What Is a Neonatal Nurse for 2025?

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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All newborns should have access to high-quality health care, including protection from infection and injury, assessment of breathing and overall health, and support for breast milk feeding from the time of birth until the next four weeks. Some infants require specialized care and more attention than others to overcome health challenges during their transition period after birth. This is why neonatal nurses play a very essential role in family health care. If you think this profession is for you, read on and find out more, including neonatal nurse responsibilities and neonatal nurse education and training.

What are the benefits of becoming a neonatal nurse?

• Neonatal nurses earn a higher salary than the average registered nurse (RN) in the United States.
• You can become a neonatal nurse with either an associate degree in nursing or a bachelor of science in nursing degree.
• With enough number of years experience with acutely or critically ill neonatal patients, you can get certified as a critical care RN for neonates (CCRN Neonatal).

Table of Contents

1. What is a neonatal nurse?
2. Where do neonatal nurses work?
3. What are the types of neonatal nurses?
4. What makes neonatal nursing a good career?
5. What skills and qualities does a neonatal nurse need?
6. How to become a neonatal nurse
7. How much do neonatal nurses in the United States make?
8. What does advanced education mean for neonatal nurses?
9. What are the educational pathways to specialize in neonatal care?
10. How long does it take to become a neonatal nurse?
11. How Can I Transition to Advanced Neonatal Nursing Roles?
12. What is the job outlook for neonatal nurses?
13. What are the common challenges neonatal nurses face in their careers?
14. Can I become a neonatal nurse if I am not currently a nurse?
15. How Can Clinical Residency Programs Bridge the Gap Between Theory and Practice in Neonatal Nursing?
16. What Other Educational Opportunities Can Enhance My Career as a Neonatal Nurse?
17. Can dual degree programs expand my leadership opportunities in neonatal nursing?
18. Are accelerated advanced nursing degree programs right for my career?
19. How can post-master's acute care NP online programs enhance my neonatal practice?
20. What financial aid options are available for advancing my neonatal nursing education?
21. What are the certification options for neonatal nurses?
22. Other things you should know about neonatal nurses

What is a neonatal nurse?

Neonatal nurse definition is pretty straightforward: it is a registered nurse who provides essential care for infants during the neonatal period. The neonatal period refers to the first month of a newborn’s life. Neonatal nurses also specialize in the care of infants born prematurely or facing specific challenges.

Where do neonatal nurses work?

Neonatal nurses usually work in hospitals and other healthcare facilities such as community health and in-home settings. In hospitals, most of them are assigned to the neonatal intensive care unit (NICU), which provides care for infants who are acutely or critically ill.

Hospitals provide a total of four levels of care for newborns:

• Level I. This level cares for healthy newborns.
• Level II NICU. This level provides care for infants born at 32 weeks gestation and above or born at full-term who require close observation and monitoring of their vital signs, fluid status, and weight.
• Level III NICU. This level cares for infants born earlier than 32 weeks of gestation and weighing under 1,500 grams. It also includes newborns delivered at any gestation age and considered critically ill. These infants require close observation, the use of ventilators and other machines and equipment, and/or surgery.
• Level IV NICU. This NICU unit provides the highest level of care for newborns with issues like congenital heart defects. These are infants in need of major surgery.

Neonatal nurses can also work in other specialized departments such as cardiac care, critical care transport and flights, and trauma units.

What are the key responsibilities of a neonatal nurse?

Key neonatal nurse responsibilities include:

• providing constant monitoring and care to ill or premature infants
• performing newborn tests such as hearing and vision tests
• administering special feedings, such as tube feedings
• operating specialized NICU equipment such as infant ventilators, incubators, and radiant warmers
• inserting intravenous (IV) lines
• managing medications

The extent of a neonatal nurse’s responsibilities depends on where they work. For example, neonatal nurses who work in community or in-home settings help educate new parents on how to care for their newborns and provide follow-up care for high-risk babies after discharge.

Level II NICU nurses monitor vital signs, weight, and fluid status of newborns, as well as administer IV fluids and medications and provide special feedings. Level III NICU nurses observe newborns closely, care for babies needing surgery, and have mastery of ventilators and other equipment. Level IV nurses, on the other hand, help prepare newborns for major surgery and provide a high level of care and monitoring pre- and post-operation.

What are the types of neonatal nurses?

There are four types of neonatal nurses according to specialty, education, and roles or responsibilities.

1. Neonatal Nurses

Neonatal nurses are registered nurses who care for newborns immediately after birth. These are nurses who have completed an associate’s or bachelor’s degree in nursing online programs or on-campus programs and work in health care settings with neonatal departments or neonatal care units.

Neonatal nurses also assist in labor and delivery, conduct newborn screening or tests, and help implement care plans for infants. Neonatal nurses typically work in hospitals and take 12-hour shifts.

2. NICU Nurses

NICU nurses are also RNs who work in the NICU, caring for newborns that require additional care and rigorous monitoring, including premature newborns and babies with medical issues. NICU nurses need to have prior clinical experience as a neonatal nurse.

3. Pediatric Surgical Nurses

Pediatric surgical nurses are RNs who care for children undergoing surgery, including newborns. Nurses who specialize in neonatal surgical care monitor infants before undergoing a surgical procedure and assist surgeons in performing such procedures. These nurses check on the patients post-operation and aid in their recovery.

4. Neonatal Nurse Practitioners

Neonatal Nurse Practitioners (NNPs) are advanced practice registered nurses (APRNs) who provide specialized care to high-risk newborns and infants, including premature newborns and babies with medical conditions. Neonatal nurse practitioners determine the needs of these newborns after conducting regular health assessments, order diagnostic tests, interpret the results of these tests, prescribe medications, and can also perform NICU procedures under the supervision of physicians. The following infographic summarizes a few key points that you need to know about neonatal practice.

What makes neonatal nursing a good career?

Neonatal nursing can be a very challenging career and it can be emotionally, physically, and mentally demanding. It requires you to cope with difficult situations and potential losses. However, it is also one of the most rewarding jobs. There are many reasons why neonatal nursing can be a good career choice, and these include:

• Making a life-changing difference. You will be caring for the littlest, most vulnerable, and most helpless patients who often require intensive care. Your skills and dedication could mean the difference between life and death for these tiny humans and their families, and that knowledge alone can be incredibly rewarding.
• Rapid skill development. Neonatal nursing comes with a highly specialized skill set, from monitoring vital signs to administering complex medications and operating advanced equipment. You will quickly learn these skills and constantly push your knowledge and expertise to provide the best possible care to newborns with their own unique needs.
• Intellectual challenge. Neonatal nursing is far from boring because it keeps your mind sharp and engaged. Every baby is unique and you will need to analyze data, make critical decisions, and adapt your approach based on its individual needs.
• Strong teamwork and collaboration. Working in the NICU fosters a sense of teamwork and shared purpose. You will need to collaborate and work closely with doctors, other nurses, therapists, other specialists, and, of course, the families, to create a supportive and rewarding work environment.
• High demand and job security. Neonatal nurses are in constant demand as the country’s birth rates go up and technology allows for the survival of even more premature newborns and critically ill infants. This means that the salary and career outlook for neonatal nurses is good and you will enjoy strong job security and a rewarding income.
• Personal growth. NICU nurses witness miracles through the infants they care for and they also see the fragility and the resilience of life firsthand. This can have a profound impact on your own growth as a healthcare professional and as a person. You will develop empathy, compassion, physical and mental strength, and adaptability, among others.
• Opportunities for advancement. Neonatal nursing is a great stepping stone for those various healthcare workers. Licensed practical nurses (LPNs), for example, can take online LPN to BSN programs and work in neonatal departments as RNs. After gaining enough experience, they can pursue a master’s degree and become neonatal nurse practitioners. They can then become doctors of nursing practice and lead a team of neonatal nurses.

Ultimately, whether neonatal nursing is the best career choice for you depends on your skills, personality, and interests. If you are interested in the healthcare industry and are particularly passionate about children’s health, if you thrive in challenging environments, and if you find meaning in making a difference in the lives of the most vulnerable humans, then this could be the perfect career path for you. The dedication also means you have to spend at least six years to complete the requirements to become a certified neonatal nurse practitioner.

What skills and qualities does a neonatal nurse need?

Neonatal nurses face a unique set of challenges and rewards, and for you to thrive in such a demanding environment, you need a specific combination of skills, character traits, and personal qualities. These are the qualities and skills needed for neonatal nursing:

• Technical skills. You need to learn how to be proficient in using advanced medical equipment, administering medications, monitoring vital signs, and performing specialized procedures like ventilation and blood draws.
• Critical thinking and problem-solving. As a neonatal nurse, you need to be able to analyze complex data, make quick decisions during emergencies and under pressure, and adapt to rapidly changing situations.
• Communication skills. A neonatal nurse needs to communicate with families, doctors, and other healthcare professionals effectively, clearly, and compassionately.
• Interpersonal skills. Neonatal nurses have to build strong relationships and trust with families experiencing worry and distress, and promote open communication and collaboration.
• Documentation skills. As a neonatal nurse, you also need to accurately and efficiently document observations, interventions, and newborn progress.
• Empathy and compassion. It is very important for a neonatal to deeply understand and share the emotions of families and infants, as well as provide emotional support and reassurance.
• Emotional stability. A neonatal nurse should be able to cope with highly demanding work conditions, challenging situations, and potential losses with a positive and constructive attitude.
• Attention to detail and meticulousness. You need to ensure accuracy when administering medication, operating equipment, and documenting to avoid errors that could potentially have serious consequences.
• Ability to work well with others. Neonatal nurses have to effectively collaborate with other healthcare professionals to create a cohesive and supportive care environment.

How to Become a Neonatal Nurse

Do you want to know how to become a neonatal nurse? You just need to follow these steps:

1. Earn a nursing degree. Complete a program for a nursing major at an accredited college or university. The minimum educational requirement to become a neonatal nurse is an Associate Degree in Nursing (ADN). However, many employers now require a four-year Bachelor of Science in Nursing (BSN) degree.

That means licensed practical nurses (LPNs) cannot qualify to become neonatal nurses. LPNs can, however, pursue online LPN to RN programs first to become neonatal RNs.

2. Pass the NCLEX for RN licensure. After obtaining your nursing degree, you need to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Passing the NCLEX-RN is a requirement for getting your license as an RN.

3. Gain experience working with neonatal patients. You need to work in a hospital or a health care setting with a neonatal care unit or department to gain clinical experience as a neonatal nurse.

4. Obtain certification as a critical care RN. A CCRN (Neonatal) credential is a specialty certification for RNs who provide care to newborn patients with acute or critical illnesses. This certification is not mandatory, but it is recommended if you want a more advanced role.

You are qualified for certification if you have an unencumbered RN or APRN license with either two years experience as an RN or an APRN and 1,750 hours of direct acute or critical care for newborn patients, or five years experience as an RN or an APRN and at least 2,000 hours caring for acutely or critically ill newborns.

How much do neonatal nurses in the United States make?

The average annual salary for neonatal nurses in the United States is $71,497 as of September 2023. This means an average hourly rate of $34.37. But this salary could range between $41,000 and $122,000, depending on location, education, and experience.

This average salary figure is lower than the $89,010 mean annual wage for registered nurses in general. However, nurse practitioners — which include NNPs — can earn an average of $124,680 annually, or $59.94 per hour.

According to Zippia, neonatal nurses earn the highest salaries in Washington, California, and Pennsylvania.

What does advanced education mean for neonatal nurses?

Neonatal nurses can pursue a Master of Science in Nursing (MSN) and/or a Doctor of Nursing Practice (DNP) and specialize in neonatal care to become a Neonatal Nurse Practitioner (NNP). NNPs are APRNs.

NNPs with an MSN degree provide care to high-risk infants with complications, including premature newborns and infants with infections or heart abnormalities. However, for you to practice as an NNP (and not just as a neonatal RN), you will need to pass the National Certification Corporation (NCC) board exam for NNPs.

Meanwhile, NNPs with a DNP degree can become hospital administrators and oversee the health services and daily activities of a hospital or healthcare facility. They can also head the NICU unit. They can attend high-risk deliveries, evaluate diagnostic and clinical data, perform advanced assessments, manage critically ill and intermediate-care neonates, support and educate caregivers, and perform advanced practice clinical skills like delivery room resuscitation, lumbar puncture, intubation and non-invasive respiratory management, umbilical line placement and suturing, and pleural needle aspiration.

The good thing is that you can pick the best RN to MSN programs or the best DPN programs online so you can complete your graduate degree while you work.

What are the educational pathways to specialize in neonatal care?

Pursuing a specialization in neonatal care requires a clear educational trajectory based on your career goals. The foundational step for any aspiring neonatal nurse is to earn either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) from an accredited institution. While ADN programs typically take two years and provide entry-level credentials, BSN programs, which span four years, are increasingly preferred by employers for their comprehensive curriculum and preparation.

Those who wish to advance further in neonatal care can pursue a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) specializing in neonatal care. These programs prepare nurses to become Neonatal Nurse Practitioners (NNPs), equipping them with the skills to perform advanced assessments, order and interpret diagnostic tests, prescribe medications, and manage critically ill newborns. Additionally, there are bridge programs like RN-to-MSN or ADN-to-MSN pathways that facilitate progression for those holding a diploma or associate degree.

For nurses seeking flexibility, online options now abound, allowing for the completion of both undergraduate and graduate degrees. These hybrid offerings blend virtual coursework with in-person clinical training, enabling students to study while balancing professional and personal responsibilities. For those prioritizing affordability, exploring the cheapest RN to MSN online programs can help achieve their educational goals without excessive financial strain. Ultimately, choosing the right educational pathway is influenced by personal goals, time availability, and financial considerations, but each level of education opens doors to increased expertise and higher earning potential in neonatal nursing.

How long does it take to become a neonatal nurse?

Depending on the academic path you decide to take, you can become a neonatal nurse in two to four years. With an ADN, you can become a registered nurse in two years and apply for a job at a hospital’s nursery or neonatal care unit. Meanwhile, if you decide to go for a bachelor’s degree, you can become a neonatal nurse in four years.

After obtaining your RN license, you will need at least two years of experience to earn your CCRN (Neonatal) certification.

Obtaining an MSN and becoming an NNP will take you at least two more years. There are ADN to NP bridge programs that allow nurses to skip a bachelor’s program and earn their graduate degree in just two to three years.

How Can I Transition to Advanced Neonatal Nursing Roles?

Transitioning from bedside care to advanced roles requires strategic career planning and targeted educational enhancements. By leveraging clinical experience and seeking leadership opportunities, neonatal nurses can progress into specialized or managerial positions. Pursuing an advanced practice degree is a critical step; for example, enrolling in programs like the BSN to nurse practitioner pathway can equip you with the skills and credentialing necessary for expanded clinical responsibilities. Engaging in professional mentorship, networking with experts, and participating in continuing education tailored to advanced neonatal care are additional measures that support a successful transition.

What is the job outlook for neonatal nurses?

The career or job outlook for neonatal nurses is promising. Demand is driven by various factors, including the increasing survival rates of premature newborns, the rising number of high-risk pregnancies, the growing need for specialized neonatal care, and the advancements in medical technology. Healthcare professionals also have an expanding understanding of neonatal health issues, and this has contributed to the growing demand for skilled neonatal nurses and NNPs.

The employment of RNs, in general, has a projected growth of 5% to 8% from 2022 to 2032, with projected job openings of 193,100 every year over this 10-year period (O*NET OnLine 2022). Meanwhile, the employment of nurse practitioners, in general, is projected to grow 9% or higher from 2022 to 2032, with projected job openings of 26,300 every year over this 10-year period (O*NET OnLine).

Each year, a growing number of NPPs are seeking certification. According to the NCC, there were 348 NNP candidates who applied for certification in 2020, 471 candidates in 2021, and 435 candidates in 2022.

What are the common challenges neonatal nurses face in their careers?

While neonatal nursing is a rewarding career, it also comes with unique challenges. Here are some of the most common hurdles neonatal nurses encounter:

• High emotional demands: Caring for critically ill newborns can be emotionally taxing. Nurses often witness difficult situations, including health complications and loss, which can lead to emotional exhaustion over time.
• Physical strain: The job often involves long shifts, physical tasks like lifting and repositioning patients, and constant movement, which can contribute to physical fatigue and even long-term physical strain.
• Complex patient needs: Neonatal nurses must manage a variety of intricate medical conditions, often requiring advanced skills in handling ventilators, IVs, and other specialized equipment. The high level of care needed can be challenging, especially in critical cases.
• High-stress environment: Working in a Neonatal Intensive Care Unit (NICU) means facing high-stakes situations daily. The need to stay calm under pressure, make quick decisions, and respond to emergencies is essential, which can be mentally demanding.
• Family communication: Neonatal nurses must communicate effectively with families under stressful circumstances. Balancing empathy with delivering complex medical information can be challenging but essential for family support.

These challenges require resilience, strong support systems, and ongoing self-care practices to ensure a sustainable and fulfilling career in neonatal nursing.

Can I become a neonatal nurse if I am not currently a nurse?

Yes, you can! While a traditional Bachelor of Science in Nursing (BSN) is the most common path to becoming a registered nurse (RN), there are alternative paths available for those who already hold a bachelor's degree in another field. These programs, often referred to as Accelerated Bachelor of Science in Nursing (ABSN) programs, can help you earn your nursing degree in a shorter timeframe. Research.com has a helpful guide on online ADN programs for non nurses that you might find useful.

How Can Clinical Residency Programs Bridge the Gap Between Theory and Practice in Neonatal Nursing?

Clinical residency programs serve as critical platforms where theoretical knowledge is directly applied in high-stress, real-world settings. These structured residencies, guided by experienced mentors, enhance clinical proficiency while cultivating key skills such as critical thinking and collaborative decision-making. By integrating immersive hands-on experiences with formal education, residents refine their ability to manage complex neonatal cases and transition smoothly into advanced roles. This practical approach not only reinforces clinical expertise but also optimizes entry into reputable institutions like nursing schools with highest acceptance rates, thereby offering a competitive edge in career progression.

What Other Educational Opportunities Can Enhance My Career as a Neonatal Nurse?

As a neonatal nurse, you may also consider pursuing education in related fields to enhance your career prospects. For instance, understanding the principles of sonography can be beneficial in neonatal care. If you're interested in exploring such opportunities, you can look into accelerated sonography programs that can provide you with advanced knowledge in a shorter timeframe, allowing you to expand your skill set and possibly take on more specialized roles within neonatal care.

Can dual degree programs expand my leadership opportunities in neonatal nursing?

Dual degree programs uniquely blend clinical expertise with business strategies to prepare neonatal nurses for leadership roles. Pursuing a combined MSN and MBA equips professionals with advanced clinical skills alongside strategic management, financial planning, and operational excellence. This integrated approach enables neonatal nurses to effectively manage healthcare teams and drive organizational improvements. Explore flexible pathways through online MSN MBA programs designed specifically for busy healthcare professionals.

Are accelerated advanced nursing degree programs right for my career?

An accelerated advanced degree can streamline your progress toward specialized practice and leadership roles in neonatal care. These targeted programs integrate advanced clinical, research, and management skills within a condensed timeframe. For working professionals aiming to enhance their credentials without lengthy interruptions in practice, exploring options such as accelerated MSN to DNP programs may offer a significant competitive advantage.

How can post-master's acute care NP online programs enhance my neonatal practice?

Post-master's programs offer a streamlined pathway for neonatal nurses to expand their clinical scope and leadership competencies. These advanced online courses integrate specialized coursework with rigorous clinical practice, enabling practitioners to refine acute care techniques and stay current with emerging treatment protocols. Enrolling in post-master's acute care NP online programs can provide the flexibility needed to balance ongoing professional work with advanced education, ensuring that neonatal care remains at the forefront of innovative, evidence-based practice.

What financial aid options are available for advancing my neonatal nursing education?

To mitigate the financial challenges associated with advanced neonatal nursing education, exploring diverse funding opportunities is essential. Many accredited programs offer scholarships, grants, employer tuition assistance, and low‐interest student loans to offset tuition costs while maintaining a flexible schedule. Investigating these options early can facilitate a smoother transition into premium online programs, such as the easiest RN-to-BSN programs to get into, which are designed to balance affordability and quality. Additionally, specialized financial aid opportunities for healthcare professionals and neonatal specialists can further ease the cost burden, empowering you to prioritize academic excellence and clinical advancement without compromising on financial stability.

What are the certification options for neonatal nurses?

As a neonatal nurse, continuing education and obtaining advanced certifications are essential steps to advancing your career and expanding your scope of practice. While a basic nursing degree (either an associate's or bachelor's degree) can start you on the path, several advanced educational opportunities and certifications can enhance your qualifications and open doors to specialized roles within neonatal care.

One of the most popular career advancements is becoming a Neonatal Nurse Practitioner (NNP). NNPs are advanced practice registered nurses (APRNs) who focus on providing high-level care to newborns in critical care settings. To become an NNP, you must complete a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) with a focus on neonatal care. After completing your graduate education, you will need to pass a certification exam to become a board-certified neonatal nurse practitioner.

In addition to becoming an NNP, neonatal nurses can pursue various other certifications to demonstrate expertise in specialized areas. Some common certifications include:

• Neonatal Intensive Care Nursing (RNC-NIC): For those focusing on neonatal intensive care unit (NICU) nursing, this certification is recognized as a mark of expertise in caring for critically ill infants.
• Certified Pediatric Nurse (CPN): While not neonatal-specific, this certification can be valuable for nurses who wish to broaden their skill set to include general pediatric care.
• Critical Care Registered Nurse (CCRN) – Neonatal: For nurses with several years of experience in neonatal critical care, this certification can further enhance your career opportunities and earning potential.

For nurses looking to take advantage of flexible learning options, there are a variety of online programs offering advanced degrees and certifications tailored to neonatal nursing. These programs are ideal for working professionals who wish to continue their education while managing their schedules. If you are interested in affordable online programs, you can explore the cheapest online PMHNP certificate programs for further options that allow you to advance in your field without the financial burden of traditional on-campus education.

Other Things You Should Know About Neonatal Nurses

What is the difference between a neonatal nurse and a neonatal nurse practitioner?

An entry-level neonatal nurse and a neonatal nurse practitioner are different in terms of their education. A neonatal nurse only needs an associate’s degree or a bachelor’s degree, with optional neonatal RN certification. Meanwhile, a neonatal nurse practitioner or NNP requires an advanced practice RN degree, which can either be a master’s or a doctorate, with a focus on neonatal care. Moreover, an NNP is also required to pass a certification exam after completing graduate school.

How hard is it to be a neonatal nurse?

The level of difficulty for any job is subjective, so whether it is easy or hard depends mainly on the individual. However, neonatal nursing can be intellectually and emotionally demanding, and it requires technical skills, critical thinking, decisiveness, and compassion. It is challenging but also incredibly rewarding, offering people the chance to make a life-changing difference for infants.

What is the difference between a neonatal nurse and a NICU nurse?

The difference between the two is that not all neonatal nurses are NICU nurses, but all NICU nurses are neonatal nurses. Neonatal nurses are nurses who provide care to all newborns, from birth up to four weeks, including those who were born healthy. NICU nurses, however, provide care to newborns who are critically ill or who require extra medical attention.

Is a neonatal nurse a pediatric nurse?

No, neonatal and pediatric nurses are different specialists, though both care for children. Neonatal nurses focus on tiny newborns, typically from birth to 28 days of age, while pediatric nurses work with a wider age range, from infancy up to 18 years old, in diverse settings.

References:

• United States Bureau of Labor Statistics. (2023, April 25). Occupational Employment and Wages, May 2022 | 29-1141 Registered Nurses. BLS.
• United States Bureau of Labor Statistics. (2023, April 25). Occupational Employment and Wages, May 2022 | 29-1171 Nurse Practitioners. BLS.
• O*NET OnLine. (2023). Registered Nurses 29-1141.00. O.NET OnLine.
• O*NET OnLine. (2023). Nurse Practitioners 29-1171.00. O.NET OnLine.
•  National Certification Corporation. (2022). Exam Results 2017 to 2022. NCC.