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Be a Neonatal Nurse #beaneonatalnurse

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:
 
o            Babies born with an antenatally diagnosed condition needing surgery after birth
o            The surgical neonate can have all the issues associated with prematurity.
o            Full term or premature infants that are found to have a congenital abnormality requiring surgery
o            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.
o            Supporting parents in caring for their baby and helping with communication across a wide multidisciplinary team including pre and post operative care
o            providing ongoing care for the infant and training for parents eg. Stoma care, bowel washouts, tracheostomy care, gastrostomy care, Jejunal feeding, NG feeding.
o            Care for the premature infant that needs surgery for severe NEC or ROP surgery.
o            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

The official website for Health & Social Care Jobs in N Ireland

NHS for England & Wales

NHS Scotland

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

My story as a NICU Nurse

How I became a Neonatal Nurse

Watch Shauny's story

Neonatal Nursing - career opportunities

Neonatal Transport Nurse

Careers in nursing on our neonatal unit

Becoming a neonatal educator

Watch Sarah's story

Being a Neonatal Nurse

Watch Hannah's story

Moving into Neonatal Nursing

Watch Victoria's story

Become a member of the NNA today

Come and join a growing community of neonatal nurses and feel supported, heard and valued!

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A big thank you to our partners

All working toward optimising the neonatal experience for babies and families.

Quick links

Special interest groups

Neonatal Nurses Association 

9 Riverside Walk, Dartford, Kent, DA1 5TN

EMAIL: admin@nna.org.uk

Registered Charity in England & Wales number 295696. We also operate in Northern Ireland.

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Dräger is incredibly proud to support the NNA by sponsoring the NNA Shared Learning & Best Practice in Neonatal Care Scholarship.

Dräger is an international leader in the fields of medical and safety technology.

Visit the Dräger website:: https://www.draeger.com/en_uk/Home

The Kate Farrer Foundation was established in memory of Dr Kate Farrer, a distinguished neonatal consultant at Addenbrooke’s Hospital and Transport Lead for the East of England. Sadly, Kate died in 2014 following a short illness. Her family set up a foundation in her name & have funded the Kate Farrer Scholarship since 2021.

Visit the Kate Farrer Foundation website: http://www.katefarrer.org/

The NNA is a member of the Council of International Neonatal Nurses (COINN) who we collaborate and partner with closely. COINN is a global organization that represents nurses who specialize in the care of newborn infants and their families. As a COINN partner, the NNA and its members are part of an international community and voice of neonatal nurses across the world. NNA members are automatically joined to COINN membership and can be a valued and integral part of this global voice.

Visit COINN: https://www.coinnurses.org/

Armstrong Medical is the proud sponsor of the NNA Team of the Year Award. Now part of Eakin Healthcare, the company supports neonatal teams across the world, working closely to understand the challenges and pressures faced.  The company join the NNA praising Neonatal teams for their inspirational work as they deliver care to the tiniest and most vulnerable patients.

Armstrong Medical provide options for heated resus, invasive and non-invasive ventilation. NeoFlow® is a complete range of critical and supportive respiratory solutions, designed to give neonates the best possible start in life, from their very first breath.

Visit the  Armstrong Medical website:

https://www.armstrongmedical.net/care-areas/neonatal-critical-care/

vCreate Diaries is a secure video messaging service providing reassurance to parents in NICUs. The vCreate team is working with us on awareness campaigns, communications and video projects to support families during their neonatal journeys.

Visit the vCreate website:: www.vcreate.tv/diaries

Enhanced Neonatal Nurse Practitioner (ENNP)

About the role
“Within Newborn Services the role of the ENNP has been utilised to support the medical staffing within the SC and HDU areas. The role follows a medical model and nursing staff gain confidence in managing planned care with the medical staff on ward rounds. They will assess and feedback to the medical staff on infants who deteriorate, prepare infants for discharge and order investigations as per planned care. All plans of care are discussed with the medical team in order to support the safe care of infants in these areas. There is the opportunity to undertake the role of the non-medical prescriber if the ENNP wishes to develop their skills. The experience gained working within the team can often become a springboard to moving towards the ANNP course” Stephanie Dow (Matron for Intensive Care and High Dependency, Manchester Foundation Trust)

How to get in to it
Speak to your manager or senior nurse during appraisal. Consider undertaking some of the below courses for CPD and to ready yourself for if/when a post becomes available

Essential courses, example: https://www.bmh.manchester.ac.uk/study/cpd/courses/nursing -practice-bsc-cpd-units/?pg=2&unit=NURS9319C&unitYear=1 
10 study days 

Other courses/CPD which may help 
NIPE (Newborn Infant Physical Examination) 
Leadership 

Transport

About the role
Neonatal transport nurses provide care and support to babies during transfer to another unit. This may be an acute uplift transfer alongside a doctor or ANNP, such as a transfer to an intensive care unit for ongoing medical/surgical/cardiac care, or it could be an elective repatriation back to their local hospital or to a specialist hospital for an outpatient appointment

How to get into it
Speak to your manager or senior nurse during appraisal. Transport Nurse secondment posts are often available from your regional transport team. Consider undertaking some of the below courses for CPD and to ready yourself for if/when a post becomes available

Courses/Resources
Neonatal Transport Special Interest Group – https://nna.org.uk/special-interest-groups/neonatal-transport-special-interest-group/
Neonatal Transport Group | British Association of Perinatal Medicine (bapm.org) – Neonatal Transport Group | British Association of Perinatal Medicine (bapm.org)
STAN – Home – Neonatal Skills

Community Outreach

About the role
Some Neonatal units have Neonatal Outreach Nurses who will provide ongoing support to parents and carers in the community setting. The nurses may be supported by clinical support workers or Nurse Associates. As a team they will offer specialist care to premature babies and to those babies with complex health needs requiring additional support who have been discharged from the neonatal unit, transitional care or postnatal ward.
 
Outreach nurses are involved in discharge planning, facilitating an early and seamless discharge for the baby and parents to the home environment, and work with other health professionals.
Neonatal Outreach nurses will provide support to parents and carers that may include establishing feeding at home, those with a low birth weight, home oxygen and home phototherapy.
 
How to get into it
Speak to your manager or senior nurse during appraisal. Consider undertaking some of the below courses for CPD and to ready yourself for if/when a post becomes available
 
Courses
UCLAN – community care of the neonate – https://www.uclan.ac.uk/cpd/courses/community-care-neonate-cert  
Safeguarding children, young people and adults level 3
Newborn Infant Physical Examination
 
CPD ‘Working with families to transition from neonatal units to home’ e-learning for health module

Advertisement of the career structure available within neonatal nursing

Coming soon

Quality Roles

Infant feeding

Coming soon

Bereavement & Palliative Care

Coming soon

Quality Improvement

Coming soon

Consolidation of QiS

Coming soon

Completion of QiS

Coming soon

Completion of formal preceptorship programme competencies

Coming soon

Knowledge of educational support available within the neonatal setting

Induction

There will likely be an induction programme designed by the ODN Neonatal Clinical Educators to support newly qualified nurses, or nurses new to neonates in the transition to neonatal staff nurse and in preparation for the Neonatal Foundation Programme, if one is offered by their ODN.

An induction programme might include topics such as:

Basic Clinical Observations and Assessment of the Neonate. Aim: To be able to complete a full and comprehensive assessment of the neonate.

Nutrition and Fluids. Aim: To provide adequate and appropriate nutrition using skills and knowledge to encourage healthy growth.

Infection Control. Aim: To provide a healthy and safe environment and take steps to prevent and treat neonatal sepsis.

Skin Integrity. Aim: To maintain healthy skin integrity

Jaundice. Aim: To identify jaundice and treat accordingly.

Medicines Management. Aim: Can administer medications safely and competently.

Family Integrated Care. Aim: The nurse is able to provide Family Integrated Care.

Recognising the deterioration of the neonate. Aim: The nurse is able to recognise when an infant is deteriorating and initiate resuscitation.

Pain management and assessment. Aim: The nurse understands how to assess and manage infant pain.

Admission, Discharge and Screening. Aim: To provide holistic care from Admission to Discharge.

Professional Conduct, Communication and Documentation. Aim: To work in accordance with the NMC standards and maintain professional accountability.

(Content example taken (with permission) from the Yorkshire & Humber Neonatal ODN induction programme)

On-going educational support

Neonatal ODNs will offer their own programme of educational support. This will include webinars, study days, skills sessions and supporting you to complete qualifications such as a Foundation Programme, QiS, plus Masters and PhD level courses.

The NNA also offer an on-going programme of online and in person learning events.
View our events

Access to neonatal placement

As a pre-registration student undertaking a children’s nursing programme, you will hopefully get an opportunity to gain a practice placement on a neonatal unit that offers an opportunity to work within special care, high dependency and intensive levels of care, under the supervision of practice staff. Some Universities accommodate all their students to ensure this neonatal-specific experience happens, while for others, you might need to arrange this experience as an ‘elective’ placement. The latter would also apply to a student on an adult nursing programme.

Placements on a neonatal unit vary between on average 6 to 12 weeks depending on your year of study and whether students have supernumerary status. Student midwives also undertake varying lengths of time on a neonatal unit to gain clinical exposure to babies requiring special care.

To find out more about neonatal placements as a student, view our NNA webinar -‘Making the most of the neonatal placement‘.

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