Three Levels of Neonatal Nursing Care

Neonates Range from Healthy to Critically Ill

Nurses drawn to child care and with a special touch for infants and newborns often find Neonatal Nursing extremely rewarding. This nursing specialty is a fairly recent addition to many hospital environments. Nurses work with premature and very ill infants that have no other outside touch or assistance in some cases. The job requires sensitivity and compassion for life, in combination with a set of ultra-specialized skills only suitable to infants. Nurses in neonatal practice often work very closely with family as well as neonates.

Newborn Baby.

Neonatal Environments

Neonatal nurses work in hospital settings. Many neonatal departments have three different, but relatively standard, types of care areas:

  • A Neonatal Intensive Care Unit, sometimes called Level III, is reserved for the sickest babies. Newborns with birth defects, those that require surgery, or those born very prematurely and requiring medical support are located to a neonatal ICU. Here infants receive constant, one-on-one attention from a neonatal ICU nurse.
  • Level II neonatal care is equipped to handle newborns requiring a modest level of care and monitoring. In most cases these are premature newborns that will be receive care for a limited amount of time. Also most Level II units are equipped to handle ICU overflow, so nurses may be expected to have some knowledge associated with a neonatal ICU setting.
  • Level I neonatal units are equipped for healthy newborns requiring limited care. In most cases, unless mothers need more bed rest or medical attention, healthy newborns go home in a matter of hours after birth.

Degree Program Requirements

Neonatal nursing requirements differ from hospital to hospital, but all require RN licensure. RNs may have two-year, Associates degrees, or four-year Bachelor of Science (BSN) degrees.

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  • Entry-level neonatal nurses may find that they can learn the skills required through careful preceptorships. Novice nurses work one on one with an experienced nurse before managing his or her own patients.
  • Nurses with experience in intensive care units, critical care, medical-surgical, obstetrics, or pediatrics, may move laterally to neonatal units.
  • Advanced nursing degree programs such as Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS), may offer sub-specialties in neonatal nursing. These degrees confer a Masters upon completion and typically take about two years to complete. Nurses at this level of training will often find jobs in administration, management, research, or education, or go into an advanced clinical practice in a hospital or on their own.

Field Credentials

Nurses earn professional credibility with a particular set of licenses and credentials that indicate an accepted level of knowledge and education of a particular topic, subject, technique, or specialty. State boards of nursing also mandate a particular level of practice that a nurse must maintain and sometimes how many continuing education hours are acceptable each year.

The National Association of Neonatal Nurses is the leading professional organization that promotes and supports the field. Nurses are urged to complete regular continuing education courses to keep their resumes current and stay abreast of industry changes.


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