NICU Nurse and One

Overview

One in every 10 infants born in the United States is preterm, meaning they are born before 37 weeks gestation. Many of these babies have birth defects, low birth weight, and other conditions requiring special care from neonatal intensive care unit (NICU) nurses. NICU nurses are specialized pediatric practitioners who provide critical care to ill newborns requiring advanced medical and nursing treatment.

They also provide education and support to family members during one of the scariest times of their lives.

NICU nurses provide around-the-clock primary care for newborn infants requiring medical and surgical interventions such as bathing, feeding, and diapering. They also perform advanced assessments and procedures for premature infants who are often critically ill and require tube feedings, medications, IV fluids, blood transfusions, and mechanical ventilation. Nurses in the NICU may provide one-on-one care for the most critically ill infants, or they may be assigned three to four infants, often called "feeder-growers,” who are past the critically ill phase of care but still require monitoring as they learn to breathe, eat, and grow independently before going home with their parents.

These highly-skilled nurses often gain clinical experience on adult medical-surgical units or general pediatric units before transferring to the NICU. Some healthcare facilities offer internships in neonatal nursing care for new graduates with active RN licensure to gain experience with this specialized patient population.

• Most of the time, neonatal nurses work in hospitals with special care nurseries.
• Provide patient care in critical care transport, trauma, and cardiac care units as needed.
• Perform comprehensive patient care, including assessments and vital sign monitoring.
• Draw blood and perform other specialized procedures.
• Collaborate with the healthcare team, including nurses, physicians, and neonatal nurse practitioners.
• Administer medications, IV fluids, oxygen therapy, and specialized feeding techniques such as tube feedings.
• Work with specialized medical equipment such as incubators, ventilators, IV pumps, and specialized oxygen delivery systems.
• Provide pre- and post-surgical care for infants.
• Provide hands-on patient care for newborns, including diapering, feeding, bathing, and dressing.
• Educate parents and family members about the newborn's condition and any post-hospital care they may need.

• Level I nurseries provide standard patient care to healthy babies in hospitals. The newborns are usually discharged within a few days after birth.
• Level II nurseries provide hands-on care for premature babies at 32 weeks gestation or above and full-term infants who need close observation.
• Level III nurseries give specialized care for babies born before 32 weeks gestation and those with low birth weight who are critically ill.
• Level IV nurseries are NICU units that provide patient care to the most critically ill newborns needing surgery and other advanced nursing and medical treatment. These units are often found in specialized pediatric hospitals and academic institutions that employ advanced healthcare professionals in many specialties.

According to the Bureau of Labor Statistics (BLS), RNs make an average annual salary of $77,600. However, BLS doesn't provide data specifically on NICU nurse salaries. Payscale reports that the average NICU nurse salary in March 2023 was just over $75,000, with the 90th percentile of earnings at $119,000. Salaries vary based on the level of the NICU unit, experience, education, licensure, certification, geographic location, and facility type.

NICU nurses are registered nurses (RNs) with at least an ADN or associate's degree in nursing. Many facilities require a BSN or bachelor's degree to work in this highly advanced and specialized field. Nurses may pursue an advanced nursing degree to provide a higher level of care, including roles such as neonatal nurse practitioners (MSN) or doctor of nursing practice (DNP).

Certifications and leadership roles are common paths, including titles such as charge nurse, nurse manager, or director of nursing.

• Attend an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) program.
• Pass the NCLEX-RN exam and obtain your RN license.
• Gain nursing experience on a general nursing unit or apply to a NICU internship to gain NICU experience.
• Apply to and work at any level of special care nursery to gain clinical nursing experience.
• Become a member of the National Association of Neonatal Nurses or other organizations to stay current on new care modalities.
• Consider specialized neonatal nurse certifications such as:
  • Critical Care Registered Nurse (CCRN)
  • RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC)

NICU nurses make a meaningful difference in the lives of vulnerable…