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What is a Neonatal Nurse

Neonatal nurses are Registered Nurses (RNs) who specialize in the care of critically ill premature babies and infants. They have specialized training in caring for the very sick neonate. Neonatal nursing can be both rewarding and challenging. Often, it is difficult for nurses to see babies that are so sick having to endure multiple surgeries, feeding and breathing tubes and numerous needle sticks. Sometimes, despite giving every life-saving effort, the babies die, which can be especially hard for the neonatal nurse to cope with. For the right nurse, though, comfort and hope can be found in the babies that thrive and grow and are able to one day be discharged home with their parents.

Neonatal Nurse Job Description

Neonatal nurses typically work in the hospital setting. They can be found in neonatal intensive care units, but may also work as neonatal transport nurses, flying in planes or helicopters to move a neonate from a rural area to a larger hospital. Neonatal nurses care for premature or term critically ill infants. They care only for infants that are born and stay in the hospital, as opposed to pediatric nurses who may care for newborns admitted to the hospital after they have been discharged for a period of time. They also attend high-risk deliveries to be able to provide life-saving efforts immediately after birth. Neonatal RNs utilize Neonatal Resuscitation protocol when providing life-saving treatment to newborns. These nurses may care for babies with a range of congenital defects as well as diseases and illnesses. Some babies are born extremely premature and may have severe respiratory and cardiac distress. Often these babies are on ventilator support for a period of time, have central umbilical lines, and are constantly monitored. Given their prematurity, the babies are often kept in incubators where the environment is strictly controlled. Unlike other nursing units, neonatal RNs often draw their own blood for lab work from central lines or do heel sticks. Neonatal nurses care for this very sick patient population, but they also are responsible for educating and supporting the parents. Parental support is perhaps more important in neonatal nursing than in any other nursing field as parents are often overwhelmed, scared and lost as they try to cope with having a very sick child.

Neonatal Nurse Training

Neonatal RNs begin their careers by earning an associate or bachelor degree in nursing. These programs can be found across the country and require two to four years of study. While many programs offer a clinical pediatric rotation, many nurses do not get to rotate through the neonatal intensive care unit as it is very specialized. Students interested in this field may be able to arrange to shadow a nurse for a few days as a special request. If neonatal intensive care rotations are not available, students would do well to partake in any rotations involving critical care for pediatric or adult patients as they will at least get exposure to caring for patients on ventilators, with multiple intravenous access lines and intensive monitoring.

Most training as a neonatal nurse takes place on the job. Many hospitals offer a training program of six to twelve weeks which includes working with an experienced preceptor neonatal RN, classroom instruction and additional certification training, such as Neonatal Resuscitation and Pediatric Advanced Life Support. Once the training period is completed, new neonatal RNs are often given more stable patients to begin with, and as they gain experience, are assigned more critical patients. Experienced neonatal RNs can apply for certification through the American Association of Critical-Care Nurses (AACN) with an emphasis in neonatal nursing. Nurses must have completed 1,750 hours of bedside neonatal nursing within the preceding two years; have a professional associate willing to vouch for their experience and an unencumbered nursing license to be eligible for certification.

Salary for a neonatal RN ranges from $44,814 to $88,390. Pay may be slightly higher than other nurses given the advanced training and specialized nature of neonatal nursing. Pay also varies depending on regional location of employment and years of neonatal nursing experience. Neonatal RNs in a supervisory position or those with a certification can command higher pay.

Opportunities For Nursing Career Advancement

Neonatal nurses can choose to become Neonatal Nurse Practitioners to gain more autonomy and responsibility in caring for critically ill neonates. Given the specialized nature of the field, there are only just over thirty programs in the United States that offer a graduate degree focusing on the care of neonates. Programs are generally two to three years in length and feature in-depth neonatal nursing education, including both classroom and clinical components. Prior to admission, most programs require at least two years of neonatal nursing experience. Neonatal Nurse Practitioners can become certified through the same certifying body as RNs, the AACN. Neonatal Nurse Practitioner salary ranges from $43,823 to $118,395.

Neonatal nurses face a challenging, yet rewarding career. They enjoy job security and flexibility due to their specialized skill set. There is opportunity for advancement should a neonatal nurse choose to pursue an advanced degree. Even with all these benefits, however, some nurses may find it difficult to work with babies who are critically ill. For those that can overcome the challenges, neonatal nursing can be very gratifying as they help newborns overcome illness and finally be able to go home. If you are interested in critical care nursing, but would like to work with neonates, neonatal nursing may be the right choice!

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