Are you considering being a neonatal nurse?
Here are some things to know
- Most hospitals that have a maternity services will have a neonatal unit
- Neonatal nurses care for babies who are born preterm or unwell and their families
- Adult nurses, paediatric nurses or midwives can be neonatal nurses
- There are different ways of getting into neonatal nursing – including apprenticeships & associate training
Not all neonatal units are the same, there are:
Neonatal Intensive Care Units (NICUs) care for babies needing all levels of care, intensive, high dependency and special care.
NICU’s provide all levels of care including intensive, high dependency, special care and transitional care. They care for the smallest and sickest patients with babies being admitted from 22+0 weeks gestation. Some units also provide co-located surgical services. If you choose to work in a NICU you will gain experience and exposure to all aspects of NICU including but not limited to:
- Ventilation (including HFOV)
- Care of infants born <28+0 weeks and <800g
- Care and stabilisation of babies requiring surgery
- Therapeutic Hypothermia
- All areas of SCBU & HD
Local Neonatal Units (LNUs) care for babies needing high dependency and special care or requiring short periods of intensive care.
LNSs care for babies >26+6/27+6 weeks gestation depending on the unit, weight and multiple births. They often provide some short term ITU as well as HDU, SCBU and TC. If you choose to work in an LNU you will gain experience and exposure to:
- Short term ITU including ventilation and stabilisation of babies requiring transfer to NICU
- Care of infants born >26+6/27+6 depending on the unit
- Non-invasive ventilation (CPAP, high flow)
- All areas of SCBU and HDU
Special Care Baby Units (SCBUs) care for babies needing special care or short periods of high dependency transferring babies that require intensive care.
SCBUs care for babies >31+6 and weighing over 1000g. If you choose to work in a SCBU you will get experience in and exposure to:
- Stabilisation of unexpected deliveries requiring ITU/HDU care and transfer to an LNU or NICU
- Care of babies >31+6 and >1000g
- Care of babies requiring NG/NJ feeds
- Care of babies requiring nasal cannula oxygen
- Care of babies requiring IV fluids
- Care of babies requiring special observations
These centres provide highly specialised care and treatment for preterm and full-term babies. Babies can be born with a variety of congenital abnormalities. Babies can be born within these hospitals or will need to be transferred in from regional neonatal units.
There are 26 tertiary paediatric surgical centres in the UK and Ireland. Only a few of these centres will support infant cardiac and liver surgery. These settings are called quaternary centres, and they are considered super-specialist centres.
Be a neonatal nurse in a surgical centre and you will gain exposure to:
- Babies born with an antenatally diagnosed condition needing surgery after birth
- The surgical neonate can have all the issues associated with prematurity.
- Full term or premature infants that are found to have a congenital abnormality requiring surgery
- Full term or premature infants that needs to be assessed by surgeons and have specialist investigations to rule out or confirm a surgical cause for their health concerns.
- Supporting parents in caring for their baby and helping with communication across a wide multidisciplinary team including pre and post operative care
- Providing ongoing care for the infant and training for parents eg. Stoma care, bowel washouts, tracheostomy care, gastrostomy care, Jejunal feeding, NG feeding.
- Care for the premature infant that needs surgery for severe NEC or ROP surgery.
- Supporting the complex discharge planning and liaising with transport teams, local hospitals, paediatric care and community multidisciplinary teams to provide ongoing support and follow up after discharge.
Neonatal Transport Services exist to support the transfer of babies between neonatal units. Some babies need to be transferred to a unit where they can receive specialist intensive or surgical care, others need to be transferred back to their local hospital. Babies may also need to be transferred to their home region, if they were born whilst the parents were away. There are around 16,000 neonatal transfers a year, with around 10% of babies in neonatal care experiencing at least one external transfer. Most of these transfers are via road, though a growing number are undertaken by helicopter and aeroplane.
A Neonatal Transport Nurse will:
- Undertake the transfer of critically unwell babies, working closely with other members of the transport team
- Undertake palliative care transfers for babies and families where this is part of their wishes
- Undertake nurse-delivered transfers independently, with remote support from the medical tier
Fundamental to this is:
- Supporting parents during stressful transitions between hospitals
- Supporting referring staff who are involved with the stabilisation of babies prior to transfer
- Teaching and supporting members of the transport team
- Working on audit and service development/QI projects within the transport service
Day to day elements of this role include:
- Checking transport equipment to make sure it is ready for use
- Maintaining familiarity with all transport equipment to ensure continued expertise
- Planning and prioritising transfers
Be a neonatal outreach nurse and support families on their transition from the neonatal unit to home. Support families in the community with:
- babies who were born prematurely
- being discharged home at a low weight
- going home on low flow oxygen
- supporting early discharge home part tube feeding to establish full oral feeds at home
- offering home phototherapy support to prevent readmission to hospital
- palliative or end of life care at home
Neonatal Transitional Care (NTC) is care additional to normal infant care, provided in a postnatal clinical environment by the mother or other resident carer, supported by appropriately trained healthcare professionals. If you work on NTC you will gain exposure to:
- Babies requiring feeding support
- Jaundiced babies on phototherapy and requiring frequent blood tests
- Stable babies born between 34 weeks to 35+6 weeks gestation
- Significant neonatal abstinence syndrome
- Babies requiring medication
Branching out - Gillian & Colm discuss their varied roles within neonatal nursing
In partnership with vCreate
Hospitals are working towards Family Integrated Care - providing for babies and families where the whole multidisciplinary team wrap around the baby and the family.
Neonatal nurses have countless career opportunities such as:
- Infant Feeding, Developmental Care, Infection Prevention & Control, Bereavement/Palliative Care, Safeguarding, Governance, Community Outreach, Transport, Educator
- Research, Leadership, Management. Network Roles
- Enhanced and Advanced Practice, up to and including Nurse Consultant
There are currently neonatal nurse vacancies across the country click below for more information
For more information about how to get into neonatal nursing in your area, please contact your local neonatal operational delivery network (ODN)
Neonatal stories
A nurse's day on the neonatal unit
Become a member of the NNA today
Come and join a growing community of neonatal nurses and feel supported, heard and valued!