How to Become a Neonatal (NICU) Nurse

Neonatal nurses work in the neonatal intensive care unit (NICU) caring for infants born prematurely or with life-threatening conditions. These nurses need extensive knowledge, compassion, a level head, and empathy.

If you want to become a neonatal nurse, there’s more of a need than ever.

Neonatal intensive care is at an all-time high, but more nurses are experiencing burnout and turnover, according to Taryn M. Edwards, MSN, APRN, NNP-BC, president of the National Association of Neonatal Nurses (NANN).

“I have been a neonatal nurse for 21 years, and there isn’t a day that goes by that I regret that choice. There are so many opportunities to grow and be involved in creating a lasting impact for your patients, families, and this specialized nursing field,” Edwards said.

“The NICU is a special place where you will see resilience, strength, and determination of the smallest of patients and their families.”

Becoming a NICU nurse starts with earning either an associate or bachelor’s degree in nursing and earning clinical hours in a healthcare setting. Then you’ll take and hopefully pass the NCLEX-RN exam to apply for a nursing license. Then you begin working in the NICU.

The first step to becoming a nurse is earning either an associate degree in nursing (ADN) or bachelor of science in nursing (BSN). If you already have a bachelor’s degree, there are programs designed for non-nurses to transition careers.

If you’re interested in going into the NICU after earning your license, you’ll need to take clinical hours at a medical institution during your time in college. See if you can be placed in a division where you can get experience with parents, newborns, and expecting mothers.

While you can become a nurse with just an ADN, 72% of employers strongly prefer those with BSNs and almost 28% require a bachelor’s. A BSN also typically earns you more money. According to Payscale, nurses with a BSN made $18,000 more than those with just an ADN.

States’ licensure requirements include passing the National Council Licensure Examination (NCLEX) for registered nurses (RNs). It is administered by the National Council of State Boards of Nursing (NCSBN). The NCLEX-RN costs $200 as of July 2025.

The NCLEX-RN uses a computer-adaptive format, meaning the number of questions varies by test-taker depending on how you are doing on the exam. They answer 75-265 questions over a maximum six-hour testing window. The NCSBN uses a passing standard formula rather than a traditional score cutoff.

Visit the NCSBN website to access exam-preparation materials, such as a free practice test.

After passing the NCLEX-RN exam, you can start the licensure application process. Requirements vary by state but usually include official transcripts, exam scores, and a criminal background check.

You pay a fee when you submit your application — for example, individuals in Delaware pay $181, and California charges $300 as of July 2025.

You’ll also need to pay for continuing education classes necessary for licensure renewal on top of any renewal fees that states may charge.

With your new license, you can now gain neonatal nursing experience by working in your hospital’s NICU.

July 2025 Payscale data reports that entry-level nurses made almost $36 per hour. When applying for your first job, be sure to custom tailor your resume and cover letter to each position.

Edwards said one of the most important things a nurse can do is join a specialty professional organization like NANN to invest in your professional and career development.

Through the organization, neonatal nurses can connect with others locally and nationally at in-person conferences and at one of 36 national chapter meetings. They also can meet virtually in webinars.

Once you’ve spent 1,750 hours in the previous two years as an RN or advanced practice registered nurse (APRN) directly caring for critically or acutely ill neonatal patients, you can apply for a certification with the American Association of Critical-Care Nurses (AACN).

Earning the Certified Critical Care Nurse (neonatal) credential involves passing a comprehensive exam. Question topics cover six core areas, such as body systems and typical medical conditions. The exam costs $255 for AACN members and $370 for nonmembers.

The National Certification Corporation awards the Registered Nurse Certified (RNC) certification for neonatal intensive care nursing to nurses who have at least 2,000 hours experience within the last two years and pass an exam. The exam costs $325 as of July 2025.

Neonatal nurses care for infants with exceptional medical needs. Like other healthcare careers, experience, certification, and additional education affect day-to-day responsibilities.

Gaining experience lets you pursue professional certifications that may qualify you for more jobs and salary growth.

“Neonatal nurses get to experience the joy of birth and discharging patients that are truly miracles,” Edwards said. “But it’s also a place where difficult diagnoses, ethical dilemmas, and challenging conversations occur. Regardless of the situation, it’s an honor to care for these patients and their families.”

Here’s what a typical neonatal nursing career path might look like for someone who wants to advance their education and salary along the way.

Source: Payscale