How To Become a Neonatal (NICU) Nurse

By Joelle Jean, FNP

January 21, 2022

Joelle Y. Jean is a family nurse practitioner and writer. She currently works at CVS Minute Clinic. She lives in Queens, NY with her husband, two little boys and cat, Zuzu.

Neonatal intensive care nurses, also known as NICU nurses, help provide various levels of care and support to newborn babies and their families. They work with neonates or babies with health problems, such as infections or cardiac defects. If you work well under pressure and are interested in helping newborns and their families, you may find being a NICU nurse to be a rewarding career.

In this article, we explain everything you need to know about becoming a NICU nurse, including what they do, their job outlook and average salary, plus answers to common questions about the career.

What does a NICU nurse do?

NICU is a subspecialty of nursing that focuses on providing care to newborns with special health care needs. Neonatal nurses may work with newborns with a variety of health concerns such as:

  • Born premature

  • Having congenital defects such as heart issues

  • Chronic health conditions such as genetic disorders

  • Surgical issues and other body malformations such as a cleft palate

NICU nurses are trained to provide care and support during a newborn's first month of life. They are also responsible for:

  • Educating families about caring for their newborns

  • Communicating with the medical team, including doctors, nurse practitioners, physician assistants, nutritionists and surgeons

  • Comfort care, including changing diapers, skincare and positioning

  • Giving medications, such as Tylenol or antibiotics

A NICU nurse works in a critical care unit. The level of care a NICU nurse may provide varies from supportive care to intensive care. NICUs are classified into four levels. They are:

  • Level I: Basic care of a newborn

  • Level II: Born at or after 32 weeks and have some health issues such as breathing problems

  • Level III: Born before 32 weeks and have serious health issues such as breathing problems or born with serious health problems

  • Level IV: Highest level of care. These newborns have critical health problems, such as heart defects, and need surgery.

Read more: Learn About Being a NICU Nurse

How to become a NICU nurse

If you’re interested in becoming a NICU nurse, you can follow these steps to get started:

1. Complete a registered nursing program

The first step to becoming a NICU nurse is to obtain a nursing degree from an accredited nursing program that is approved by your state nursing board. Nursing programs typically include coursework such as:

  • Anatomy and physiology

  • Biology

  • Chemistry

  • Psychology

  • Microbiology

  • Statistics

2. Become an RN

Some students choose to obtain an Associate Degree in Nursing (ADN) before obtaining a Bachelor of Science in Nursing (BSN). An ADN is a two-year degree in nursing. Many hospitals hire ADNs; however, some will only hire RNs with a BSN.

Upon graduating from a nursing program, you will need to pass the National Council Licensure Exam for Registered Nurses (NCLEX-RN). This will give you the license to practice as an RN. You can take this exam after you have completed an ADN or BSN.

3. Gain clinical experience

Once you have become an RN, you can begin gaining clinical experience. If you are a new graduate or a nurse who wants to transfer into the NICU, you will likely need a minimum of two years of clinical experience in neonatal care focusing on:

  • Labor and delivery

  • Pediatrics

  • Mother/Baby (Maternal-Child)

Some hospitals hire new graduates right into the NICU without experience. Usually, they offer a fellowship for those interested in working in the NICU.

4. Become certified

In addition to becoming a registered nurse and obtaining clinical experience, NICU nurses may desire to earn certifications for career advancement and skill development. One certification is the Neonatal Resuscitation Program (NRP). The NRP is typically required before hire or during the first few months of working as a NICU nurse.

NRP teaches NICU nurses how to properly take care of and help a newborn baby who isn’t doing well. It covers:

  • Cardiopulmonary Resuscitation (CPR)

  • Life-saving medications such as epinephrine, atropine, adenosine

  • Mechanical ventilation, helping the baby breathe with a machine

NICU nurses can obtain additional certifications through the National Certification Corporation (NCC). Certifications include:

  • Low-Risk Neonatal Nursing

  • Neonatal Intensive Care Nursing

Another popular certification for neonatal nurses is the Critical Care Registered Nurse- Neonatal (CCRN-Neonatal) certification. According to the American Association of Critical Care Nurses, nurses interested in this certification may work in areas such as:

  • NICUs

  • Cardiac care units

  • Combined ICU/CCUs

  • Medical/surgical ICUs

  • Trauma units

  • Critical care transport/flight

  • Experience caring for critically or acutely ill neonatal patients

These certificates can help you become a stronger candidate for a NICU nursing position, especially if you want to work at a Level III or Level IV NICU. As is common with many professional certifications, NICU nursing certifications have continuing education requirements to maintain your certification, including maintaining an unrestricted RN license.

5. Search for available jobs

Once you've gained the education and experience needed to become a NICU nurse, you are ready to begin searching for and applying to jobs. You can start by doing an online search for available NICU nurse positions in your area on Indeed.com.

It's important to research NICU nurse positions you are interested in before creating your resume so you can customize your resume to the position.

6. Create a resume

After you have found the NICU nurse positions you are interested in applying to, use the descriptions from the job postings to create a resume that highlights your greatest hiring features for those specific NICU positions. After you've completed your resume, you can return to the job posting and use the online application process to submit your application.

Related: Resume for a Pediatric Nurse Position: Crafting a Top-Quality Resume

7. Pursue advanced degree options

NICU nurses interested in advancing their careers may consider obtaining a Master of Science in Nursing (MSN) degree to become a NICU NP. Many NICU nursing programs offer MSN degrees through two-year Advanced Practice NICU Nursing programs. NICU NPs are granted greater flexibility in the type of care and treatment they are allowed to provide to newborns because of their advanced education and training.

Related: 6 Universal Rules for Resume Writing

The average salary of a NICU nurse

The national average salary for a NICU intensive care unit nurse is $1,733 per week with a salary range between $600 to $3,300 per week. NICU nurses usually work full-time positions on varying shifts. Some NICU nurses work per diem—or the days they are needed by the hospital.

The salary of a NICU nurse varies based on their level of:

  • Education

  • Experience

  • Geographic location

  • Level of NICU care they provide

  • Amount of overtime

Related: 10 Highest-Paid Nursing Jobs

Frequently asked questions about being a NICU nurse

The following are frequently asked questions about being a NICU nurse:

Do NICU nurses deliver babies?

NICU nurses who are assigned to the birth of a newborn may assist in the delivery of the baby. Their responsibilities include:

  • Weighing and measuring the baby upon birth

  • Bathing

  • Monitoring the health of the newborn

  • Providing support to the medical team and family

  • Educating new parents about newborn care and breastfeeding

What types of shifts do NICU nurses work?

A NICU nurse's shift is similar to that of other RNs. RNs usually work 12-hour shifts in the hospital or 13 shifts a month. Depending on where you work and the level of care you provide, a NICU nurse may work:

  • Eight-hour shifts

  • Nights

  • Evenings

  • Weekends

  • Holidays

What is the work environment of a neonatal nurse?

Neonatal nurses typically work in hospital settings within:

  • Labor and delivery

  • Postpartum maternity

  • Pediatrics

  • NICU

Some neonatal nurses also work in:

  • Physician's offices

  • Birthing centers

  • Other healthcare clinics

NICU nurses often work in stressful environments where they need to be able to remain calm and provide support and care to newborns and their families. It is important for NICU nurses to be quick problem-solvers who work well under pressure and have excellent communication skills.


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