With an increase in the number of premature babies requiring acute hospital care, new and experienced nurses are finding more career opportunities in neonatal nursing.

Neonatal nurses work in general maternity wards and in neonatal intensive-care units (NICUs). Those caring for premature and critically ill babies spend their shifts diapering and feeding the infants, checking vital signs, administering medications and tests, and teaching families how to care for their children properly.

"For parents, having a baby is one of the best times of their life," says Lori Loan, PhD, a former NICU charge nurse. "To share that with so many people every week is really exciting. And even when you have really sick babies, there's personal reward from taking care of them as if they were your own."

Training and Growth Paths in Neonatal Nursing

Neonatal nurses are typically RNs, though some hospitals prefer to hire those who also have a BSN or an associate's degree. In addition, some facilities require continuing-education credits. Others provide on-site classes or send nurses to workshops, such as those offered by the National Association of Neonatal Nurses (NANN).

Neonatal nurses can work in hospitals as floor nurses, transport nurses or case managers. Experienced neonatal nurses can move up to management roles or, with advanced education, become neonatal nurse practitioners.

Research is another career option, as Loan discovered when, after several years as a NICU charge nurse, she was asked to serve as project director of a National Institutes of Health study on neonates. She is now chief of the nursing research service at Madigan Army Medical Center in Tacoma, Washington, where she continues to conduct research on neonatal nursing.

Neonatal Holds Special Appeal for Younger Nurses

Nurses with a maternal instinct, meticulous nature and an interest in education are drawn to neonatal nursing. But the specialty also holds appeal for young nurses seeking to work with technology. NICUs are usually stocked with the latest high tech equipment, giving preemies and ill newborns who may not have survived a generation or two ago a chance at life.

Cathy Quinn, RN, landed a position as a neonatal nurse at Tucson Medical Center in Arizona 10 years ago as a new graduate -- uncommon for a new nurse at the time, but more common now.

Quinn views her job as being a liaison between the medical staff and patients' families. It's especially important for neonatal nurses to foster strong ties with physicians, while helping the families cope with the trying experience of having an ill child.

"[Neonatal nurses] have to care about the babies and realize the families aren't just people," Quinn says. "The people who stay NICU nurses are people who care about the family as a whole."

Nurturing Long-Term Patient Relationships

Typically, neonatal nurses work 12-hour shifts, caring for as many as three babies. Patients born slightly premature but otherwise healthy may stay in the NICU for just a few days, whereas those born with more complicated health problems may stay several months.

Developing long-term relationships with their patients is common for neonatal nurses, who often receive cards and photos of their former patients' birthdays and holidays and even college-graduation announcements. It's those relationships that make neonatal nursing so fulfilling, Quinn says, and the specialty one that engenders loyalty. In fact, some Tucson Medical Center nurses spend their entire careers in the NICU.

A patient's death and seeing families in distress are the job's biggest challenges, she says, but those experiences are rare. When a baby goes home, it's a bright day on the NICU floor.

"You never know what the outcome will be, [but] most of us think it will be a good outcome, because that's what we've seen," Quinn says.

For more on neonatal nursing, visit the NANN, the Association of Women's Health, Obstetric and Neonatal Nurses and the Academy of Neonatal Nursing.