How to Become a Neonatal Nurse

Holland Webb, MA
Updated July 12, 2023
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Neonatal nurses provide care to babies less than 28 days old. Most of these newborns need serious medical attention. Although the work presents emotional and mental challenges, neonatal nurses can enjoy the rewards of helping newborns and their families.

To become a neonatal nurse, students must obtain a nursing degree, complete licensure requirements, gain experience, and earn relevant certificates. Neonatal nurses can pursue graduate education and career opportunities to become nurse practitioners, earning a $111,670 median annual salary as of May 2020, according to the Bureau of Labor Statistics (BLS).

The page below explores in more detail the steps required to become a neonatal nurse.

Read the Specifics:Required Education | Required Credentials | Steps to Become a Neonatal Nurse | FAQs

What Is a Neonatal Nurse?

Neonatal nurses work with newborn infants with problems such as congenital disorders, infections, or low birth weight. Often, these medical challenges stem from premature birth, making neonatal patients among the most fragile residents in medical facilities.

Generally, neonatal nurses work in the newborn (or neonatal) intensive care unit (NICU). NICU nurses’ work requires excellent judgment, quick reactions, empathetic conversational skills, and vast medical knowledge. With experience and further education, neonatal nurses may become nurse managers, nurse specialists, or nurse practitioners.

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Required Neonatal Nursing Education

Neonatal nurses must hold at least a diploma or associate degree in nursing. Because of NICU patients’ vulnerability and the complexities of their medical situations, many employers require neonatal nurses to hold a bachelor’s degree at a minimum.

NICU nurses also typically pursue specialized certificates in neonatal pediatric transport, advanced cardiovascular life support, or electronic fetal monitoring. Holding one or more NICU-related certificates can make a neonatal nurse more competitive in the job market.

Nurses who want to specialize, earn more money, or take on leadership roles should consider graduate study. By pursuing a master’s degree or doctorate in nursing, neonatal nurses can advance to providing primary care for their patients as nurse practitioners (NPs).

Becoming an NP requires experience in NICU patient care along with graduate education and other licensure requirements. A master’s degree can also equip neonatal nurses to become nurse midwives, who usually earn higher salaries than registered nurses.

Experience Requirements for Neonatal Nurses

A neonatal nurse must hold licensure as a registered nurse. Technically, a nurse with an associate degree, RN licensure, and no additional experience could find work in a NICU. Most hospitals, however, only hire highly educated, experienced nurses for these positions.

In general, a NICU nurse’s resume should include a bachelor’s degree and at least two years of nursing experience, preferably in pediatrics. Neonatal nurse certificates often require two years of experience before nurses can apply to take the exams.

Some hospitals may give preference to nurse practitioners over registered nurses when hiring for neonatal nursing roles. These professionals have earned a master’s degree or doctorate in nursing, hold several years of experience, and have passed an additional licensure exam.

Required Credentials for Neonatal Nurses

All registered nurses — including neonatal nurses must hold licensure. Each state sets its own requirements for obtaining a nursing license. Once licensed, nurses can pursue certification in specialty areas. Neonatal nurses can obtain certification in critical care or intensive care to strengthen their skills in the NICU specialty.

Licensure for Nurses Who Work With Babies

Neonatal nurses begin their careers as registered nurses. State boards of nursing oversee nurse licensure. Specific licensure requirements vary by state, but in general, applicants need to meet three conditions. They must hold a degree from an approved prelicensure nursing education program, pass the NCLEX-RN exam, and pass a background check.

To maintain their nursing licenses, nurses need to complete a number of continuing education requirements as their state nursing board mandates. States may also require nurses to complete a minimum number of patient contact hours. NCSBN gathers information about regulations, testing, and licensure requirements across all 50 states.

Neonatal Nurse Certifications

For neonatal nurses, licensure as an RN is essential, but certification is optional. Nevertheless, neonatal nurses and nurse practitioners can hone their skills by completing a certification program from the organizations listed below:

ANCC offers pediatric nursing certification. Eligible nurses must have active RN licensure, two years of nursing experience, at least 2,000 hours of clinical experience in pediatrics, and 30 hours of continuing education in the last three years.
PNCB offers a host of certifications, each featuring its own eligibility requirements. Nurses can register for credentialing programs online. PNCB currently offers a “no pass, no pay” policy that allows nurses to take the CPN exam twice a year.
Nurses can earn several neonatal nursing certifications through NCC. These include neonatal neuro-intensive care, electronic fetal monitoring, neonatal pediatric transport, and care of the extremely low birth weight neonate.
The American Academy of Nurse Practitioners established AANPCB in the early 1990s as a credentialing body. The organization now certifies family nurse practitioners, emergency nurse practitioners, and adult-gerontology primary care nurse practitioners.
AACN certifies acute care nurse practitioners and clinical nurse specialists in several subspecialties, including pediatric and neonatal nursing.

How Do I Become a Neonatal Nurse?

Neonatal nurses first need a degree in nursing. If studying full time, an associate degree takes about two years, while a BSN requires four years. A nursing degree can cost up to $60,000 per year at a top nursing school, though not all schools are so expensive. Students can pursue nursing degrees online, but most complete hands-on clinical experience requirements in person.

After graduation, nurses need to pass the NCLEX-RN and complete their state’s other requirements for licensure. Before qualifying for neonatal certification, nurses need to work in NICU nursing for about two years.

Steps to Becoming a Neonatal Nurse

  1. Earn a nursing degree. An associate degree in nursing or a bachelor of science in nursing can qualify a student to take their state’s nursing licensure exam. Some NICU units prefer bachelor’s degree-holders for these positions.
  2. Secure a nursing license. After earning a degree, aspiring nurses need to pass the NCLEX-RN, which tests candidates in four specific areas of the profession. State licensure requires passing the NCLEX-RN.
  3. Obtain clinical experience in a NICU. After obtaining RN licensure, nurses need hands-on experience with critically ill infants. Employers may require up to two years of experience in a hospital with a NICU.
  4. Earn certification as a neonatal nurse. Several private organizations offer certifications relevant to neonatal nursing, including resuscitation, electronic fetal monitoring, neonatal pediatric transport, and advanced cardiovascular life support.
  5. Consider pursuing a master’s in nursing. Nurses can advance in the field by earning a master’s degree or a doctorate in nursing. Becoming a nurse practitioner, a nurse midwife, or a nurse educator in neonatal nursing requires advanced education.
  6. Consider licensure as a neonatal nurse practitioner. With an MSN or a DNP, nurse practitioners can obtain clinical leadership roles in managing the healthcare needs of newborns. These professionals can order diagnostic tests, manage ventilators, or even do heart catheterizations on pediatric patients. Becoming a neonatal nurse practitioner requires two years of relevant nursing experience, a graduate degree, and passing the licensure exam.

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Should I Become a Neonatal Nurse?

Working with newborns sounds rewarding, but the demands of the job may not appeal to all nurses. Typically the best neonatal nurses observe situations carefully, can make quick decisions, and show high emotional intelligence.

Review the possible pros and cons of choosing this career:

Pros of Becoming a Neonatal Nurse

  • Emotionally fulfilling work
  • A chance to serve vulnerable patients
  • Can move into nursing management roles
  • Lucrative salary opportunities
  • Can help critically ill infants recover and thrive

Cons of Becoming a Neonatal Nurse

  • Mentally and emotionally depleting job
  • May face challenging ethical questions
  • Requires mental agility and focus due to the patients’ size and instability
  • Often work 12-hour shifts
  • Parents or other staff may disagree with medical decisions

The Neonatal Nurse Job Hunt

Neonatal nurses can find jobs in one of two ways: through personal connections or through job listings. A nurse who leverages personal connections for a job may rely on mentor recommendations, residencies, or professors for introductions.

By contrast, a nurse who competes for an open position may locate opportunities through career fairs, professional organizations, annual conferences, or job sites like those listed below.

Nurses can also identify potential employers by searching hospital databases and insurance provider directories. Joining LinkedIn also allows nurses to connect with potential employers.

The American Association of Nurse Practitioners (AANP) maintains this job board. Applicants can get job alerts, upload their resumes, or browse open positions by state or specialty.
Tailored to physicians and advanced practice professionals, this job board allows applicants to search for open positions by specialty, state, and profession. Users can also learn about nationwide career fairs.
Maintained by a healthcare technology company, this job board specifically focuses on open positions for nurse practitioners. Qualified professionals can upload their resumes or search for job postings.
This neonatal-specific professional association maintains listings of relevant NICU job openings. Applicants can set job alerts, so they receive notifications.

Career and Salary Outlook for Neonatal Nurses

Like other healthcare careers, neonatal nursing can provide a lucrative salary. According to PayScale, neonatal nurses earn an average annual salary of $68,760 as of July 2021. Many factors can influence the salary of a NICU nurse or neonatal nurse, including experience and education.

Nurses who pursue additional training to become nurse practitioners or nurse midwives earn a median annual salary of $117,670 as of May 2020, according to the BLS. Neonatal nurses who serve in urban settings can earn higher wages than those working in rural areas.

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Frequently Asked Questions About Neonatal Nurses

What are the minimum education requirements for neonatal nursing?

Neonatal nurses need an associate or bachelor’s degree in nursing and a registered nurse license. Often, NICU nurses also pursue neonatal care credentials.

What is the role of a NICU nurse?

A NICU nurse provides specialized care to newborns facing critical health challenges. They also administer treatment and operate medical equipment. Most of their patients have congenital disorders, were born prematurely, or have a low birth weight.

Is NICU nursing stressful?

Faced with complex situations, NICU nurses can experience stress due to the high-pressure environment.

How much do NICU nurses make?

According to PayScale, neonatal nurses earn an average annual salary of $68,760 as of July 2021. Neonatal nurses with experience or additional education can earn even higher salaries.

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