NICU Nursing Careers

What Does a NICU Nurse Do?

NICU nurse gloved hand holding infant hand

The very first neonatal intensive care unit (NICU) in the United States was formed at Yale-New Haven Hospital in 1960. Prior to its opening, sick or premature newborn infants received care from nurses in nurseries or pediatric areas. Today, however, NICUs can be found at practically any general care hospital, and NICU nursing has grown into a profession that requires a specific set of knowledge and sophisticated skills.

Most NICU nurses work as staff registered nurses. They are responsible for total care of infants who may be diagnosed with congenital defects, delivery complications, or most often, prematurity. They formulate nursing care plans and assess, plan, implement, and evaluate the effectiveness of treatments in these plans. On a daily basis, they administer medications, perform complex procedures, work with complicated technology, and consult with an interdisciplinary healthcare team to coordinate all aspects of a patient’s care. In the midst of all of these tasks, they comfort the infants they care for and provide education and reassurance to families.

With the evolution of the NICU specialty, careers for advanced practice registered nurses (APRNs) have proliferated. Neonatal nurse practitioners (NNPs) work in conjunction with a multidisciplinary team to assess, diagnose, initiate medical treatment orders, and perform procedures. They may also conduct research, act as consultants, and educate other nurses and health professionals. Neonatal clinical nurse specialists (CNSs) may also provide some direct patient care, but they are more likely to act as consultants, educators, researchers, or administrators. Their primary role is to evaluate and improve nursing care and to fine-tune NICU-specific hospital policies and procedures.

Workplace Details

Neonatal nurses may work in different NICUs that provide varying degrees of care. The designated level assigned to a NICU is based on the type of care provided and the extent of technology available.

  • Level II NICUs are designed for less critically ill infants who may require breathing assistance, support with feedings, or special medication. These units are usually found in community hospitals and in smaller healthcare facilities and are typically referred to as special care nurseries.
  • Level III NICUs are located in large medical centers and general-care children’s hospitals. They house infants who need advanced care, including respiratory support, diagnostic and imaging studies, and access to medical specialists.
  • Level IV NICUs provide the most sophisticated care for ill or premature infants; these facilities are often referred to as regional NICUs because infants from other healthcare centers may be transferred to these facilities for the care they provide, such as advanced life support and surgery

Nurses who work in Level II NICUs may care for up to three or four patients at a time, whereas in Level III or Level IV NICUs, the nurse-to-patient ratio is usually 1:1 or 1:2. Crying infants, medical equipment, and the presence of doctors, specialists, therapists, ancillary staff, administrators, and family members make for a somewhat noisy and busy working environment regardless of the NICU level.

Most NICU staff RNs work shifts that are 12 hours in duration, although some may work eight-hour shifts. They may be required to work days, evenings, nights, or a combination of all three. Working weekends, holidays, and overtime is also expected as part of the job, as the facility is open 24 hours a day, every day of the week. Advanced practice registered nurses work primarily during the day, but their presence and expertise may be required at any time.

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.

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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.

The median annual salary of RNs in the United States is about $67,490, according to the Bureau of Labor Statistics. The lowest 10% of salaries hover near $46,360, while the top 10% of wage earners make around $101,630 per year. Advanced practice nurses are compensated at the higher end of that range, though staff NICU RNs tend to make a little more than nurses in non-specialized care. Staff nurses with bachelor’s degrees are usually compensated more than nurses without this degree.

According to the U.S. Department of Labor, the registered nursing profession will experience 16% growth from 2014-2024. This is much faster than average growth, due in part to a large number of nurses who are expected to retire. Neonatal nursing careers at all levels will be readily available, as NICUs across the country are expanding their services to meet the complex needs for care of ill and premature babies and to continue to improve these infants’ chances of survival.

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 NICU Nurse

1

Earn a college degree and become an RN.

To become an RN, it is necessary to complete a college degree or, less commonly, a diploma from a diploma program. While it is possible to work as a staff NICU RN with a two-year associate’s degree from a community college, employers prefer to hire nurses with four-year bachelor’s degrees to work in this highly specialized environment.

Show Me Schools »

2

Get a registered nursing license.

After successful completion of an undergraduate program, a nurse needs to pass the National Council Licensure Examination (NCLEX) to get a registered nursing license. The RN license is necessary before starting work and it is also a prerequisite for entry into an APRN program.

3

Enroll in a graduate or doctorate program to become an advanced practice nurse.

Advanced practice nurses are educated in graduate programs that take two or three years. Most of these programs result in a master’s degree, but according to the American Association of Colleges of Nursing, many are changing to Doctorate of Nursing Practice (DNP) programs and a DNP may eventually be the standard terminal degree for all advanced practice nurses in the NICU.

To learn more about undergraduate- and graduate-level degrees, visit our nursing degree guide.

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Obtain the necessary experience and training.

Before working in a NICU, most nurses need some prior experience and training in a general pediatrics area or another ICU setting. The mastery of basic nursing skills is essential for adapting to the fast pace and complexity of a NICU. Training for NICU nurses is provided on the job, with six to eight weeks as a typical training duration. Some NICUs may hire new nursing graduates (especially those with bachelor’s degrees) and in these cases, training may take three months or more. All new NICU RNs are trained by other nurses who already have solid NICU experience.

For advanced practice nurses (APRNs), training is acquired in graduate school, but employer-specific training is usually necessary for several weeks under the guidance of another APRN or from a nursing supervisor.

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Become certified.

Staff NICU nurses have certification options through several organizations including the American Nurses Credentialing Center. Eligibility for certification is possible after a few years of NICU experience and successful completion of an exam. A NICU nurse may achieve certification in several areas related to neonatal care, including certification in pediatric or perinatal nursing. Advanced practice nurses have mandatory certification requirements that they must achieve before they can work in their professions; for example, an NNP must be certified as a neonatal nurse practitioner, while a neonatal CNS would most likely need certification as a pediatric critical care clinical nurse specialist for employment eligibility.

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Consider opportunities for advancement.

With some experience behind them, NICU staff nurses may become charge nurses or supervisors. With additional education, they may move on to specialty nursing roles within the NICU, such as discharge planners or case management nurses.

Advanced practice nurses may choose to specialize in a particular type of neonatal care such as cardiology, respiratory care, or prematurity. They may take their NICU experience with them to pursue a position in education, research, consulting, or healthcare administration.

Exploring Degree Paths

DIPLOMA PROGRAM

2-3 years

Diploma (hospital-based) training programs qualify students for RN licensure, but don’t confer a college degree.

Diploma programs have dwindled in number as the nursing profession moves toward higher educational standards. However, they still represent about 10 percent of entry-level training programs in nursing.

Diploma training involves a combination of classroom instruction and supervised, hands-on practice covering:

Nursing foundations

Introduces the profession of nursing as well as fundamental skills and processes.

Medical-surgical nursing

Teaches the theory and procedures needed to care for hospitalized patients.

Family nursing

Explores the role family relationships play in human health and nursing care.

Human anatomy

Students learn about the three-dimensional organization of the body and its systems.

So is a diploma program a good choice if you ultimately want to become a NICU nurse? It can be, but there are some things to consider.

First, many employers require NICU nurses to hold a Bachelor of Science in Nursing (BSN). Because you’re ultimately going to continue your education, look for a diploma program that grants college credit. Some diploma programs also have articulation (automatic transfer) agreements with local BSN programs.

Second, look for accreditation. Graduates of accredited programs have a much easier time enrolling in BSN bridge programs designed for practicing RNs. There are two nursing education accreditors in the United States:

Finally, watch out for nursing education scams. This is important for all nurses but especially those at the diploma and associate levels.

ASSOCIATE DEGREE IN NURSING (ADN)

2-3 years

There are several advantages to entering the nursing profession with an associate degree.

First, an ADN from an accredited training program is well recognized by both employers and colleges across the country. This makes it much easier to transfer your credits in order to continue your education.

Second, starting out with an ADN and working for a few years can actually save you money. Many employers will pay for RNs to earn a bachelor’s or graduate degree.

Show Me Schools »

It takes two to three years of full-time study to earn an ADN. In addition to extensive practical training, you’ll take courses like:

Advanced nursing concepts

Apply nursing theory to the care of complex patients.

Advanced pharmacology

Learn how medications affect the body and practice using them to restore health and function.

Behavioral health nursing

Practice caring for patients with mental health and substance abuse issues.

Pediatric nursing

Care for children with common health conditions and explore the family’s role in child health.

BACHELOR'S DEGREE (BSN)

1-4 years, depending on previous training

The nursing field is moving toward more stringent education requirements. Many hospitals require RNs to hold a bachelor’s degree (or earn one as a condition of hire). This is especially true of Magnet hospitals and academic health centers. Some employers, including the U.S. Public Health Service and the Veterans Administration, exclusively hire RNs who have earned a bachelor’s degree.

Formal education is especially important for students interested in NICU work. Because the environment is so complex, many employers prefer to hire neonatal RNs who are trained at the bachelor’s level.

So what makes a BSN so desirable to employers? For one, it offers training in advanced techniques that allow nurses to care for more complex patients. Second, BSN students receive extensive instruction in cultural issues that can affect healthcare. And third, they have an opportunity to study leadership, communication, and other techniques that advance their careers.

Other benefits of earning a BSN include higher salary and greater opportunities for advancement and leadership.

In addition to their clinical rotations, BSN students take courses in:

Clinical nutrition

Learn to use diet to restore and promote health.

Nursing ethics

Practice recognizing and resolving ethical dilemmas that arise in healthcare settings.

Leadership

Explore the legal, regulatory, professional, and personal dimensions of leading healthcare teams.

Public health

Develop the skills to care for patients outside traditional healthcare settings and promote community health.

There are several pathways to a BSN:

  • As a first bachelor’s degree and first nursing degree (4 years)
  • As a second bachelor’s degree (1–2 years)
  • Through a BSN bridge program designed for diploma and ADN graduates (1–2 years)

MASTER'S DEGREE IN NURSING (MSN)

2–3 years (beyond the bachelor's level)

Master’s-trained neonatal nurses care for more complex patients, perform more advanced procedures, and have more responsibility within the NICU. They also have more opportunities for leadership – both within the department and across their hospital or health system.

Graduate-level NICU nurses generally take one of two career pathways:

  • Neonatal Nurse Practitioner (NNP) – provides direct clinical care to high-risk newborns and their families. Admission to an NNP program typically requires a few years of clinical experience in neonatal nursing.
  • Clinical Nurse Specialist (CNS) – acts as a coach and consultant to improve the quality and delivery of healthcare. CNS specialties are broader than nurse practitioner specialties. Options for NICU-focused nurses include pediatric critical care CNS, pediatric CNS, and perinatal CNS.

In addition, some schools offer a dual-track master’s degree that combines CNS and NNP training.

MSN students must complete supervised clinical rotations in order to practice new skills and complete projects related to quality and care delivery. In addition, they take classes in subjects like:

Neonatal pathophysiology

Learn about common conditions affecting newborns and how these can be managed.

Advanced procedures

Practice using advanced NICU equipment and diagnostic tests to manage high-risk newborns.

Theories of instruction and learning

Improve your teaching and coaching skills by applying advanced techniques.

Underserved populations

Explore ways to meet the needs of social groups and geographic areas that have limited access to healthcare.

Many schools offer post-master’s NNP and CNS certificate programs for advance practice nurses who initially trained in a different specialty. These typically take 1–2 years to complete.

RN-to-MSN bridge programs are an option for diploma- and ADN-trained nurses who wish to advance their education.

DOCTOR OF NURSING PRACTICE (DNP)

1–2 years beyond the master's level

The DNP is the highest degree awarded to nurses who wish to continue practicing clinically (as opposed to entering academia). It’s also worth noting that professional organizations are lobbying to make the DNP the entry-level degree for all nurse practitioners, including NNPs.

Earning a DNP is a great way to make a difference. America is experiencing a nursing shortage, in part because we don’t have enough doctoral-level nurses to educate the new generation. DNPs are also in an excellent position to lead the improvement of healthcare for the benefit of patients and communities.

There are two common pathways to a DNP:

  • As a standalone DNP program (for MSNs) – 1-2 years
  • A combined MSN-DNP program (for BSNs) – 2-3 years

DNP training involves a combination of classroom and experiential learning. Candidates typically complete projects in partnership with hospitals or health systems while taking courses like:

Health care economics

Learn to manage the finances of a hospital or health system.

Evidence-based practice

Complete a project designed to improve patient health outcomes.

Quality and safety

Practice assessing and improving the effectiveness of health care delivery systems.

Organizational management

Explore how program development, strategic planning, and change management can help your hospital reach its goals.

Keys to Success as a NICU Nurse

Necessary Skills and Qualities

Awareness

Neonatal nurses must be skilled observers of infant behaviors and must know how illnesses affect patients and their families.

Problem solving skills

Quick thinking in order to make appropriate treatment decisions and to deal effectively with emergencies.

Stress management skills

Well-developed stress management skills, as NICU work can be emotionally demanding – especially when a nurse has to manage a poor prognosis, a patient’s death, or cases of neglect and abuse.

Ability to adjust

Flexibility, because a nurse’s patient caseload may change from day to day.

Communication skills

Solid skills in communication and education, particularly when teaching families how to care for an ill infant.

Attention to detail

Precise documentation is a large part of NICU nursing, and sometimes adding special touches to a care regimen can bring great comfort to patients and their families.

Additional Credentials

If you have a few years of experience as a NICU RN, you’re eligible for specialty certifications. These credentials are voluntary but can help to demonstrate your commitment to excellence and lifelong learning:

In order to work clinically in the NICU, advanced practice nurses must usually be certified in the specialty:

Voluntary certifications for CNS’s who wish to focus on neonatal care include:

National Certification Corporation offers the following subspecialty certifications for RNs and advanced practice registered nurses:

Other certifications that may be required by employers include:

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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