This guide on how to become a neonatal nurse is designed as an overview to give you an idea and a step-by-step plan of action to help you achieve your goals. Below you will learn about what a neonatal nurse does, salary expectations, what type of person typically succeeds as a neonatal nurse, how long does it take to become a neonatal nurse practitioner, and other related information which will help you to learn how to become a NICU nurse.

What Does a Neonatal Nurse Do?

A neonatal nurse, also often referred to as a NICU nurse, is trained to provide a full and comprehensive range of medical services to newborn infants, primarily during the first four weeks of their lives. Through a combination of educational instruction and supervised practice, they learn to care for acutely and critically ill newborns, who may be suffering from congenital defects, infections, organ problems, chronic health conditions, or complications due to premature birth. Neonatal nurses are frequently deployed in special care nurseries or neonatal intensive care units, tending to sick infants who require round-the-clock monitoring and access to specialized medical equipment.

Neonatal nurses also offer advice, guidance, and instruction on newborn care to parents. They work primarily in hospitals and large clinics, although some neonatal nurses will make home visits to patients in need. While trained to provide intensive medical services, neonatal nurses are sometimes employed in conventional hospital nurseries, caring for healthy newborns to make sure no medical complications arise.

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How Much Does a Neonatal Nurse Make?

In 2019, the annual median pay for registered nurses of all types was $73,300. Experienced neonatal nurses can expect to earn more than this, as can neonatal nurses who work in intensive care units. Salaries for neonatal nurses in the United States can vary significantly by geographical location, with compensation levels generally higher in areas with higher costs of living (i.e., the West Coast and the Northeast). So, in answer to the question how much do NICU nurses make, the majority will earn somewhere between $60k to $85k per year.

Overall, the demand for registered nurses of all types in the United States is expected to increase by seven percent between 2019 and 2029. This is nearly twice the average growth rate for all occupations combined. Since the services of neonatal nurses are required everywhere, neonatal nurses with the proper preparation should be able to find employment opportunities in any city, state, or region where they’d like to work.

How Long Does it Take to Become a Neonatal Nurse

For most people, from start to finish, it will take a little more than four years to become a neonatal nurse. In addition to a four year degree, you will have to take and pass the National Council Licensing Examination for Registered Nurses (see step two below for more on this exam), which you will usually need to take once your degree has been posted (usually a few weeks after graduation).

However, it is possible to shorten this to a little more than two years if you go the route of obtaining an associates degree instead of bachelor’s. So, how many years of college to be a neonatal nurse depends on your educational path. See below for more details.

How to Become a Neonatal Nurse: A Step-by-Step Guide

Step 1: Complete an Undergraduate Degree Program at an Accredited University

It is possible to obtain either an associate’s or a bachelor’s degree in nursing. However, your prospects of finding entry-level employment will be significantly enhanced if you have a bachelor’s degree from a four-year college.

Respected institutions of higher learning in every state offer Bachelor of Science Degrees in Nursing. Once accepted into a program, you’ll train to become a registered nurse, which is the status you must acquire before you’ll be eligible to practice nursing regardless of your specialty. As an aspiring neonatal nurse, your choice of electives would likely include ample instruction in infant and pediatric care.

Hands-on, practical experience is an essential element of any nursing curriculum. Consequently, nursing departments at major universities are always willing to help their students secure internships or externships at local hospitals or clinics. You might be able to find internship and externship programs through your own initiative as well, since neonatal nursing services are needed everywhere. The real-world experience you gain from these programs will be valued by potential employers, and may count toward the clinical hours you need to qualify for neonatal certification exams in the future.

Step 2: Take the National Council Licensing Examination for Registered Nurses

With your Bachelor’s degree in hand (or associate’s degree, if you chose that option), you’ll be eligible to take the National Council Licensing Examination for Registered Nurses (the NCLEX-RN). Passing this examination will grant you official status as a registered nurse, which is the label you must attain to be able to practice nursing at the professional level. This requirement must be met before you can accept a nursing job at a hospital or other medical facility, regardless of the state or city where you choose to work.

Step 3: Seek Entry-Level Employment and/or Residency Opportunities

As a newly minted neonatal registered nurse, you could find entry-level employment in hospitals or at clinics that specialize in infant care. Opportunities are generally available across the United States, since even small hospitals deliver babies and offer specialized healthcare services to newborn patients.

Beginning neonatal nurses may find job openings at one of four care levels:

  • Level 1: Well newborn nurseries
  • Level 2: Special care nurseries
  • Level 3: Neonatal intensive care units (NICUs)
  • Level 4: Regional NICUs

Neonatal nursing residency programs are increasingly available for recent college graduates who’ve achieved RN status. Neonatal nursing residents are frequently assigned to special care or intensive care units, where they receive additional training and instruction as they learn to apply their skills to help infants facing serious health challenges.

In general, you’ll need to gain about two years of on-the-job experience before you’re eligible to take certification exams, which will open opportunities for promotions or better positions.

Step 4: Obtain a Neonatal Resuscitation Certificate

To advance beyond entry-level employment, you should obtain specialized certificates that recognize your knowledge base, clinical skills, and previous achievements in the neonatal nursing profession.

While most of these certificates are optional, one is not—the Neonatal Resuscitation Certificate. All registered neonatal nurses are required to complete a short course that teaches neonatal resuscitation, which will eventually lead to certification in this vitally important skill. The course will include a two-part written examination, online simulation training, and attendance at an in-person, instructor-led training event. At the end of the latter, your instructor will test your knowledge and technical skill, and if you pass this evaluation you’ll be issued a Neonatal Resuscitation Certificate.

Step 5: Seek Neonatal Nursing Certification

Neonatal certifications testify to your specialized expertise in certain facets of neonatal care, and will significantly improve your chances of finding nursing jobs with higher salaries and more responsibility.

The National Certification Corporation is responsible for developing and administering exams for neonatal nurses seeking specialized certifications. Depending on your interests and past experiences, your options for NCC certification would include:

  • Inpatient Obstetric Nursing (RNC-OB)
  • Maternal Newborn Nursing (RNC-MNN)
  • Low Risk Neonatal Intensive Care Nursing (RNC-LRN)
  • Neonatal Intensive Care Nursing (RNC-NIC)
  • Obstetric and Neonatal Quality and Safety (C-ONQS)

Each of these exams currently costs $325, and can be taken at licensed testing centers or online with live remote proctoring. To be eligible to sit for these exams, you must be a registered nurse in good standing and have at least two years of prior experience in the neonatal nursing field (with a minimum of 2,000 hours of providing healthcare services). Certifications are good for three years, and must be renewed before their expiration deadlines if they are to be maintained.

NCC certification is quite prestigious. But you can enhance your future employment prospects even further by seeking additional certification through the American Association of Critical Care Nurses (AACN). Certifications through this organization are available for registered neonatal nurses who have spent at least two years providing direct care to acutely and/or critically ill infants in licensed healthcare facilities.

AACN certification is especially appropriate for neonatal nurses who want to work in neonatal intensive care units, trauma units, medical or surgical ICUs, or in critical care transport. The certifications offered by the AACN include:

  • Critical Care RN (CCRN Neonatal)
  • Critical Care RN Knowledge Professional (CCRN-K Neonatal)
  • Acute Care Clinical Nurse Specialist (ACCNS-N)

AACN certification exams currently cost $245 for organization members and $360 for non-members, and are administered at various testing centers across the United States.

Step 6: Pursue Graduate-Level Studies for Further Career Advancement

There are many outstanding universities that offer master’s degrees and doctoral degrees in nursing. Should you eventually choose to continue your education, and successfully acquire one or more graduate degrees in neonatal nursing, you could pursue new and exciting career opportunities.

For example, you could find employment as an associate professor at a university or community college. You could also qualify for a job as a hospital administrator, overseeing critical care programs for newborns. You could pursue a position in research, where you could dedicate yourself to finding cures or better forms of treatment for infants suffering from dangerous health conditions.

Many neonatal nurses pursue graduate study because they’d like to become a neonatal nurse practitioner (NNP). Officially known as advance practice registered nurses (APRNs), neonatal nurse practitioners are eligible to assume duties and responsibilities that are generally not available to neonatal registered nurses. NNPs may be asked to develop comprehensive care programs, prescribe medications, supervise other nurses in neonatal departments, or take on administrative duties related to their clinical practice.

At the present time, you can become eligible for employment as a neonatal nurse practitioner by obtaining a Master’s Degree in Nursing. However, starting in 2025, graduate programs in U.S. universities will only grant official nurse practitioner designations to those who complete doctoral programs in their chosen nursing specialty.

The National Certification Corporation administers a Neonatal Nursing Certificate (NNP-BC) exam, for aspiring neonatal nursing practitioners who’ve obtained a post-graduate degree and would like to achieve certification as well.

Pros and Cons of Becoming a Neonatal Nurse


If you love children and are especially fond of infants, a career as a neonatal nurse can bring great rewards. You’ll be able to use your hard-earned medical skills to help infants in distress. You’ll gently and skillfully guide them toward recovery, helping them get a good start in life even if they’ve faced severe health challenges. Infants respond to kindness and a soft touch, and if you bring your empathy to your medical practice you’ll be able to help your young patients thrive.


Despite the rewards, there are also challenges. Neonatal nurses are sometimes required to work long shifts on consecutive days. This is especially true during the initial stages of a neonatal nursing career, when there is still much to learn. Tragedy is unavoidable in medicine, and neonatal nurses must be prepared to manage the disappointment and emotional pain they experience when the infants in their care are struggling to recover, sometimes without success.

Important Characteristics of a Successful Neonatal Nurse

The best neonatal nurses are motivated by compassion and empathy. They must be highly observant and pay great attention to detail, since their young patients are unable to express their feelings or describe their symptoms verbally. Neonatal nurses must be resilient enough to handle setbacks and sad outcomes, since there will always be new patients that require their skilled assistance.

Because neonatal nurses frequently deal with parents who are stressed and anxious, they must be exceedingly patient. Regardless of the situation, neonatal nurses must remain composed and authoritative at all times. They must radiate a sense of confidence and purpose, which will reassure worried moms and dads and help them earn the trust of their colleagues.

Neonatal nursing is a demanding career choice that requires hard work and personal sacrifice. The most successful neonatal nurses see their work as a calling rather than a job, which helps them maintain the perseverance they need to succeed. If you enter the profession with this type of dedication, a career in neonatal nursing could bring you tremendous satisfaction and a sense of profound fulfillment.


Becoming a neonatal nurse (a ‘baby nurse’ for those who love infants!) is a noble and rewarding goal to strive for. We hope this guide on how to become a neonatal nurse practitioner has been helpful for you and that it will support you along your path. If you were asking what steps you need to take to become a neonatal nurse practitioner, how long does it take to become a NICU nurse or how many years of school to be a neonatal nurse, this guide should have answered this for you (two to four years depending on the type of education you pursue). This career guide will continue to be here whenever you need to come back and refer to it.

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