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Neonatal Intensive Care Unit (NICU) is where newborn babies who need intensive medical attention are taken. The NICU combined advanced technology with trained health care professionals to provide the tiniest patients with specialized care. The NICU Registered Nurse takes care of babies struggling after birth to make the adjustments necessary to living outside the mother’s uterus. Many body systems must change dramatically from the way they functioned while the mother was carrying the baby. The lungs must breathe air, the cardiac and pulmonary circulation changes, the digestive system must begin to process food and eliminate waste, the kidneys must begin working to balance fluids and chemicals in the body and the liver and immune systems must begin functioning independently of the mother. Sometimes a baby has difficulty with these transitions and being born prematurely, difficulty in delivery or birth defects can make these transitions even more challenging. Neonatal Intensive Care is available for these infants.

Most patients admitted to the NICU are born premature (before 37 weeks gestation), low birth weight (less than 5.5 pounds) or some may have a medical condition that requires specialized care. Nearly half a million babies are born prematurely in the U.S. and most of these have low birth weight. Multiple births such as twins, triplets and more are often admitted to NICU as they usually are born earlier and smaller. Babies with medical conditions such as heart problems, infections or birth defects are also care for in the NICU.

There are many specialists and health care professionals that will care for these NICU babies. The NICU RN will have to work closely with many others involved in the care of the NICU baby including: Neonatologist, respiratory therapists, occupational therapists, lactation consultant, dietitians, social workers, pharmacists and hospital chaplains.

The NICU team will work together with the parents to develop a care plan for the high-risk newborn. In addition to providing around-the-clock care to these patients the NICU RN must also offer support to the parents. Parental support can range from emotional encouragement to advising parents on proper care of the infant after discharge. The prime responsibility of the NICU RN is to ensure the newborn’s critical care treatment is secure. The NICU RN performs life sustaining care for the newborn. Duties include administering medications, providing vital nutrients, and monitoring vital signs. Many premature and sick newborns lungs are not fully developed and the NICU RN must ensure that the infant is breathing and maturing property. These specialized nurses work with upper-level nurses and physicians and assist in planning treatment and examinations. They must maintain and update precise records of the patient’s care.

The NICU RN must also provide basic baby care such as changing diapers and bedding. Newborns may also require medications and IV fluids to be administered as well as oxygen therapy. Feeding the babies is done with bottles as well as insertion of feeding tubes for those too small or ill to be nursed. Constant monitoring of the NICU patient is required including temperature, pulse and heart rate. If a baby is not responding well or conditions worsen the NICU RN will alert the doctor on duty and administer emergency treatment as directed.

Some NICU RNs work at birthing center or clinics, most work exclusively in Neonatal Intensive Care units of hospitals. High tech equipment is needed to sustain these infants and therefore most NICU are in large children’s hospitals. Most NICU RNs do not rotate between departments because only nurses with this advanced training can provide the care necessary for these infants.

Neonatal Intensive Care Unit Registered Nurses spend much of their shift on their feet. They must remain calm under pressure and respond quickly in a crisis. Many of these young patients are so ill that their condition could deteriorate quickly at any second. NICU RNs may encounter significant emotional stress when caring for an infant whose condition does not improve or when they lose a patient. Compassion, patience and people skills are necessary when interacting with distraught or worried parents.


NICU RN’s need at least an associate degree in nursing and most facilities will require a bachelor of science in nursing. There are no undergraduate degree programs specifically for neonatal nursing but most schools do offer elective courses in neonatal and pediatric nursing. Training in fetal monitoring and neonatal resuscitation is necessary.

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