Neonatal nursing is a subspecialty of nursing that works with newborn infants born with a variety of problems ranging from prematurity, birth defects, infection, cardiac malformations, and surgical problems. The neonatal period is defined as the first month of life; however, these newborns are often sick for months. Neonatal nursing generally encompasses those infants who experience problems shortly after birth, but it also encompasses care for infants who experience long-term problems related to their prematurity or illness after birth. A few neonatal nurses may care for infants up to about 2 years of age. Most neonatal nurses care for infants from the time of birth until they are discharged from the hospital.
Approximately 40,000 low-birth-weight infants are born annually in the United States. Because of significant medical advances and the efforts of physicians and nurses who provide for very vulnerable babies, survival rates are 10 times better now than they were 15 years ago.
Founded in 1984, NANN represents the community of neonatal nurses that provides evidence-based care to high-risk neonatal patients. With more than 7,000 members, NANN is recognized as the expert voice that influences standards of practice through advocacy, education, networking, collaboration, and leadership.
NANN is the only national nonprofit association created by neonatal nurses for neonatal nurses. The National Association of Neonatal Nurse Practitioners (NANNP), a division of NANN, gives NNPs a distinct voice within NANN to address career development and educational needs and provides representation to address advanced neonatal practice issues in the larger nursing community.
As a professional nursing association, NANN supports its members by sponsoring an annual conference and publishing Advances in Neonatal Care, a bimonthly peer-reviewed professional journal.
Are you a nursing student looking for a career in neonatal nursing? NANN student membership is an affordable way to connect with practicing neonatal nurses, including potential employers, and increase your knowledge in neonatal nursing. Student membership is open to students who are interested in neonatal nursing and are currently enrolled in an entry-level nursing program that leads to eligibility for the NCLEX examination upon graduation. Learn more about NANN membership.
National Student Nurses' Association (NSNA) members can join NANN at a special discounted student rate of $45 (verification of NSNA membership status is required). Learn more.
Many career options are open to neonatal nurses. Many start out as staff nurses caring for critically ill newborns. As a staff nurse you may provide highly technical care for acutely ill infants or supportive care for convalescent or mildly ill newborns. On an average day you may assist a new mom with breastfeeding her infant, care for a very ill full-term infant who is on a ventilator and receiving numerous IV medications, or attend the delivery of a very small and premature infant. You will find many opportunities to work with parents and families as they learn how to care for their infants, and you will help integrate parents into the critical care that you provide. You'll find tremendous satisfaction in watching some of the smallest and sickest babies stabilize, grow, and eventually go home with their families.
As you become more experienced in your neonatal nursing role, you'll find many opportunities to grow professionally and expand your practice. After working with neonates for a time, many neonatal nurses choose to take a national certification test to validate their knowledge. You may choose to be part of a neonatal transport team or participate on an ECMO (extracorporeal membrane oxygenation) team that provides heart-lung bypass for critically ill infants. You may develop leadership skills as a charge nurse or stabilization nurse in moderate- or high-risk deliveries. You will find that you learn something every day when you work in a neonatal intensive care unit (NICU).
Other roles for working with newborns are also available. Neonatal nurse practitioners (NNPs) are advanced practice nurses who work with the physicians and nursing staff to provide comprehensive critical care to the infants in the NICU. This role requires additional schooling in a master's or doctoral program. In this role you share your expertise with a multidisciplinary team as you take on the medical management for a group of critically ill infants. You become skilled in procedures such as line placements, intubations, lumbar punctures, and newborn resuscitation. NNPs often provide education to nurses, house staff, and other members of the neonatal team.
You'll find further opportunities for career advancement in the role of a nurse manager, nurse educator, clinical nurse specialist, or developmental care specialist. Nurse managers provide leadership for the staffing and administration of the NICU, ensuring that the environment and resources needed for high-quality patient care are available. Nurse educators and clinical nurse specialists are advanced practice nurses who provide educational programs and support to both nursing staff and ancillary staff so that they provide care that is up-to-date and based on the best available evidence. Clinical nurse specialists may provide direct patient care at the bedside and give support to staff who are learning clinical skills. Developmental care specialists are nurses who have studied the developmental care of sick and preterm infants. They provide direct care and assist their colleagues in meeting the developmental needs of these special babies. Other nurses may work in developmental follow-up, in research, or with specialized populations of infants.
The first step is enrollment in an accredited school of nursing. Basic nursing education can be achieved through three routes. The baccalaureate degree is earned through a college or university and generally takes 4 years to obtain. This route permits the greatest amount of flexibility in your career path. An associate degree can be obtained in 2-3 years at a junior or community college. A diploma degree can be obtained through a hospital-based school of nursing. However, diploma programs are being phased out in most areas of the country. The remaining programs are often affiliated with a community college and provide students with more flexibility for continuing toward a bachelor's degree.
If you have a degree in another field, you may be eligible for an accelerated program through which you can obtain a bachelor of science in nursing (BSN) or master of science in nursing (MSN) in 1-2 years. If you want to pursue work in advanced practice nursing, you will need a master's or doctoral.
In the near future, a doctor of nursing practice (DNP) degree will be required to work as an advanced practice nurse. Entrance into this practice-focused doctoral program requires a bachelor's degree. Some nurses who have a master's degree choose to pursue a PhD, a research-focused doctorate.
When you become a registered nurse, you will want to work in a hospital with a NICU. Some NICUs require prior experience in infant care such as work in pediatrics or in a well-newborn nursery. However, most NICUs will hire new graduate nurses with a strong interest in neonatal intensive care and have orientation programs that teach you how to care for sick infants. A variety of educational programs provide introductory information about neonatal care. If you plan to go on to become an NNP, you should practice in a Level III NICU as a staff nurse before applying to graduate school. These units provide the most highly skilled care to the sickest of infants.
As you progress through your undergraduate education and then grow professionally, membership in NANN will provide you with the tools, information, and standards you need to practice. Membership includes a subscription to a professional neonatal nursing journal, Advances in Neonatal Care, so that you can stay up-to-date in your field. You may also want to purchase some basic neonatal nursing texts to provide a ready reference for you if such resources are not available at your institution.
For more information about neonatology or nursing education in general, see the following websites in addition to NANN's:
Most neonatal nurses work in hospital settings. A few have positions in the community, providing home care or follow-up of high-risk infants. When you work in the hospital, you may work in a Level II nursery with less acutely ill or convalescing infants or in a Level III nursery with the most critically ill patients. Staffing levels in NICUs vary, depending on the acuity of the infant. Generally, staff ratios range from 1:1 to 1:4; you may care for one to four patients depending on how sick they are. Neonatal critical care is provided around the clock and on weekends and holidays. Many neonatal nurses work 12-hour day or night shifts; however, some nurseries offer 8- and 10-hour shifts or other flexible alternatives.
Salaries vary regionally, and advanced practice nurses are compensated at a higher level. Additional compensation is given for work on nights and weekends. For specific information in a particular geographic region, contact the hospitals where you are interested in working. For information on wages by occupation and region, refer to this website: www.bls.gov/bls/blswage.htm.
Neonatal nursing allows you to make a difference in the lives of infants and their families. Many neonatal nurses continue to hear from families and infants they have cared for throughout their lives. Neonatal nurses are the voice for the smallest and sickest of patients that have no voice. Consider a rewarding career in the neonatal nursing field and help make a difference.