How to Become a Neonatal Nurse Practitioner
Duties, Requirements, Certifications, Job Outlook, and Salary
Upon entering the field, Registered Nurses (RNs) gain experience by working with various patient groups. After gaining that experience, some nurses advance their careers by becoming specialized in a particular healthcare field or patient category.
Nursing specializations can range from pediatric and geriatric care to oncology, mental health, and many others. Choosing a specialization allows nurses to focus on an area of healthcare that is personally meaningful and professionally rewarding. With proper education, training, and experience, specialized nurses play a critical role in providing targeted care and expertise.
(Click here to learn how to become a Registered Nurse)
As a Registered Nurse, you can specialize in a healthcare concentration of your choice.
However, you can expect unique job responsibilities, work environments, and patient groups for every nursing specialization. Furthermore, each discipline comes with its own educational and licensing requirements.
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This article will focus on the nursing specialists who help expectant mothers safely and successfully deliver their newborn babies, Neonatal Nurse Practitioners.
If you enjoy working with mothers and their newborn children, this guide will explore a Neonatal Nurse’s role, job responsibilities, salary*, and educational requirements.
What is a Neonatal Nurse?
A Neonatal Nurse Practitioner is an Advanced Practice Registered Nurse (APRN) with an advanced degree in nursing. Neonatal Nurse Practitioners care for infants and families when the newborn’s health condition requires more care than a standard postnatal ward can provide.
What Does a Neonatal Nurse Do?
Neonatal Nurses provide care for newborns and their families. They work with newborn infants born with health problems such as congenital disabilities, premature birth, or heart malformations. They work alongside physicians and other healthcare team members to provide medical treatment and counseling for their patients and their families.
Neonatal Nurses also care for sick or premature babies by administering oxygen, medication, and other basic procedures in a neonatal intensive care unit (NICU).
There are four levels of NICU. Each group represents the level of care needed for an infant. The first level is designed for relatively healthy newborns, while the fourth is for infants with critical conditions.
Neonatal Nurse: Day-to-Day Responsibilities
Some of the day-to-day responsibilities of Neonatal Nurses include:
- Coordinating, writing orders, and implementing neonatal care
- Starting and maintaining IV lines
- Assessing vital signs and drawing blood
- Educating the infant’s parents on treatments and procedures
- Ordering and administering medications and oxygen
- Assisting and participating in deliveries of high-risk newborns
In addition to the listed responsibilities, Neonatal Nurses often engage in complex care planning, work closely with physicians, dietitians, and therapists to create a comprehensive care strategy, and provide emotional support to the family members. Their role extends to organizing and participating in developmental care programs to promote an infant’s growth and well-being.
Where Do Neonatal Nurses Work?
Neonatal Nurse Practitioners work within a neonatal intensive care unit (NICU). As previously mentioned, there are four levels of the NICU, each providing varying levels of care depending on the infant’s condition.
Levels of NICU Explained
- Level 1: Basic care for healthy, full-term infants. Includes routine monitoring and short-term support.
- Level 2: Special care for infants born at 32 weeks gestation or higher, or who are moderately ill but expected to recover rapidly. Offers more intensive treatment, such as oxygen therapy.
- Level 3: Advanced care for seriously ill or premature infants. Provides life-saving technologies like mechanical ventilation.
- Level 4: The highest level of neonatal care. Equipped to deal with the most critical cases and complex surgeries.
Neonatal Nurses may also work in outpatient clinics and pediatric offices or provide home health care services, offering continued support for infants after discharge.
How Long Does It Take to Become a Neonatal Nurse?
Becoming a Neonatal Nurse Practitioner requires a significant level of education and training. It also requires substantial experience working in pediatrics and neonatal care.
The entry-level requirements for a Neonatal Nurse Practitioner may vary depending on location, but you must earn a Bachelor of Science in Nursing Degree at a minimum.
It is a lot of work, but the dedication will pay off in the end, as Neonatal Nurses rank among the best-paying nursing jobs in the US.
Here are the steps required to become a Neonatal Nurse Practitioner:
1. Earn your Bachelor of Science in Nursing (BSN) Degree
The first step to becoming a Neonatal Nurse Practitioner is earning your BSN or Bachelor of Science in Nursing Degree. A BSN program will take about three to four years to complete.
However, if you’ve already earned your associate degree in nursing, you can enroll in an RN-to-BSN program. These bridge programs are convenient and can be completed in as little as 20 months.
Accelerated nursing programs are also available to Licensed Vocational Nurses with an associate degree in vocational nursing (AVSN or LPN). These LVN to BSN programs allow you to skip the first three semesters of the BSN program.
2. Pass the NCLEX-RN Certification Exam
Upon earning your nursing bachelor’s degree, the next step to becoming a Neonatal Nurse Practitioner is earning your nursing license. To do that, you must pass the NCLEX-RN or the National Council Licensure Examination for Registered Nurses. With the NCLEX, you’ll be certified to enter the workforce as a Registered Nurse (RN).
(Click here to read our NCLEX-RN Exam Review & Study Guide)
3. Gain Real-World Experience Working as an RN
To be hired as a Neonatal Nurse Practitioner, most NICUs require applicants to have some experience working with infants or children. RNs can work in pediatrics or hospital nurseries before applying for neonatal nursing positions. Some nursing schools offer internship opportunities for students to gain experience working in neonatal care before graduating. The amount of experience required varies depending on the location.
4. Become Certified in Neonatal Care
Although becoming certified is optional, Neonatal Nurse Practitioners will complete certification to validate their skills and strengthen their resumes.
Neonatal Certification Options:
The American Nurses Credentialing Council (ANCC) offers a pediatric nursing certification.
The National Certification Corporation (NCC) offers several neonatal certifications. Some of the credentials administered by the NCC include:
- The Credential in Inpatient Obstetric Nursing (RNC-OB) to evaluate competence in “providing care to hospitalized pregnant women during the antepartum, intrapartum, postpartum and newborn periods.”
- Certification in Maternal Newborn Nursing (RNC-MNN) tests nurses on their ability to “provide care to the childbearing family from birth to six weeks within hospital or outpatient settings.”
- Certification in Low-Risk Neonatal Intensive Care Nursing (RNC-LRN) to certify “experience in providing care to acutely and chronically ill neonatal patients and their families within level II, chronic care, special care, or step-down units.”
- RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC) tests the ability to “provide care to acutely and critically ill neonatal patients and their families within an intensive care environment.”
Finally, the American Association of Critical Care Nurses also administers several neonatal certification examinations, including:
- The CCRN (Neonatal) is a specialty competency exam “for nurses who provide direct care to acutely/critically ill neonatal patients regardless of their physical location.”
- The CCRN-K (Neonatal) Certification is for nurses “who influence the care delivered to acutely/ critically ill neonatal patients but do not primarily or exclusively provide direct care.”
- The ACCNS-N (Neonatal)Advanced Practice Board Certification is for “Clinical Nurse Specialists (CNSs) educated at the graduate level to provide advanced nursing care to meet the specialized needs of the neonatal patient population.”
5. Earn Your MSN Degree
To become a Neonatal Nurse Practitioner, an additional step is often required: earning a Master of Science in Nursing (MSN) focusing on neonatal care. This specialized education prepares nurses for advanced practice, allowing them to diagnose and manage common and complex neonatal conditions. It’s important to distinguish between Neonatal Nurses, who may have a BSN or higher, and Neonatal Nurse Practitioners, who must have at least an MSN.
Alternative Educational Pathways:
Besides the BSN route, there are options to pursue a direct-entry Master’s in Nursing (MSN) program for those with a bachelor’s degree in another field. Some institutions offer fast-track options for individuals with prior healthcare experience. Researching and choosing the best educational pathway to align with career goals is crucial to success in the nursing profession.
Career Growth and Professional Development
Neonatal Nurse Practitioners can continue to grow and advance their careers through ongoing education, workshops, and conferences. Engaging in research, mentoring, leadership roles, and contributing to policy development can have a broader impact on the field. Earning additional certifications and pursuing higher degrees, such as a Doctor of Nursing Practice (DNP), can also lead to further specialization, higher positions, and increased earning potential.”
Neonatal Nursing Salaries
How Much Do Neonatal Nurse Practitioners Make?
According to the US Bureau of Labor Statistics (BLS), the average salary* of Nurse Practitioners, including Neonatal Nurse Practitioners, was about $125,000 annually as of May 2022.
The average salary* of Neonatal Nurse Practitioners can vary widely depending on factors like geographic location, years of experience, type of certification, and the specific healthcare setting. For example, those working in large city hospitals might earn more than those in rural areas. Additional credentials and specializations may also lead to higher compensation.
Highest Paying Industries for Neonatal Nurses
According to the BLS, these are the industries where you’re most likely to find the top-paying jobs for Neonatal Nurse Practitioners:
| Industry | Average Hourly Pay | Average Salary |
| Home Health Care Services | $71.62 | $148,960 |
| Rehabilitation Services | $67.14 | $139,640 |
| Psychiatric & Substance Abuse Hospitals | $64.69 | $134,540 |
| Outpatient Care Centers | $64.44 | $134,030 |
| General Hospitals | $62.18 | $129,330 |
Highest Paying States for Neonatal Nurses
According to the BLS, these are the states where you’re most likely to find the top-paying jobs for Neonatal Nurse Practitioners:
| State | Average Hourly Pay | Average Salary |
| California | $76.02 | $158,130 |
| New Jersey | $68.87 | $143,250 |
| Massachusetts | $66.68 | $138,700 |
| Oregon | $65.51 | $136,250 |
| Nevada | $65.49 | $136,230 |
Highest Paying Cities for Neonatal Nurses
According to the BLS, these are the cities where you’re most likely to find the top-paying jobs for Neonatal Nurse Practitioners:
| City | Average Hourly Pay | Average Salary |
| San Jose, CA | $95.98 | $199,630 |
| San Francisco, CA | $91.38 | $190,070 |
| Napa, CA | $90.96 | $189,190 |
| Vallejo, CA | $87.01 | $180,990 |
| New York, NY | $81.89 | $170,320 |
| Yuba City, CA | $77.74 | $161,690 |
| Sacramento, CA | $75.87 | $157,810 |
| San Luis Obispo, CA | $75.72 | $157,490 |
| Salinas, CA | $75.44 | $156,920 |
| El Centro, CA | $73.26 | $152,370 |
What is the Job Outlook for Neonatal Nurses?
According to the BLS, the job growth for Nurse Practitioners is projected to increase by 40% by 2030. In addition, the increase in the frequency of premature births and the steady population growth will provide a strong job outlook for Neonatal Nurse Practitioners.
The projected growth in the field is influenced by increased access to healthcare, advances in medical technology that improves the survival rates of premature and critically ill infants, and a general trend toward specialized care. The aging baby-boomer population also increases the need for healthcare services, indirectly affecting the demand for Neonatal Nurse Practitioners. The challenges in the field may include high stress and emotional demands, but the opportunity to make a profound impact on families’ lives is a rewarding aspect of this career.
Are You Ready to Start Your Career as a Neonatal Nurse?
Neonatal Nurses are saving the lives of children every single day, and their work is truly remarkable.
If you feel passionate about caring for infants and their families during a critical moment in their lives, then a career in neonatal nursing could be tremendously gratifying.
Start your BSN degree program at Provo College to begin your journey of becoming a Neonatal Nurse.
