03/21/2023
Did you know that NICU nurses rank among the most valuable nursing professionals? These nurses have always enjoyed the reverence of every practitioner in the field.
However, they’ve gained more popularity due to increasingly worrying birth stats, with the CDC reporting that one of every eight babies in the USA is born prematurely.
But how can NICU nurses help with these statistics? This piece examines relevant information about this high-ranking nurse caste, covering their responsibilities, job prospects, and the various pathways to becoming one yourself.
Ready? Here we go!
A NICU nurse works in the neonatal intensive care unit to cater to healthcare issues in newborns, such as premature birth, infections, and cognitive problems.
These practitioners may be responsible for one to three babies, including some who may be on life support.
NICU nurses are responsible for feedings, checking vital signs, cardiorespiratory monitoring, blood pressure monitoring, and other health readings.
In addition, these nurses can start and terminate intravenous (IV) lines, conduct cardiopulmonary resuscitation (CPR), and perform drug dose calculations. They also monitor specialized equipment (e.g., incubators and ventilators) that stabilize a newborn’s life in a controlled setting.
What’s more? NICU nurses can advise parents on their child’s status and specific behaviors. As such, a NICU practitioner is an empathetic and skilled communicator.
NICU nurses work up to 12-hour shifts and could opt to follow a traditional schedule of three 12-hour shifts per week.
Yes, there are four NICU nurse levels, and we briefly explain each below:
Neonatal and NICU nurses work with infants, but the scope of responsibilities differentiates both groups.
A neonatal nurse works with critically ill infants who are not necessarily admitted to the NICU. In other words, they can work outside the NICU.
On the other hand, a NICU nurse works solely on infants in the neonatal intensive care unit, as they are limited to the NICU.
So, every NICU nurse is a neonatal nurse, but not every neonatal nurse is a NICU nurse.
A neonatal nurse must have a license from their state for a start. Additionally, they must maintain specific continuing education requirements and patient contract hours for their certificate to remain valid.
The organizations in charge include the American Nurses Credentialing Center, the American Academy of Nurse Practitioners Certification Board, and the American Association of Critical-Care Nurses.
Becoming a NICU nurse requires the following:
The first step to NICU nursing is to secure a nursing degree. Complete an accredited two-year Associate Degree in Nursing (ADN) or four-year Bachelor of Science in Nursing (BSN) in a licensed school. Expect plenty of psychology, microbiology, biology, chemistry, and anatomy.
You must pass the National Council Licensure Examination (NCLEX) to become a licensed registered nurse after your degree.
This exam covers various nursing subjects, including medical, pediatric, psychiatric, obstetric, and surgical.
As an RN, you can enter the field to gain experience for two years at least. Units you may work in include pediatric, maternal-child, labor & delivery, and well-baby.
Gaining a career-specific license gives you an edge over other nurses. Earn widely recognized neonatal practice certifications, such as the license from the American Association of Critical Care Nursing (AACN) and the National Certification Corporation (NCC).
Alternatives include the RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC), Neonatal Neuro-Intensive Care (C-NNIC), and the Care of the Extremely Low Birth Weight Neonate Subspecialty (C-ELBW).
Each certificate has varying requirements, mainly in the years you’ve practiced as a registered nurse. Some come with state-mandated continuing education requirements for updated licensure.
Continuing education requirements and fees vary by state and certifying body. For example, California requires 30 continuing education units every two years. Conversely, Arizona, Colorado, and Connecticut have no such requirements.
Various institutions offer accredited NICU programs. We’ve shortlisted the best five according to the educational quality, NCLEX pass rate, and cost.
Program Length: 4 years
Tuition: $14,188
Description: Discounted rate for NE region residents and affiliations with reputable healthcare systems in the state, including the Boston Children’s Hospital
Program Length: 4 years
Tuition: $56,212
Description: Ivy League school with closest ties to the Children’s Hospital of Philadelphia
Program Length: 4 years
Tuition: $16,104
Description: 98% graduation rate, affiliation with top institutions (e.g. Seattle Children’s Hospital) and 1,000+ clinical hours required to graduate
Program Length: 4 years
Tuition: $539 per credit hour
Description: Opportunity to work clinicals at the Children’s Hospital Colorado, one of the best children’s hospitals in the country
Program Length: 4 years
Cost: $2,358 per credit hour
Description: Highly regarded research university requiring 850 clinical hours at top healthcare networks such as the Children’s National Hospital.
With ten years of experience, neonatal nurses can average over $120,000 yearly, recording far higher than the national median.
Below is a Ziprecruiter table showing the average earnings of NICU nurses per state.
| State | Annual Salary | Monthly Pay | Weekly Pay | Hourly Wage |
| Alabama | $79,127 | $6,594 | $1,522 | $38.04 |
| Alaska | $98,448 | $8,204 | $1,893 | $47.33 |
| Arizona | $83,988 | $6,999 | $1,615 | $40.38 |
| Arkansas | $84,795 | $7,066 | $1,631 | $40.77 |
| California | $90,777 | $7,565 | $1,746 | $43.64 |
| Colorado | $90,118 | $7,510 | $1,733 | $43.33 |
| Connecticut | $102,931 | $8,578 | $1,979 | $49.49 |
| Delaware | $89,533 | $7,461 | $1,722 | $43.04 |
| Florida | $76,365 | $6,364 | $1,469 | $36.71 |
| Georgia | $81,022 | $6,752 | $1,558 | $38.95 |
| Hawaii | $103,986 | $8,666 | $2,000 | $49.99 |
| Idaho | $85,047 | $7,087 | $1,636 | $40.89 |
| Illinois | $84,336 | $7,028 | $1,622 | $40.55 |
| Indiana | $83,449 | $6,954 | $1,605 | $40.12 |
| Iowa | $94,722 | $7,894 | $1,822 | $45.54 |
| Kansas | $93,252 | $7,771 | $1,793 | $44.83 |
| Kentucky | $86,606 | $7,217 | $1,665 | $41.64 |
| Louisiana | $97,259 | $8,105 | $1,870 | $46.76 |
| Maine | $84,571 | $7,048 | $1,626 | $40.66 |
| Maryland | $95,754 | $7,979 | $1,841 | $46.04 |
| Massachusetts | $105,493 | $8,791 | $2,029 | $50.72 |
| Michigan | $84,525 | $7,044 | $1,625 | $40.64 |
| Minnesota | $100,290 | $8,357 | $1,929 | $48.22 |
| Mississippi | $87,398 | $7,283 | $1,681 | $42.02 |
| Missouri | $82,535 | $6,878 | $1,587 | $39.68 |
| Montana | $84,861 | $7,072 | $1,632 | $40.80 |
| Nebraska | $94,085 | $7,840 | $1,809 | $45.23 |
| Nevada | $97,673 | $8,139 | $1,878 | $46.96 |
| New Hampshire | $96,022 | $8,002 | $1,847 | $46.16 |
| New Jersey | $85,796 | $7,150 | $1,650 | $41.25 |
| New Mexico | $96,390 | $8,033 | $1,854 | $46.34 |
| New York | $99,473 | $8,289 | $1,913 | $47.82 |
| North Carolina | $76,906 | $6,409 | $1,479 | $36.97 |
| North Dakota | $98,409 | $8,201 | $1,892 | $47.31 |
| Ohio | $99,940 | $8,328 | $1,922 | $48.05 |
| Oklahoma | $87,444 | $7,287 | $1,682 | $42.04 |
| Oregon | $94,303 | $7,859 | $1,814 | $45.34 |
| Pennsylvania | $85,002 | $7,083 | $1,635 | $40.87 |
| Rhode Island | $100,070 | $8,339 | $1,924 | $48.11 |
| South Carolina | $90,249 | $7,521 | $1,736 | $43.39 |
| South Dakota | $95,536 | $7,961 | $1,837 | $45.93 |
| Tennessee | $100,678 | $8,390 | $1,936 | $48.40 |
| Texas | $82,144 | $6,845 | $1,580 | $39.49 |
| Utah | $97,880 | $8,157 | $1,882 | $47.06 |
| Vermont | $90,315 | $7,526 | $1,737 | $43.42 |
| Virginia | $92,851 | $7,738 | $1,786 | $44.64 |
| Washington | $100,318 | $8,360 | $1,929 | $48.23 |
| West Virginia | $86,465 | $7,205 | $1,663 | $41.57 |
| Wisconsin | $101,334 | $8,445 | $1,949 | $48.72 |
| Wyoming | $89,184 | $7,432 | $1,715 | $42.88 |
Not all babies born with health conditions are considered the same. According to their skill sets, Neonatal nurses can choose from Level 1, Level 2, Level 3, or Level 4 care.
The US Bureau of Labor Statistics estimates that the registered nursing field will grow 9 percent through 2030 as one of the most in-demand fields in the country. In addition, thousands of nurses may retire along the line due to their age.
The implication? New NICU nurses will have plenty of roles to fill across the USA.
Becoming a neonatal nurse introduces you to countless network opportunities, as many organizations exist to serve you. They include the National Association of Neonatal Nurses Academy of Neonatal Nursing and the Association of Women’s Health.
Suppose they gain the multi-state license. NICU travel nurses can earn as high as $30,000 for a three-month assignment and other perks such as housing allowances and weekly food stipends.
One of the most significant downsides to NICU nursing is the harsh psychological toll. NICU nurses are constantly exposed to babies on the brink of death, performing life-saving tasks such as mechanical ventilation and battling alarm fatigue. Expect a lot of interactions with worried parents as well.
Babies are by far some of the most fragile patients in hospitals today. Neonatal nurses must calculate all medical doses to the dot. Babies are also very quick to develop complications, requiring your mental insight and guidance to see them through. Babies deemed healthy could go into a severe state at any moment.
Neonatal nurse practitioners are a step up from neonatal nurses. They are advanced practice nurses with an MSN (master’s degree in nursing) or DNP (Doctor’s in Nursing Degree) through an Advanced Practice Neonatal Nursing (APNN) program.
These practitioners have more responsibility than neonatal nurses, such as conducting invasive procedures, prescribing medications, and changing medical treatments. Neonatal nurse practitioners can work independently or under a physician’s supervision, depending on the state.
Below is the median neonatal nurse practitioner salary by state, courtesy of Ziprecruiter:
| State | Annual Salary | Monthly Pay | Weekly Pay | Hourly Wage |
| Alabama | $94,163 | $7,847 | $1,811 | $45.27 |
| Alaska | $100,702 | $8,392 | $1,937 | $48.41 |
| Arizona | $99,949 | $8,329 | $1,922 | $48.05 |
| Arkansas | $88,166 | $7,347 | $1,695 | $42.39 |
| California | $112,944 | $9,412 | $2,172 | $54.30 |
| Colorado | $93,887 | $7,824 | $1,806 | $45.14 |
| Connecticut | $102,993 | $8,583 | $1,981 | $49.52 |
| Delaware | $93,748 | $7,812 | $1,803 | $45.07 |
| Florida | $90,874 | $7,573 | $1,748 | $43.69 |
| Georgia | $96,418 | $8,035 | $1,854 | $46.35 |
| Hawaii | $105,745 | $8,812 | $2,034 | $50.84 |
| Idaho | $106,261 | $8,855 | $2,043 | $51.09 |
| Illinois | $87,686 | $7,307 | $1,686 | $42.16 |
| Indiana | $99,309 | $8,276 | $1,910 | $47.74 |
| Iowa | $93,435 | $7,786 | $1,797 | $44.92 |
| Kansas | $94,150 | $7,846 | $1,811 | $45.26 |
| Kentucky | $89,778 | $7,481 | $1,726 | $43.16 |
| Louisiana | $94,991 | $7,916 | $1,827 | $45.67 |
| Maine | $104,632 | $8,719 | $2,012 | $50.30 |
| Maryland | $100,313 | $8,359 | $1,929 | $48.23 |
| Massachusetts | $109,057 | $9,088 | $2,097 | $52.43 |
| Michigan | $88,105 | $7,342 | $1,694 | $42.36 |
| Minnesota | $97,948 | $8,162 | $1,884 | $47.09 |
| Mississippi | $88,204 | $7,350 | $1,696 | $42.41 |
| Missouri | $86,245 | $7,187 | $1,659 | $41.46 |
| Montana | $100,988 | $8,416 | $1,942 | $48.55 |
| Nebraska | $98,715 | $8,226 | $1,898 | $47.46 |
| Nevada | $99,910 | $8,326 | $1,921 | $48.03 |
| New Hampshire | $115,402 | $9,617 | $2,219 | $55.48 |
| New Jersey | $100,808 | $8,401 | $1,939 | $48.47 |
| New Mexico | $92,713 | $7,726 | $1,783 | $44.57 |
| New York | $119,209 | $9,934 | $2,292 | $57.31 |
| North Carolina | $80,295 | $6,691 | $1,544 | $38.60 |
| North Dakota | $99,948 | $8,329 | $1,922 | $48.05 |
| Ohio | $97,188 | $8,099 | $1,869 | $46.72 |
| Oklahoma | $91,747 | $7,646 | $1,764 | $44.11 |
| Oregon | $95,551 | $7,963 | $1,838 | $45.94 |
| Pennsylvania | $101,843 | $8,487 | $1,959 | $48.96 |
| Rhode Island | $101,394 | $8,449 | $1,950 | $48.75 |
| South Carolina | $94,225 | $7,852 | $1,812 | $45.30 |
| South Dakota | $97,029 | $8,086 | $1,866 | $46.65 |
| Tennessee | $97,898 | $8,158 | $1,883 | $47.07 |
| Texas | $103,033 | $8,586 | $1,981 | $49.54 |
| Utah | $95,865 | $7,989 | $1,844 | $46.09 |
| Vermont | $108,908 | $9,076 | $2,094 | $52.36 |
| Virginia | $97,421 | $8,118 | $1,873 | $46.84 |
| Washington | $126,564 | $10,547 | $2,434 | $60.85 |
| West Virginia | $103,596 | $8,633 | $1,992 | $49.81 |
| Wisconsin | $97,571 | $8,131 | $1,876 | $46.91 |
| Wyoming | $106,581 | $8,882 | $2,050 | $51.24 |
Basic NICU nurses must work for two to three years before working towards practitioner roles. Meanwhile, they may secure a Master’s of Science in Nursing.
However, MSN programs contain hundreds of clinical hours and nursing simulation labs. Therefore, combining this program with your tasking service to infants may be highly challenging.
The next step is to take the NCC (National Certification Corporation) exam to obtain Neonatal Nurse Practitioner status. This test is computer-based and multiple-choice structured, and it assesses your knowledge of neonatal, infant, and toddler care across a wide range of disciplines, including physiology and pathophysiology.
Results are mailed within 21 days, and there is no limit to the number of times you can retake the test, provided you don’t take it twice in a calendar year. The exam costs $275 with a $50 non-refundable application fee.
Note all NCC certification is valid for three years before its time to take continuing education credits. For more details on Neonatal Nurse Practitioner Core Certification, visit NNP Candidate Guide.
NICU nurses play a vital influence on infant survival and birth rates across the country. Their importance is well-pronounced, evident in their excellent pay and favorable job prospects.
However, this role requires courage, calmness, and utmost mental alertness. So, we recommend you build up these attributes if neonatal care genuinely interests you.
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