Nursing is such a wonderful profession with infinite possibilities. For registered nurses interested in a growing specialty, a career as a neonatal nurse might be worthy of consideration.
Daily Clinical Practice
Compared to other areas of nursing (adult health, geriatrics, pediatrics), neonatal nursing is relatively new, partly due to technological advances in the past 50 years. Because the specialty is still emerging, there are great opportunities for nurses to devote their skills to newborns who need specialized care.
“Neonatal” refers to the first 28 days of life. A neonatal staff nurse can work in a Level I, II, or III nursery. These levels of care are recognized by the American Academy of Pediatrics and American College of Obstetrics and Gynecology:
- A Level I nursery is usually a healthy newborn nursery, now largely nonexistent because these mothers/babies have a very short length-of-stay and often share the same room.
- A Level II nursery is an intermediate care or special care nursery where the baby may be born prematurely or may be suffering from an illness. These babies may need supplemental oxygen, intravenous therapy, specialized feedings, or more time to mature before discharge.
- The Level III neonatal intensive care unit (NICU) admits all neonates (during the first 28 days of life) who need more advanced medical care than a Level I or II nursery can provide. These babies may be small for their age, premature, or sick term infants who require high technology care, such as ventilators, special equipment or incubators, or surgery. The Level III NICUs may be in a large general hospital or part of a children’s hospital. Neonatal nurses provide the direct patient care to these infants.
History of the Specialty
At the beginning of the 20th century, a shift occurred in childbirth: fewer births took place at home and more took place in hospitals. This movement prompted an interest in the care of the newborn. By the 1950s, pediatricians were creating the field of neonatology. Other medical advances were occurring: (1) Dr. Virginia Apgar proposed a standardized birth assessment (The Apgar Score); (2) the development of formula as an option for infant nutrition; (3) development of incubators to combat thermal imbalance; and (4) developments in artificial ventilation and surfactant replacement therapy. Details of these interesting advancements can be found: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200660/
Parallel developments to these medical advances were occurring, as neonatal nursing evolved as a subspecialty of maternal-child nursing. Today, there are three professional organizations dedicated to this specialty:
- National Association of Neonatal Nurses (NANN) http://www.nann.org/
- Association of Women’s Health, Obstetric and Neonatal Nurses (AWHOON) www.awhonn.org
- The Academy of Neonatal Nursing (ANN) www.academyonline.org
Salary and Job Outlook
In October 2016, the website Payscale reported that the average salary for a neonatal nurse was $59,991. The U.S. Bureau of Labor Statistics forecasts job growth of 16% for all registered nursing positions between 2014 and 2024.
Qualifications and Requirements
An employer usually establishes requirements for their neonatal nurses. However, most require nurses to be proficient in using medications, math calculations, intravenous lines, cardiopulmonary resuscitation, and other knowledge needed for direct patient care. These continuing education topics, from ANN, might appeal to neonatal nurses:
- Tracheostomy for Infants: Parent Education for Home Care
- Cardiac Assessment in the Neonatal Population
- The Retinopathy of Prematurity Screening Examination
- Feeding Challenges in the Late Preterm Infant
- Fluid and Electrolyte Management in the Postsurgical Neonate
- Sodium Bicarbonate Use in the Treatment of Acute Neonatal Lactic Acidosis
While earning a BSN degree does not instantly qualify a nurse for any career, a bachelor’s degree is a vital step in career advancement. A NICU nurse may also wish to seek certification. The credential awarded to NICU nurses who successfully pass the Neonatal Intensive Care Nursing certification examination is the RNC-NIC. In order to be eligible to take the certification examination, a licensed RN must have a minimum 2,000 hours of specialty experience in the field within the past 24 months and have been employed in the field within the past 24 months. Seeking another degree or certification may open a vast array of job opportunities that wait for NICU nurses