NICU Nurse

NICU nurses work in neonatal intensive care units (NICUs). These are specialized units within a hospital for newborn babies who are very sick or need advanced care.

NICU nurses can come from many different nursing paths. Most are registered nurses (RNs). But many are advanced practice registered nurses (APRNs). These are nurses who take their education and training further. In the NICU, APRNs may work as clinical nurse specialists or certified nurse practitioners, or in similar roles.

One thing to remember is that neonatal nurses and NICU nurses aren’t necessarily the same. A neonatal nurse is any nurse who takes care of newborns. But not all neonatal nurses work in NICUs.

Being a NICU nurse is a huge job. Some of the key parts of the job include:

• Assessment and monitoring: This starts with checking a newborn and recording key details, like heart rate, oxygen level, blood pressure, weight, length and temperature. Babies in the NICU also need around-the-clock monitoring so they can get the right care and support. This includes updating babies’ records regularly to track how they’re doing.
• Clinical care: This includes a wide variety of tasks, like starting and maintaining access to blood vessels (for example, with IVs), feeding newborns, changing diapers, keeping newborns warm and giving medications. It also includes taking samples of things like blood for lab testing when needed.
• Surgical care: Many babies are in the NICU because they need surgery. NICU nurses provide surgery-related care before, during and after a procedure.
• Infection prevention: Newborns are at risk for all kinds of infections. NICU nurses do a lot of behind-the-scenes work to prevent as many infections as possible.
  Developmental care: NICU nurses help create a healing environment for babies. This may include positioning babies comfortably, protecting sleep, reducing unnecessary noise and light, and timing care to avoid overstimulation.
• Discharge preparation: NICU nurses teach families how to feed, bathe and care for their baby as they get closer to going home. Nurses may also teach parents how to give medicines, use special equipment or know when to call their baby’s healthcare team.
• Family support: NICU nurses do more than care for newborns. They also support loved ones like parents, grandparents, siblings and family friends. NICU nurses also teach loved ones key care skills, like feeding, changing diapers and swaddling.
• Palliative care: Newborns often need specific types of care to treat symptoms like pain or trouble breathing. Palliative care is all about easing symptoms and effects, maintaining good communication between the treatment team and the family, and keeping newborns as comfortable as possible.
• End-of-life care: Babies in the NICU are often very sick, and some don’t survive, even with the very best care. NICU nurses do everything they can to ease pain and prevent suffering for babies and their loved ones.

What does it take to be a NICU nurse?

NICU nurses don’t necessarily need to have any special certifications. But some healthcare facilities and organizations may encourage or even require earning one. There are a few main certifications that NICU nurses can earn.

Two of these certifications come from the American Association of Critical-Care Nurses:

• ACCNS-N^®: For clinical nurse specialists
• CCRN^®: For bedside nurses, nurse educators and leaders

There are three neonatal-specific core certifications from the National Certification Corporation (NCC):

• RNC-NIC^®: Neonatal intensive care nursing
• RNC-LRN^®: Low risk neonatal intensive care nursing
• NNP-BC^®: Neonatal nurse practitioner-board certified

The NCC also has a neonatal subspecialty certification. That’s the neonatal neuro-intensive care (C-NNIC) certification.