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How to Become a Neonatal Nurse

What Does a Neonatal Nurse Do?

neonatal nurse with infant incubator

The first few weeks of an infant’s life are a time of changes, transitions and challenges unique to this stage of existence. Neonatal nurses are the experts who care for newborns in a nursery setting; the neonatal period is considered to be the first 28 days of an infant’s life, but neonatal nurses may work with babies for much longer. The care that a neonatal nurse provides depends upon the baby’s gestational age, the method of delivery, and the infant’s overall health. Nursing care ranges from intensive care of critically ill neonates to monitoring infants who are entirely well and who are only occasionally in the nursery when they are not sharing a room with Mom and Dad.

Over the past 50 years, advances in medical technology have made it possible for more ill and premature babies to survive and thrive. These changes have expanded the range of responsibilities for neonatal nurses and the spectrum of care they provide. Neonatal nurses formulate, implement and evaluate care plans for these tiny patients. They administer vaccines and medications, assist with diagnostic tests, and operate sophisticated medical equipment such as ventilators, incubators and phototherapy lamps. They also maintain patient records and provide support and education to parents regarding their baby’s unique circumstances and future care requirements.

Most neonatal nurses are registered nurses who work in hospital nurseries or neonatal intensive care units. These nurses have experience and specific training to meet the particular needs of infants. Many neonatal nurses also work as advanced practice registered nurses (APRNs), such as neonatal nurse practitioners (NNPs) and neonatal clinical nurse specialists (CNSs). Advanced practice registered nurses have specialized knowledge and may provide direct care to patients, educate staff or conduct research. Regardless of their level of practice, most neonatal nurses believe that there are few undertakings more rewarding than nursing sick infants to wellness and seeing them leave the hospital with their parents.

Workplace Details

Historically, new mothers and their babies stayed in the hospital for a week or more after delivery. Most neonatal nurses worked in hospital nurseries, caring for babies while new mothers recovered. Today, with very brief hospital stays and the availability of rooming-in options, the nursing care of healthy babies falls largely to maternity nurses.

A small percentage of neonatal nurses care for healthy babies in level I nurseries that are designed for healthy, full-term newborns and for babies born between 34 and 37 weeks gestation – known as late preterm infants – without health complications. However, most neonatal nurses work primarily in neonatal intensive care units (NICUs). Depending on the hospital, a NICU may be defined according to different levels.

  • A level II nursery houses premature or sick babies who may need extra time in the hospital for oxygen, medication or special feedings. These babies are expected to recover and go home within a few days or weeks. Level II nurseries are often located in community hospitals and in smaller facilities.
  • Level III nurseries are designed for premature and ill babies who need high-tech medical and nursing care, including specialized respiratory support and care of critical illness
  • Level IV nurseries provide care for the most complex conditions; they offer the services of level II and III nurseries, but may also include surgical care and transport of critically ill infants

Level III and IV NICUs are found in most large metropolitan hospitals or in specialized children’s hospitals. A nurse who works in a NICU can expect irregular hours and shift work (including weekends and holidays) to accommodate the needs of the babies in her care.

Some neonatal nurses may also work in community settings or in home care situations where they care for babies who are transitioning out of the hospital. They may meet with families in their homes and provide education to parents who are getting ready to bring their babies home from the hospital. The work hours in these settings are typically closer to normal business hours.

Salary and Job Outlook

State
Average Wage
California
$101750
Texas
$70390
New York
$80830
Florida
$64630
Pennsylvania
$68770

Hover over any state to explore local income and job growth data.

Created with Raphaël 2.1.0 AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

ALABAMA

Median Salary: 
$55,500
Bottom 10% (Entry Level): $41,600
Top 10% (Lots of Experience): $76,000

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 1,870

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Birmingham$43,240$57,670$77,370
Huntsville$41,840$56,800$75,450

ALASKA

Median Salary: 
$88,100
Bottom 10% (Entry Level): $65,200
Top 10% (Lots of Experience): $116,900

2014-2024 Job Growth: 10%
Projected Annual Job Openings: 190

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Anchorage$65,100$88,940$117,550
Fairbanks$69,190$98,120$119,580

ARIZONA

Median Salary: 
$71,500
Bottom 10% (Entry Level): $52,400
Top 10% (Lots of Experience): $96,100

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 3,500

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Phoenix$52,850$73,400$97,630
Tuscon$52,510$67,590$82,510

ARKANSAS

Median Salary: 
$55,700
Bottom 10% (Entry Level): $40,100
Top 10% (Lots of Experience): $76,700

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 870

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Little Rock$42,070$60,690$84,170
Fort Smith$39,910$52,140$63,430

CALIFORNIA

Median Salary: 
$100,400
Bottom 10% (Entry Level): $64,400
Top 10% (Lots of Experience): $147,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 10,470

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Los Angeles$63,400$95,940$129,340
San Francisco Bay$83,120$132,970$167,920
San Diego$57,610$85,470$126,550
Sacramento$67,060$116,690$155,890

COLORADO

Median Salary: 
$68,500
Bottom 10% (Entry Level): $51,200
Top 10% (Lots of Experience): $95,100

2014-2024 Job Growth: 33%
Projected Annual Job Openings: 2,350

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Denver$51,510$70,580$97,080
Colorado Springs$51,430$63,590$88,590

CONNECTICUT

Median Salary: 
$76,500
Bottom 10% (Entry Level): $55,300
Top 10% (Lots of Experience): $100,700

2014-2024 Job Growth: 6%
Projected Annual Job Openings: 990

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Hartford$55,130$76,020$97,630
Bridgeport$56,590$75,830$103,110
New Haven$57,470$78,720$105,440

DELAWARE

Median Salary: 
$71,100
Bottom 10% (Entry Level): $53,800
Top 10% (Lots of Experience): $93,300

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 420

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Wilmington$54,470$72,460$93,860
Dover$52,740$64,500$84,490

DISTRICT OF COLUMBIA

Median Salary: 
$79,600
Bottom 10% (Entry Level): $55,300
Top 10% (Lots of Experience): $103,800

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 380

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Washington DC$53,890$76,030$101,360

FLORIDA

Median Salary: 
$62,100
Bottom 10% (Entry Level): $46,100
Top 10% (Lots of Experience): $82,900

2014-2024 Job Growth: 25%
Projected Annual Job Openings: 8,110

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Miami$50,250$65,560$91,660
Orlando$43,490$61,570$79,250
Tampa$49,770$62,990$84,660
Jacksonville$48,910$61,610$79,810

GEORGIA

Median Salary: 
$63,100
Bottom 10% (Entry Level): $44,200
Top 10% (Lots of Experience): $80,900

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 2,980

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Atlanta$47,500$67,010$82,160
Augusta$46,880$65,910$88,340

HAWAII

Median Salary: 
$92,300
Bottom 10% (Entry Level): $63,400
Top 10% (Lots of Experience): $119,400

2014-2024 Job Growth: 13%
Projected Annual Job Openings: 400

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Honolulu$63,930$93,970$120,600

IDAHO

Median Salary: 
$61,000
Bottom 10% (Entry Level): $44,600
Top 10% (Lots of Experience): $78,400

Job Growth Data Not Available

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Boise$46,390$61,760$78,900

ILLINOIS

Median Salary: 
$67,100
Bottom 10% (Entry Level): $45,600
Top 10% (Lots of Experience): $99,600

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 3,970

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Chicago$51,580$73,220$103,790
Rockford$43,920$59,400$87,180

INDIANA

Median Salary: 
$57,900
Bottom 10% (Entry Level): $41,900
Top 10% (Lots of Experience): $78,600

2014-2024 Job Growth: 19%
Projected Annual Job Openings: 2,510

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Indianapolis$43,290$61,450$81,840
South Bend$43,460$58,310$76,100
Fort Wayne$40,640$53,490$73,350

IOWA

Median Salary: 
$53,900
Bottom 10% (Entry Level): $40,700
Top 10% (Lots of Experience): $73,800

2014-2024 Job Growth: 16%
Projected Annual Job Openings: 1,280

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Des Moines$41,010$56,420$75,160
Cedar Rapids$39,730$50,730$74,600

KANSAS

Median Salary: 
$56,300
Bottom 10% (Entry Level): $41,700
Top 10% (Lots of Experience): $76,600

2014-2024 Job Growth: 8%
Projected Annual Job Openings: 760

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Wichita$41,060$51,440$72,980
Kansas City$44,940$63,260$81,370

KENTUCKY

Median Salary: 
$58,000
Bottom 10% (Entry Level): $42,600
Top 10% (Lots of Experience): $77,000

2014-2024 Job Growth: 36%
Projected Annual Job Openings: 2,670

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Louisville$44,330$61,510$78,730
Lexington$44,220$59,870$76,890

LOUISIANA

Median Salary: 
$59,800
Bottom 10% (Entry Level): $42,900
Top 10% (Lots of Experience): $83,300

2014-2024 Job Growth: 16%
Projected Annual Job Openings: 1,910

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
New Orleans$49,930$66,140$99,220
Baton Rouge$42,650$56,830$78,160
Lafayette$40,670$55,480$80,510

MAINE

Median Salary: 
$62,800
Bottom 10% (Entry Level): $46,400
Top 10% (Lots of Experience): $85,900

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 510

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Portland$49,850$64,470$91,370
Lewiston$45,100$63,890$78,040

MARYLAND

Median Salary: 
$72,100
Bottom 10% (Entry Level): $53,400
Top 10% (Lots of Experience): $97,500

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 3,250

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Baltimore$53,920$72,460$98,440
Frederick$55,480$75,920$98,980

MASSACHUSETTS

Median Salary: 
$83,900
Bottom 10% (Entry Level): $55,200
Top 10% (Lots of Experience): $135,000

2014-2024 Job Growth: 7%
Projected Annual Job Openings: 2,490

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Boston$60,060$92,190$145,530
Worcester$52,460$82,700$142,480
Springfield$47,590$72,530$101,550

MICHIGAN

Median Salary: 
$65,800
Bottom 10% (Entry Level): $50,600
Top 10% (Lots of Experience): $89,400

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 3,370

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Detroit$52,500$69,600$105,020
Grand Rapids$48,130$60,180$76,730

MINNESOTA

Median Salary: 
$72,100
Bottom 10% (Entry Level): $49,400
Top 10% (Lots of Experience): $98,400

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 2,010

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Minneapolis - St. Paul$53,730$77,400$100,460
Rochester$41,210$59,810$94,640

MISSISSIPPI

Median Salary: 
$55,600
Bottom 10% (Entry Level): $40,200
Top 10% (Lots of Experience): $77,500

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 1,070

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Jackson$42,150$60,990$88,630
Gulfport$42,590$57,050$76,120

MISSOURI

Median Salary: 
$57,800
Bottom 10% (Entry Level): $41,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 2,530

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
St. Louis$42,050$59,020$83,960
Kansas City$44,940$63,260$81,370

MONTANA

Median Salary: 
$60,700
Bottom 10% (Entry Level): $47,300
Top 10% (Lots of Experience): $81,200

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Billings$51,200$62,670$88,330
Missoula$50,750$62,420$87,110

NEBRASKA

Median Salary: 
$58,000
Bottom 10% (Entry Level): $42,800
Top 10% (Lots of Experience): $77,600

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 840

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Omaha$43,460$59,630$80,340
Lincoln$42,500$56,230$75,400

NEVADA

Median Salary: 
$81,400
Bottom 10% (Entry Level): $58,800
Top 10% (Lots of Experience): $104,200

2014-2024 Job Growth: 19%
Projected Annual Job Openings: 860

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Las Vegas$62,700$84,080$108,390
Reno$55,940$75,620$98,560

NEW HAMPSHIRE

Median Salary: 
$65,400
Bottom 10% (Entry Level): $47,100
Top 10% (Lots of Experience): $93,000

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 490

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Manchester$46,320$67,900$94,190
Nashua$46,310$63,890$91,400

NEW JERSEY

Median Salary: 
$79,200
Bottom 10% (Entry Level): $57,200
Top 10% (Lots of Experience): $102,900

2014-2024 Job Growth: 13%
Projected Annual Job Openings: 3,000

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Newark$58,110$81,250$104,130
Trenton$52,450$71,710$93,130

NEW MEXICO

Median Salary: 
$64,700
Bottom 10% (Entry Level): $50,800
Top 10% (Lots of Experience): $87,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 660

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Albuquerque$52,550$66,430$88,630
Las Cruces$27,720$60,700$92,420

NEW YORK

Median Salary: 
$78,000
Bottom 10% (Entry Level): $52,300
Top 10% (Lots of Experience): $111,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 7,450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
New York City$62,140$86,520$116,630
Buffalo$50,970$70,090$93,740
Rochester$46,960$60,760$77,900
Albany$44,640$61,640$79,960

NORTH CAROLINA

Median Salary: 
$58,900
Bottom 10% (Entry Level): $43,300
Top 10% (Lots of Experience): $79,700

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 4,190

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Charlotte$44,010$59,750$78,850
Raleigh$44,970$60,090$79,230
Greensboro$43,130$61,120$86,440
Winston - Salem$43,770$58,270$77,490

NORTH DAKOTA

Median Salary: 
$57,900
Bottom 10% (Entry Level): $43,400
Top 10% (Lots of Experience): $75,700

2014-2024 Job Growth: 24%
Projected Annual Job Openings: 400

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Fargo$43,820$58,380$76,530
Bismarck$43,580$57,070$73,580

OHIO

Median Salary: 
$61,300
Bottom 10% (Entry Level): $47,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 4,830

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Cleveland$52,280$65,220$80,050
Columbus$46,330$61,330$90,830
Cincinnati$47,490$62,580$81,990
Dayton$48,440$59,850$78,710

OKLAHOMA

Median Salary: 
$58,400
Bottom 10% (Entry Level): $42,700
Top 10% (Lots of Experience): $77,000

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 1,160

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Oklahoma City$43,130$60,220$78,470
Tulsa$43,630$58,820$76,640

OREGON

Median Salary: 
$85,200
Bottom 10% (Entry Level): $61,000
Top 10% (Lots of Experience): $109,000

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 1,280

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Portland$58,970$86,940$112,620
Salem$63,450$80,010$103,720

PENNSYLVANIA

Median Salary: 
$65,700
Bottom 10% (Entry Level): $47,200
Top 10% (Lots of Experience): $93,700

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 4,890

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Philadelphia$53,320$76,110$100,010
Pittsburgh$47,760$61,520$80,320
Harrisburg$51,160$64,360$92,930
Allentown$51,170$63,980$86,160

RHODE ISLAND

Median Salary: 
$76,300
Bottom 10% (Entry Level): $55,400
Top 10% (Lots of Experience): $98,000

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Providence$55,000$76,050$99,370

SOUTH CAROLINA

Median Salary: 
$59,300
Bottom 10% (Entry Level): $42,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 1,600

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Greenville$42,380$57,960$77,620
Columbia$33,930$57,080$78,000
Charleston$49,680$65,020$92,470

SOUTH DAKOTA

Median Salary: 
$53,400
Bottom 10% (Entry Level): $41,000
Top 10% (Lots of Experience): $74,700

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 420

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Rapid City$42,750$57,830$75,800

TENNESSEE

Median Salary: 
$56,800
Bottom 10% (Entry Level): $41,800
Top 10% (Lots of Experience): $76,300

2014-2024 Job Growth: 25%
Projected Annual Job Openings: 2,440

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Nashville$41,930$58,810$78,640
Memphis$46,000$60,500$78,810
Knoxville$40,920$54,240$70,650
Chattanooga$41,680$56,130$74,340

TEXAS

Median Salary: 
$68,600
Bottom 10% (Entry Level): $50,100
Top 10% (Lots of Experience): $95,000

2014-2024 Job Growth: 31%
Projected Annual Job Openings: 10,820

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Dallas - Ft. Worth$52,170$71,920$96,640
Houston$55,040$76,670$98,900
San Antonio$45,920$65,450$89,960
Austin$51,570$66,340$86,640

UTAH

Median Salary: 
$59,700
Bottom 10% (Entry Level): $44,200
Top 10% (Lots of Experience): $79,200

2014-2024 Job Growth: 33%
Projected Annual Job Openings: 1,150

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Salt Lake City$46,020$61,730$81,490
Ogden$42,940$57,090$76,880

VERMONT

Median Salary: 
$62,800
Bottom 10% (Entry Level): $47,900
Top 10% (Lots of Experience): $91,000

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 230

VIRGINIA

Median Salary: 
$63,600
Bottom 10% (Entry Level): $43,400
Top 10% (Lots of Experience): $90,900

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 2,380

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Virginia Beach$43,130$61,350$79,450
Richmond$44,170$64,510$85,180

WASHINGTON

Median Salary: 
$77,000
Bottom 10% (Entry Level): $52,900
Top 10% (Lots of Experience): $110,000

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 2,470

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Seattle$55,410$80,960$113,850
Spokane$50,630$73,400$104,950

WEST VIRGINIA

Median Salary: 
$56,700
Bottom 10% (Entry Level): $40,500
Top 10% (Lots of Experience): $78,400

2014-2024 Job Growth: 8%
Projected Annual Job Openings: 590

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Huntington$39,560$55,600$76,120
Charleston$41,380$55,920$75,860

WISCONSIN

Median Salary: 
$65,100
Bottom 10% (Entry Level): $49,900
Top 10% (Lots of Experience): $90,000

2014-2024 Job Growth: 10%
Projected Annual Job Openings: 1,860

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Milwaukee$51,600$67,980$91,900
Madison$54,670$73,910$100,370

WYOMING

Median Salary: 
$60,800
Bottom 10% (Entry Level): $44,000
Top 10% (Lots of Experience): $81,000

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 210

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Cheyenne$47,920$64,100$88,730
Casper$40,880$57,560$77,510

Click here to see interactive state-by-state information for nurse practitioners.

Collectively, RNs in the US have a median annual salary of $67,490 according to the Bureau of Labor Statistics (BLS); the lowest paid 10 percent earn a median $46,360, while the highest paid 10 percent earn a median $101,630 yearly. Salaries tend to be higher on both coasts and in major Midwest cities. Higher educational levels typically translate to higher salaries.

Neonatal nurses who become APRNs will enjoy higher salaries. The BLS reports that nurse practitioners make a median salary of $98,190.

The Bureau of Labor Statistics predicts job growth of 16% for all RNs and growth of 31% for nurse practitioners between 2014 and 2024, which is much faster than average. According to the Centers for Disease Control and Prevention, one out of every eight babies born in the US is affected by prematurity, so there is no shortage of work for neonatal nurses. Employers more often prefer a neonatal RN with a bachelor’s degree, experience, and certification.

Because of advances in research and technology, the neonatal nursing profession is in particular need of NNPs and CNSs. These professionals have a high level of expertise and an ability to contribute valuable knowledge and services to the neonatology specialty.

Compare Salaries by City

New York City NY Median Pay

$86520 Per Year

$41.59 Per Hour

Los Angeles CA Median Pay

$95940 Per Year

$46.12 Per Hour

Steps to Become a Neonatal Nurse

1

Complete your undergraduate education.

It is necessary to obtain an undergraduate education before becoming a neonatal registered nurse. Community colleges offer associate degrees in nursing, which are usually two-year programs, whereas university-level institutions offer bachelor’s degrees, which are four-year programs. More rarely, diploma programs offered by hospitals and large health systems allow students to earn non-degree nursing diplomas. None of these programs offer nursing specialty tracks, but some may have optional neonatal nursing electives available. Nurses entering the work force with a bachelor’s degree are generally at an advantage compared to those with an associate degree or diploma.

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2

Become licensed by the state.

Following graduation, aspiring RNs must pass the National Council Licensure Examination (NCLEX) to receive a state license. Other state-specific requirements for licensure may include background checks and education verification.

3

Consider enrolling in a graduate and/or doctorate program.

If your goal is to become a neonatal nurse as an RN, then you can skip this step and proceed to step 3. Aspiring neonatal advanced practice nurses must complete either a master’s degree or a Doctor of Nursing Practice degree in neonatal nursing. Current standards state that nurses who want to become APRNs need only to complete a master’s degree program; however, the American Association of Colleges of Nursing (AACN) has recommended that students who want to practice advanced nursing achieve a Doctor of Nursing Practice (DNP) degree. The transition to making the DNP a requirement for all students in all programs is still in process. There are many programs available that offer both master’s and doctoral degrees in nursing; these graduate programs are typically two to three years in length.

4

Complete the necessary training.

Nursing training starts during school in skills labs and real-world clinical settings. After graduation, training is provided by the employer, both through classes and in the NICU through a mentorship or preceptor program. This formal training may take six weeks to three months, depending on a nurse’s prior experience and facility requirements. Some facilities may expect new nursing graduates to have a year or two of general nursing or maternal nursing experience before working in a NICU. Advanced practice nurses receive intensive training in graduate school and then further training after graduation and while working.

5

Get certified in a specialty.

Some neonatal nurses are required to gain specialty certification as part of their employment. For example, a hospital that employs neonatal nurses to work in the NICU may require that all nurses have extra certification in neonatal advanced life support training.

Once a neonatal RN has been working for a period of time, she or he may apply for certification through a national certifying body such as the American Nurses Credentialing Center (ANCC). Being certified means that a nurse has demonstrated expertise in a particular specialty. The certification process usually involves demonstrating that she has worked a certain number of hours within the specialty and then has passed an examination. In most cases, advanced practice nurses must be certified before they begin working.

6

Keep certifications and licenses active.

To maintain licensure and/or certification, nurses must verify active experience and must accrue continuing education credits, which are offered by employers or professional organizations. The number of continuing education credits required in order to maintain licensure varies from state to state.

7

Consider further education and opportunities for growth.

Because care of NICU babies involves a great amount of varied and specialized knowledge, neonatal nurses have ample opportunities to branch out within their field. Neonatal RNs can opt for a graduate education in an advanced practice specialty. Alternately, they may work in leadership, education of families and other staff, or in research. Advanced practice nurses have the option of moving into management roles such as university educators, healthcare executives or researchers.

Exploring Degree Paths

DIPLOMA IN NURSING

2-3 years

Historically, RNs trained on the job in the hospital. These diploma programs are increasingly rare but still exist in many parts of the country.

Diploma programs in nursing are sponsored by hospitals or health systems. In many cases, the hospital partners with a local community college or university, and students receive college credit for coursework.

Common diploma program courses include:

Anatomy and physiology with lab

Take a firsthand look at the organization and function of human body systems through dissection and medical imaging.

Developmental psychology

Learn how people change physically, socially, and intellectually across a lifetime from conception to death.

Health assessment

Gather diagnostic information by examining patients and taking a health history.

Microbiology

Learn how viruses, bacteria, fungii, and protozoa affect the human body and its systems.

The big downside of a diploma program is that it doesn’t grant a college degree. This can sometimes make things challenging if you later want to advance your education. When choosing a diploma program, look for one that awards college credit or has a clear articulation agreement with an RN-to-BSN bridging program.

In recent years, unaccredited for-profit schools have targeted nursing students, especially at the diploma and associate degree level. Credentials from these schools may not be recognized by state nursing boards or employers. To avoid these “diploma mills,” always look for a nursing program accredited by the Accreditation Commission for Education in Nursing (ACEN).

ASSOCIATE DEGREE IN NURSING

2-3 years

The majority of nurses today enter the field with an Associate Degree in Nursing (ADN) — also known as an Associate of Science in Nursing, or ASN. ADN programs take about as long as a diploma program to complete and cover much of the same coursework. However, you’ll graduate with a recognized degree, which makes it easier to continue your education later.

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Unlike diploma programs, which are hospital-based, ADNs are typically offered through community colleges and universities. Coursework overlaps quite a bit with the diploma curriculum, but might include:

English composition

Practice writing for a variety of purposes, audiences, and contexts.

Pathophysiology

Study how common diseases and processes affect the body’s function.

Pharmacology

Learn how different categories of medications affect the body.

Mental health nursing (and other specialty areas)

Take a closer look at the theory and techniques used to manage a certain patient population.

In addition to their coursework, nursing students practice their skills under supervision at local hospitals, health systems, and clinics.

BACHELOR OF SCIENCE IN NURSING (BSN)

4 years (for a first nursing degree)

A BSN degree offers the most career opportunity and flexibility for RNs. BSN-prepared nurses can practice in almost every RN specialty. Hospitals and health systems strongly prefer a bachelor’s degree, especially when hiring neonatal RNs. Some employers hire ADNs on the condition that they will earn a BSN within a few years.

Some RNs enter the field with a bachelor’s degree. However, many enter with a diploma or ADN and practice for a few years before returning to complete a BSN. Many colleges offer bridging programs designed for practicing RNs who want to advance their education to the bachelor’s or master’s level.

If you’re interested in nursing and already hold a bachelor’s degree in another subject, look into accelerated BSN programs, which allow you to earn a BSN in as little as one to two years.

Nursing coursework at the bachelor’s level typically includes:

Nursing law and ethics

Study values conflicts and dilemmas that arise in healthcare settings and models to address these.

Advanced assessment

Integrate your knowledge of sociology, psychology, and cultural competence into your diagnoses and care plans.

Cultural competence

Learn how differences like race and gender impact patients’ experiences of health and disease.

Education theory

Develop the knowledge and skills you need to effectively teach patients and families.

Like their ADN counterparts, BSN students receive extensive practical training at teaching hospitals.

MASTER OF SCIENCE IN NURSING (MSN)

2-3 years (beyond bachelor's level)

An MSN is currently required to practice as an advanced practice registered nurse. In the neonatal setting, this usually means certification as a Neonatal Nurse Practitioner (NNP).

It’s worth noting that professional organizations are working on increasing the entry requirement for advanced practice RNs to a doctorate. (More on that in the next section.)

NNP programs are offered by colleges and universities. Admission usually requires a couple of years of nursing experience with newborns or infants. Coursework covers:

Neonatal pathophysiology

Study the development and management of diseases affecting newborns.

Prevention and population health

Looks at how hospitals can help to promote maternal and infant health in their communities.

Nursing leadership

Prepares nurses to manage the work of others and lead projects within their hospitals.

Cultural and ethical issues

Apply philosophy, ethical principles, and cultural and existential approaches to issues affecting critically ill children and their families.

NNP candidates also complete a residency in which they rotate through neonatal ICUs at several hospitals.

DOCTOR OF NURSING PRACTICE (DNP)

1-2 years (beyond the master's level)

The American Association of Colleges of Nursing has recommended that all advance practice nurses hold a DNP. It’s therefore likely that a doctoral degree will be required to work as an advanced practice neonatal nurse in the future (though practicing nurses will likely be grandfathered in to some degree).

The DNP is the top (terminal) degree for nurses who wish to pursue clinical practice rather than research and teaching. It prepares nurses to lead improvements in quality and safety as well as bring the latest research into their hospitals. Colleges and universities offer both post-master’s DNP programs and combined MSN-DNP programs. (The latter takes about 2-3 years to complete.)

DNP candidates can expect to study:

Informatics

Apply technology to gather data that can help to improve nursing practice and patient outcomes.

Evidence-based practice

Examine how knowledge is generated and evaluated through research and how this evidence guides patient care.

Statistics

Evaluate the logic underlying nursing research through the application of descriptive mathematics.

Epidemiology

Study the distribution of diseases and their risk factors across populations.

DNP candidates also complete a scholarly project in an area of interest, often in partnership with a faculty member or hospital.

Keys to Success as a Neonatal Nurse

Necessary Skills and Qualities

Critical thinking skills

Neonatal nurses must have well-honed critical thinking skills to keep up with the rapidly changing health status of a typical NICU patient.

Attention to detail

Being detail-oriented is crucial in order to manage various technologies and equipment needed for infant care.

Interpersonal skills

Neonatal nurses need to have patience, compassion, and the ability to communicate complex concepts, and they must be able to teach infant care skills to parents from all backgrounds.

Professionalism

They have to maintain emotional objectivity when faced with ethically charged situations, such as neglect or a patient’s death.

Teamwork skills

Neonatal nurses must also be able to work effectively with a large interdisciplinary healthcare team.

Additional Credentials

For RNs, certification in neonatal nursing is optional but can be a good way to demonstrate your experience and commitment to the profession. Both of the following credentials require you to pass an exam and meet experience requirements.

Many hospitals now require advanced practice nurses working in the NICU to be certified as Neonatal Nurse Practitioners. The NNP credential is administered by the National Certification Corporation. Candidates must be graduates of an accredited NNP preparation program.

National Certification Corporation also offers subspecialty certification for both RNs and advanced practice registered nurses. Real-life experience is helpful but not required for certification.

Many employers require neonatal nurses to either hold or complete the following certifications:

Meg Brannagan, RN, BSN

Meg Brannagan is a registered nurse with over fifteen years of experience working in clinical care, including pediatrics, obstetrics, and general surgery. She has spent a significant amount of time working as a neonatal nurse in a Level III NICU, and has served the needs of ill and premature infants and their families through bedside nursing care and neonatal transport. Meg spent the last several years working to meet the needs of medically fragile infants and young children.

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