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Neonatal nursing is a relatively new specialty by comparison to adult health, midwifery, or other areas of nursing. Because it is new, 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. Neonatal care, as known in specialized nurseries or intensive care, has been around since the 1960's.


A neonatal staff nurse works in either a Level I, II, or III nursery [Note: These levels of care are set forth by the Perinatal Regionalization Model and are also described in the Guidelines for Perinatal Care, 4th ed., published by the American Academy of Pediatrics and American College of Obstetrics and Gynecology, 1997, Elk Grove Village.].

A Level I is usually a healthy newborn nursery—largely nonexistent now because mothers and babies have a very short hospital stay these days and often share the same room.

Level II 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 cannot be treated in either of the other two nursery levels. 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 units may be in a large general hospital or part of a children’s hospital. Neonatal nurses provide the direct patient care to these infants.

Requirements for neonatal nurses are established by the institution which uses a list of practice skills to assess nurses’ abilities in using medications, math calculations, intravenous lines, cardiopulmonary resuscitation, and other knowledge needed for direct patient care. 

Continuing education requirements are mandated by the state or a certifying body. The state board of nursing sets the number of hours, if any, required during a 2-to-3 year period (depending on the time of renewal) to maintain the registered nurse (RN) license. As a staff or an advanced practice nurse, you may also hold national certification —an additional exam that demonstrates specialized knowledge in neonatal nursing. 

Practice Settings: 

As a neonatal nurse, you may work in neonatal intensive care units taking care of acutely ill neonates and premature infants or you may choose to work in mother-baby or newborn nurseries taking care of healthy newborns. 


Entry level requirements for neonatal nurses vary from institution to institution. Some hospital or medical centers may require one year of adult health or medical surgical nursing while other units hire RNs after graduation from an accredited school or college of nursing who have passed a state board of nursing (NCLEX) exam for licensure. The type and length of nursing experience also varies from one institution to another, but many require no previous experience. It depends on whether positions are plentiful and if a scarcity of qualified nurses exists in that particular area of the country.


A college or university education to prepare as an RN takes 2 or 4 years, depending on whether students attend a bachelor’s- or associate-degree program. After graduating, students take the state licensing exam to become an RN. There is no special program for neonatal nursing in basic RN education. Some nursing programs have an elective course in neonatal nursing.

Once you graduate and have obtained some experience as an RN in a neonatal intensive care unit (the National Association of Neonatal Nurses recommends two years), you might want to consider going to graduate school to become a neonatal nurse practitioner or clinical nurse specialist. 

Salary Range: 

The salary depends on the cost of living in your area. In the Midwest, nurses with no experience may start in the upper 30s to mid-40s for an annual salary. On either coast, the salaries are usually higher. In Southern areas, beginning nurses start at about $30,000 per year. The upper range for someone with no experience is around $48,000. Salary ranges may be higher for experienced nurses.


National Association of Neonatal Nurses
8735 West Higgins Road, Suite 300
Chicago, IL 60631
(800) 451-3795 or (847) 375-3660
FAX: (888) 477-6266 
Web site:

Association of Women’s Health, Obstetric and Neonatal 
2000 L St., NW, Suite 740
Washington, DC 20036
(202) 261-2413
FAX: (202) 728-0575
Web site:

The Academy of Neonatal Nursing
1425 N McDowell Blvd, Suite 105
Petaluma, CA 94954-6513
(707) 568-2168
FAX: (707) 569-0786 
e-mail: Click Here for Online Inquiries
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