It is estimated that one in every nine babies is born prematurely in the United States alone each year, but survival rates are ten times better now than a decade ago thanks in part to the work of NICU nurses. Neonatal intensive care nurses are registered nurses who have specialized their skills in providing care to premature and critically ill newborns who need immediate medical attention. NICU nurses generally work under the direction of a physician in neonatal intensive care units in hospital delivery rooms to offer total nursing care to infants who may be diagnosed with congenital birth defects, surgical problems, prematurity, or delivery complications. Not only do NICU nurses play an important role in providing life-saving treatment to critical neonates, but they also give emotional support for new parents and their families during a worrisome time.


According to the Bureau of Labor Statistics, the more than 2.6 million registered nurses, including NICU nurses, employed in the United States earn an average annual salary of $68,910, which is equivalent to $33.13 per hour. NICU nurses tend to make slightly more than nurses in non-specialized care at general medical and surgical hospitals at $70,590 a year.

Beginning Salary

Registered nurses with little to no experience should expect to start out their career by earning an average yearly salary of less than $45,630. That being said, NICU nurses with additional years of experience can eventually earn upwards of $96,320 each year and advance into neonatal nurse practitioner jobs with the potential to make $126,250 or more annually.

Key Responsibilities

NICU nurses mostly work as staff RNs to formulate and implement nursing care plans that will meet the health needs of acutely ill or premature babies welcomed into the world. On a typical day in the NICU unit, these nurses will be responsible for administering needed medications, monitoring the newborn’s condition, recording the newborn’s progress, changing diapers, comforting babies in distress, collaborating with an interdisciplinary healthcare team, providing education to new mothers, and using high-tech medical equipment. Throughout a baby’s stay in the neonatal intensive care unit, NICU nurses will be liable for completing hourly physical exams to evaluate the newborn’s temperature, heart rate, pulse, and blood pressure to stay on the lookout for any abnormalities that must be reported to the neonatologist.

Necessary Skills

More so than some other registered nurses, NICU nurses must have very strong practice skills for administering medications, inserting intravenous lines, and conducting cardiopulmonary resuscitation for newborn patients with very small bodies. Having strong interpersonal skills is important for NICU nurses to effectively communicate with other members of the neonatal healthcare team and teach families to care for ill infants. Since NICU nurses sometimes need to deliver a poor prognosis, stress management and emotional coping skills are also a must. NICU nurses should also be skilled observers of infant behaviors with a keen attention to detail and quick analytical thinkers to make split-second treatment decisions for potentially saving lives.

Degree and Education Requirements

There are three approved ways for individuals to become registered nurses, which include receiving a post-secondary diploma, two-year associate’s degree, or four-year bachelor’s degree from an accredited nursing program. However, in most cases, employers will prefer to hire RNs with a Bachelor of Science in Nursing (BSN) degree for working in this highly specialized environment. Enrolling in a BSN program will build on a strong general education core to provide the fundamental and advanced nursing skills that are essential in NICU units. Nurses who pursue a Master of Science in Nursing (MSN) program will be able to advance their roles within the NICU specialty to become neonatal nurse practitioners or neonatal clinical nurse specialists too.

Pros and Cons of this Position

Most NICU nurses love their fast-paced job because they devote their days to the rewarding task of caring for the most unstable patients in the hospital. Compared to many other nursing professions, NICU nursing tends to be less physically demanding because patients are much lighter and are carefully observed within incubators. That being said, NICU nurses face overwhelming pressure at work to always ensure accurate dosage and calculations. NICU nurses work long 12-hour days with irregular shifts to provide round-the-clock care to critical newborns who could take a turn for the worst at any time. While NICU nursing is very emotionally taxing, no other registered nursing specialty grants the unique opportunity to watch newborns transform from very ill patients to healthy, happy babies.

Getting Started

After earning an appropriate education, the first step is to receive a passing score on the National Council Licensure Examination (NCLEX-RN) so that you can become registered to practice in your state. Once you earn a valid RN license, you should be working as an entry-level staff nurse in general pediatrics to acquire essential nursing experience at the bedside. With time, you will become qualified to move into open positions in NICU units to start obtaining experience working with neonatal patients with acute medical conditions. It is then suggested that you continue building your career as an NICU nurse by earning Certification for Neonatal Critical Care Nursing (CCRN) through the American Association of Critical Care Nurses (AACN). From there, you may want to consider going back to graduate school to earn an MSN with a specialization in neonatal nursing to unlock advanced practice nursing (APRN) options.

Future Outlook

As demand for healthcare services and access to health insurance increase, employment of registered nurses and NICU nurses is predicted to skyrocket at the rapid rate of 19% before 2022, thus creating around 526,800 new jobs across all RN specialty areas. In particular, NICU nurses with experience working in Level II or Level III units will have no trouble finding steady employment, even in today’s tough job market. Since the nation’s nursing shortage has been especially acute in this specialty area, the AACN has reported a 50% increase in the number of requests for registered nurses in pediatric and neonatal ICUs across America. Neonatal intensive care nurses will remain in high demand throughout the foreseeable future as many of our nation’s NICUs are expanding to meet the need for infant care to boost survival rates.

Overall, NICU nurses are specialized registered nurses who provide evidence-based care to high-risk newborn patients from the time of their birth until they are discharged from the hospital to join their new families. In one of the most rewarding specialty areas, NICU nurses are the voice for the smallest and sickest of patients that have no voice of their own.

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