How to Become a Neonatal Nurse

Neonatal nurses use specialized nursing knowledge to provide and manage the medical treatment of infants under four weeks old and those born prematurely. Most neonatal nurses work in hospital Neonatal Intensive Care Units (NICUs), but some work in a variety of other settings. To become a neonatal nurse, the steps include education, testing, and licensing, after which neonatal nurses can pursue employment. Below, we’ll detail the steps to follow, how long it takes to become a neonatal nurse, and where to start.

Become a Neonatal Nurse in 6 Steps

Neonatal nursing education provides the knowledge needed to treat very young or preterm infants and their unique physiology and medical challenges. State licensing is required to practice as a neonatal nurse, and specialty certifications highlight experts in this field.

Schooling Requirements for Neonatal Nurses

Neonatal nurses can practice with a few different levels of education, including a Bachelor of Science in Nursing and an Associate Degree in Nursing. However, general healthcare hiring trends favor nurses with a bachelor’s degree.

A survey by the American Association of Colleges of Nursing found that over 70% of healthcare employers want new nursing hires to hold a BSN. The National Academy of Medicine announced a goal in 2010 for 80% of RNs to hold a BSN degree by the year 2020. By 2020, at least 65% of nurses held BSN degrees, but in 2023, the 2022 National Nursing Workforce Survey reported that number rose above 70%.

Neonatal nurses who wish to become neonatal nurse practitioners can do so by earning a higher degree like an MSN, and DNPs can work as clinicians or in higher leadership positions.

Associate Degree in Nursing

An Associate Degree in Nursing, or ADN, is the quickest option to become a neonatal nurse with no previous university education. ADN degrees can take 18 months to two years to complete and may require some prerequisites before an application can be accepted.

Neonatal nurses with an ADN may receive lower pay and not have their first choice of positions compared to neonatal nurses with a BSN. However, the nursing shortage ensures a large pool of work for nurses with ADNs.

Bachelor of Science in Nursing

A Bachelor of Science in Nursing gives future nurses a more well-rounded education experience than an ADN. Typically done over four years, the BSN curriculum covers the basics of nursing care and how the body works but also teaches more specialized critical thinking skills.

A BSN prepares future neonatal nurses to handle a high level of care. Where an ADN focuses on quickly preparing future nurses for clinical situations, a BSN adds higher-level concepts like evidence-based practice, community health nursing, statistics used in research, nursing management and leadership, health informatics and analysis, healthcare ethics, and nutrition.

Master of Science in Nursing

A Master of Science in Nursing, or MSN, can be earned in two years, but many students continue to work throughout the program, which increases time to completion.

Doctor of Nursing Practice

A Doctor of Nursing Practice (DNP) degree is the highest level of education a nurse can achieve. This program takes longer than an MSN but may offer higher salaries and more opportunities.

Neonatal Nurse Licensing

Once a new nursing graduate has earned their degree, they must apply for licensure. Neonatal nurses must apply for a registered nurse license to practice. To become a licensed and practicing nurse in any state, all nursing graduates must pass the state licensing exam (the NCLEX-RN) and apply for a state license.

NCLEX-RN

The National Council Licensure Examination–RN (NCLEX-RN) is a computer-based exam with 85 to 150 questions. The exam takes anywhere from an hour to a maximum of five hours. Questions fall into four basic categories:

1. Safe and Effective Care Environment
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity

Once completed, the state board of nursing sends test results within six weeks, usually by email. In the time leading up to the NCLEX-RN, it’s important for graduates to study practice questions to ensure a passing grade and many students take NCLEX prep courses to increase their likelihood of success.

Registered Nurse State License Application and Renewal

Each state in the U.S. has a unique registered nurse licensing application process. The state board of nursing will want to see proof of an NCLEX passing result and a diploma from an accredited nursing program. Most states require criminal background checks and fingerprinting, and some may want to see university transcripts.

In most states, RNs must renew their license every two years after initial licensure. Each state has varying requirements for continuing education and other documentation needed for renewal. The National Council of State Boards of Nursing offers a wealth of information on registered nurse licensing requirements by state.

Specialty Certification

Some certifications, like a neonatal resuscitation program (NRP), are required to work with neonates, especially in the NICU. But apart from mandatory certifications, neonatal nurses can earn other specialty designations once they have some experience at the bedside. The American Association of Critical-Care Nurses offers the CCRN (Neonatal) specialty credential, and the National Certification Corporation offers the RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC).

Other related certifications offered by these organizations include:

• NCC Certification in Maternal Newborn Nursing (RNC-MNN)
• NCC Credential in Inpatient Obstetric Nursing (RNC-OB)
• RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC)
• RNC Certification in Low-Risk Neonatal Intensive Care Nursing (RNC-LRN)

These certifications announce neonatal experience to potential employers and often garner higher compensation.

Where Neonatal Nurses Work

Most neonatal nurses work in hospitals on a specialty unit just for preterm or very sick infants, called the neonatal intensive care unit, or NICU. These neonatal nurses are often called “NICU nurses.”

Outside of this setting, neonatal nurses can also find work in cardiac care, trauma/ER, or flight nursing. Some even work in homes and community settings to care for high-risk infants outside of the hospital.

• Level I: Healthy infants born prematurely (before 37 weeks)
• Level II: Infants born at or after 32 weeks gestation who need close observation
• Level III: Infants born before 32 weeks gestation/low birth weight (less than 1,500 grams)/critically ill infants
• Level IV: Newborn infants who require major surgery

FAQs: How to Become a Neonatal Nurse

   1. What education is needed to become a neonatal nurse?

Neonatal nurses must graduate with a nursing degree from an accredited college or university. They can pursue a 2-year Associate Degree in Nursing (ADN) or a 4-year Bachelor of Science in Nursing (BSN). After some bedside experience, they may pursue advanced degrees like a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), but these are not required to practice as a neonatal nurse.

   2. How many years does it take to become a neonatal nurse?

The time it takes to become a neonatal nurse depends on which degree they pursue, but may take anywhere from two to four years for an undergraduate degree.

   3. What are the steps to become a neonatal nurse?

To become a neonatal nurse, aspiring nurses must apply to and graduate from an accredited nursing school, pass the NCLEX-RN, and apply for and receive a nursing license in their state. After these steps, they may apply to neonatal nurse positions and pursue specialty certification and higher education.

   4. How much do neonatal nurses make an hour?

Neonatal nurses make a similar wage to any other registered nurse. According to the U.S. Bureau of Labor Statistics (BLS), RNs earn an average of $45.42 per hour, which equals about $94,480 annually. Nurses with an advanced degree will be able to earn more.