On Being a Neonatal Nurse

| Roxanne Blanford

If you think it takes a special kind of person to become a nurse, imagine what it's like to dedicate yourself to the neonatal nursing profession. Neonatal nurses care for the most delicate of patients: well newborns, preemies, neonates, and critically-ill babies.

In addition, these nurses are on the front lines when it comes to helping new parents and loved ones maneuver through health crises which are often heart-wrenchingly traumatic experiences. 

According to the National Association of Neonatal Nurses (NANN), there are approximately 40,000 low-birth-weight infants born each year in the United States. Not all of these babies make it past the first 4 weeks of life outside the womb. But thanks to advances in medicine and training, and to the hard work of highly skilled NICU nurses and other healthcare professionals, survival rates are continuing to improve. 

"I was fortunate enough to follow a 24-week baby throughout her hospitalization ... She fought her way through surgeries, infections, countless procedures, and immeasurably high stakes. I held her mother’s hand as (the baby girl) was emergently placed on the oscillator, wiped away tears as she went through narcotic withdrawal... she was discharged to home after months in our NICU; she truly was the ultimate success story."


What is a Neonatal Nurse?

A neonatal nurse is a registered nurse. He/she may have an associate, baccalaureate, master's or doctoral degree, and/or a diploma from a hospital-based school of nursing. Neonatal nurses may also be certified in their area of specialty.

Neonatal nurses provide different levels of care to babies ranging from healthy newborns and sick or premature babies to babies who have serious birth defects, severe illnesses or other critical, life-threatening problems. 

Neonatal nursing generally involves care for newly-born infants in crisis, but may additionally encompass neonates who suffer from long-term problems related to being born early, or from some severe illness encountered soon after birth. Some neonatal nurses may even care for babies up to about 2 years of age. However, most care for infants from birth until they are well enough to be discharged from the hospital.

Basic Skills

Each healthcare institution may establish its own practice standards for neonatal nurses, but most expect the nurse to be always on the alert and capable of rapidly responding to any incident or status change that may cause harm to the neonate, such as temperature fluctuations, skin discoloration, or excess/inadequate oxygen supply. Additional care responsibilities may include:

  1. management of intravenous lines
  2. medication administration
  3. newborn CPR
  4. neonatal resuscitation
  5. using feeding tubes, incubators, ventilators, and transfusion equipment

Some babies may have severe respiratory problems. Others may need a tracheostomy, or require a tube to be inserted through the chest wall to keep their lungs expanded. The neonatal nurse must be competent to manage all of these situations, at a minimum.

CAE Luna: Baby simulator for tracheostomy care

"The NICU environment is a harsh reality for so many patients and families. It’s the little things that can make such a huge difference for a family and can bring such a huge smile to their faces."  


Aptitudes and Attributes of the Neonatal Care Nurse

The neonatal nurse must be able to educate and support the infant’s parents, who may be stressed or frightened. Though the primary patients for Neonatal Intensive Care Unit (NICU) nurses are the sick and/or premature newborn babies who need to be cared for and monitored (sometimes for weeks or months), NICU nurses also need to possess empathetic critical thinking and communication skills, along with compassion, stability, and patience in order to tend to the needs of worried new mothers and new fathers.

Nurses who care for neonates must remain ever alert and be detail-oriented so that they can consistently provide the best of care to infant patients. And, with multiple babies under their care, these nurses must be able to prioritize and organize their workload so that adequate care is administered correctly to each child.

Neonatal nurses need to possess maturity and be emotionally stable at all times. They must demonstrate the ability to cope with the stress while staying strong, upbeat and as objectively detached as possible. But they also need to know that it is alright to be human and to show genuine care and concern. Emotional balance provides strength and comfort to families while allowing the nursing staff to assert humanity as they focus on the challenges of their profession.



Professional Training of the Neonatal Nurse*

Before becoming a NICU nurse, it is mandatory to first achieve Registered Nurse status and to also  

  • graduate from a program of study that is approved by the State Nursing Board
  • pass the NCLEX-RN
  • acquire two or more years of clinical experience working with neonatal patients before applying to take a certification exam for neonatal nursing


Clinical experience should cover the following units: 

  • Pediatric Nursing
  • Maternal-Child Nursing
  • Well Baby Nursing
  • Labor and Delivery Nursing

Additional certifications that all NICU nurses should pursue include:

  • Basic Life Support (BLS)
  • Neonatal Resuscitation Program (NRP)

Get to Know CAE Luna: The Only Baby Simulator You May Ever Need

Attain comprehensive neonatal assessment training, and so much more, with CAE Luna from CAE Healthcare.
CAE Luna offers several distinctive features for quality training in neonatal care, including laryngospasm management capability, and spontaneous breathing options with variable respiratory rate and breathing patterns.

Built on a configurable and expandable platform (Base, Live, Advanced) with unique and comprehensive configuration options that allow for progressive skills development from essential newborn nursing protocols, S.T.A.B.L.E., and Neonatal Resuscitation Program (NRP) skills, to Pediatric Advanced Life Support (PALS) training requirements, CAE Luna offers the best preparation for safe and effective care of a neonate.


National Association of Neonatal Nurses

Neonatal Intensive Care: Career Guide. Nurse.Org



*Please note: this is not a complete list of educational and clinical requirements for entering the neonatal nursing profession. Please consult reputable nursing resources and educational sources for more specific and detailed information.

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