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What Skills are Needed to Become a Neonatal Nurse?

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Neonatal nurses care for healthy infants and the tiniest of premature babies, as well as infants who need surgery or have serious conditions such as birth defects or infections. A neonatal nurse may provide basic supportive care or technically complex intensive care in a critical care unit for babies called a NICU. These registered nurses follow one of three educational paths up to the point of licensure and then learn their specialty through seminars, classes or on-the-job training. Neonatal nurses have the option to become certified, although it is not required for practice.

Skills and Qualifications

All registered nurses need certain skills or personal qualities, according to the U.S. Bureau of Labor Statistics. Among these are compassion and emotional stability, which allow them to be empathetic to those in their care while maintaining their poise in stressful situations. This is particularly necessary in a critical care situation such as a NICU. Detail orientation is another important characteristic, and organizational skills help ensure infants get proper care in a timely fashion. Physical stamina is necessary for long hours, with much of a shift spent standing and walking. Communication skills are important for parent education as well as collaboration with other health care professionals.

Specialized Skills

Neonatal nurses should have some additional skills that are specific to their practice. For example, a neonatal nurse is dealing with a very small patient who can easily be harmed by too much medication. The neonatal nurse should be very familiar with medications, know how to administer them and what the correct dose is for an infant. She also needs the technical skills and manual dexterity to handle small intravenous lines or infant ventilators, or draw blood from a tiny vein. Infants have specific developmental stages and differences in physique compared to adults and children. The neonatal nurse must be able to assess an infant and identify any deviations from normal. Her task is made more difficult because she cannot verbally communicate with the baby.

Neonatal Nursing is High-Tech

Neonatal nursing, especially in the NICU, is technologically intense. The nurse must know how to use equipment such as intravenous controllers and pumps, incubators, ventilators and transfusion equipment. She must know how to feed an infant through a nasal or abdominal feeding tube. Some babies may be sick enough that their kidneys fail, and the neonatal nurse must know how to manage an infant who needs dialysis. A baby with lung problems may have tracheostomy -- a surgical procedure in which a tube placed in a hole in the neck allows him to breathe. Others may have a tube inserted through the chest wall to keep their lungs expanded. the neonatal nurse must be competent to manage all of these situations.

Education, Licensing and Certification

Neonatal nurses, like all RNs, have three choices for their basic education. They may complete a two-year associate degree program, a two- or three-year nursing diploma or a four-year bachelor’s degree. After graduation, they take the NCLEX-RN exam to become licensed. Part of the clinical rotation includes time in nurseries and may include time in the NICU, but most neonatal nurses learn their skills after graduation, by reading, attending seminars or on-the-job training. Certification in neonatal nursing is an option, once an RN has some experience. A nurse must be actively practicing in the specialty and have at least 2,000 hours of experience in the field.


Beth Greenwood is an RN and has been a writer since 2010. She specializes in medical and health topics, as well as career articles about health care professions. Greenwood holds an Associate of Science in nursing from Shasta College.

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