal Intensive Care Nurse can elect to obtain additional formal education by obtaining an advanced practice Master’s degree as a neonatal nurse. The current recommendation of the American Association of Colleges of Nursing (AACN) is that students who want to have an advanced practice certification should have a Doctor of Nursing Practice (DNP) degree.