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The neonatal intensive care unit (NICU) is a highly delicate nursing specialty. Working in this healthcare field requires a particular registered nurse (RN). Please keep reading to learn more about the NICU, what it is, what types of patients go there, what kinds of healthcare clinicians work in the NICU, and how to find PRN NICU nursing jobs near you.

What is the Neonatal Intensive Care Unit?

A mother is always hoping that birth will go as usual, and they get to take their precious tiny newborn home, but in some instances, complications arise. For short, premature babies and newborns who require unique treatments and observation go to the hospital floor known as the neonatal intensive care unit, or NICU.

This is a specialized unit that is not available at every hospital. NICUs are typically only found in Level 2 trauma centers and higher, although there can be smaller units in community or rural hospitals. NICUs are equipped with the latest technology and staffed with specialized clinicians with experience and training in the care of newborns needing extra attention.

What Are the Different Levels of NICU Care?

There are different levels of NICU, and they can be broken down according to the type of care the baby requires.

  • Level one has typically healthy newborns. These are babies who are newly born and may require further observation or babies in need of more care until they can be transferred to a level that suits their requirements. 
  • Second-level care in the NICU is for babies born early or babies being moved from group one to more critical care or being pushed down from level three.
  • Third-level NICU babies may be receiving breathing assistance, or the baby is less than 3.3 pounds. This level takes care of most needs, and it’s rare for babies to be moved to level four.
  • Level four NICUs are equipped to handle all necessary conditions or the most severe problems a baby may have.

Why Are Babies Moved to the NICU?

The most common reason babies are moved to NICU is because they are born prematurely. Being born before 37 weeks qualifies a baby as preterm, also a baby less than 5.5 pounds. Twins and triplets are often moved there due to low birth weight.

List of reasons why a patient may be moved to NICU:


  • Mother was 16 years or younger or exceeded the age of 40 years
  • More than one baby (twins, triplets, etc.)
  • Mother had any of the following:
    • Drug abuse or alcoholism
    • Diabetes
    • High blood pressure 
    • Bleeding
    • Diseases (sexually transmitted) 
    • A lack of or excessive amniotic fluid
    • Membranes are being ruptured prematurely


  • Lack of oxygen
  • Baby being birthed in an abnormal position
  • The baby has stool (meconium) present in the amniotic fluid during pregnancy 
  • The umbilical cord is around the baby’s neck (nuchal cord)
  • For cesarean or the use of forceps


  • The baby was born at the gestational age of only 37 weeks or exceeding 42 weeks
  • The baby weighs less than 5 pounds, 8 ounces (2,500 grams) or greater than 8 pounds, 13 ounces (4,000 grams)
  • Small in size for gestational age
  • Medication or needed resuscitation during the delivery 
  • The baby has congenital disabilities
  • Respiratory distress, including baby breathing rapidly or ceased breathing (apnea)
  • Seizures
  • Blood sugar is low (hypoglycemia)
  • The baby needs oxygen or to be monitored IV (intravenous) therapy, or medicines
  • A blood transfusion or other special needs

Who Works in the NICU?

  • Neonatologist. A trained pediatrician who specializes in caring for babies born prematurely and those who are ill is a neonatologist. This doctor is also known as the attending physician on the unit, who is in charge of nurses, pediatric fellows, and nurse practitioners working in the NICU. 
  • NICU Nurses. Nurses on these units specialize in caring for sick and premature babies and direct the care for the baby.
  • Pediatric Resident. This is a doctor who is extra trained in the care of babies, they assist in procedures and are involved in care for babies.
  • Neonatal Nurse Practitioner. A licensed nurse practitioner (NP) is extra trained in caring for newborn babies. They do procedures and assist in the care of babies in the NICU.
  • Respiratory Therapists. They are in charge of breathing machines and the patient’s oxygen.
  • Physical, Occupational, and Speech Therapists. These clinicians oversee the baby’s development and help babies learn to eat.
  • Dietitians. They watch the baby’s growth, ensuring their food intake and vitamins are sufficient.
  • Lactation Consultants. A certified health care worker who oversees a woman breastfeeding and assists in pumping breast milk.
  • Pharmacists. These clinicians choose the medicines, write orders, clarify orders, check the dosage along with informing of side effects.
  • Social Workers. They relay and explain information giving family support in many ways; they can arrange home health care, help find financial aid, transportation, etc., and provide emotional support.
  • Hospital Chaplain. This individual helps aid in spiritual support for families in the NICU.

What Are The Requirements to Work in NICU?

To work In the NICU setting, you must have a science degree in nursing, one year of experience in an intensive care unit (ICU) or NICU, CPR certification, PALS certification, and ACLS certification. You must have continuing education in pediatrics and attend seminars that pertain to neonatal subspecialty. You must be knowledgeable with sound clinical reasoning.

A NICU nurse works long hours. Their duties may include giving medication, helping calm children, and observing their nutrition intake. This work can be pretty stressful, but the rewards are great.

Written by Miranda Booher, RN

SEO Content Marketing Administrator Miranda has been a registered nurse since 2007 and has a healthy background in travel nursing, healthcare IT, and digital marketing. She brings an interesting combination of stellar SEO content management and copywriting skills and first-hand nursing experience to the table. Miranda understands the industry and has an impeccable ability to write about it. And speaking of travel - Miranda currently lives in Bolivia, though she maintains an active Registered Nurse license in the state of Ohio and stays current on the latest healthcare news through her writing. When she is not creating killer copy, or serving others through her work as a nurse, you can find her spending time with her family traveling in the Andes Mountains.

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