Home Health & Wellness The Unique Stresses and Challenges of Neonatal Nursing

The Unique Stresses and Challenges of Neonatal Nursing

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Neonatal nursing has a natural appeal. Most people love babies and neonatal nurses get a first look at them. Humans at their very tiniest – and for that matter, cutest. But if you are looking for a job that lets you cuddle cute babies all day, this isn’t it. 

Anyone who has ever worked in labor and delivery will tell you firsthand – it’s not a fun job, nor is it a stress-free one. The stakes are very high. Complications can emerge rapidly. And, because your patients are extremely vulnerable, they are uniquely susceptible to illnesses that the general population needn’t think twice about.

What do neonatal nurses do?

Neonatal nurses work with newborns who require medical intervention. They provide medical care but also perform basic services that the young children cannot do for themselves. They feed the babies and clean them. They create care plans and work closely with parents and other family members to help them understand the child’s condition. 

Like any nursing job, much of the day will pass peacefully. However, when problems emerge, they happen quickly and require an urgent response. Below, we look at what aspects of the job may be more challenging than some people might realize. 

Working with family

Family, for many nurses, is a stressful word. On the one hand, it is good when patients receive attention from their support system. On the other hand, highly involved family members sometimes have a way of interfering with treatment. Everyone has questions to be asked, and then, asked again. 

Uncle Nick has his own theories of care. Is the nurse aware of what Reddit has to say about their treatment plan?

These conditions are only exacerbated in the neonatal wing. New parents are prone to worry in the best of circumstances. Neonatal nurses, unfortunately, do not work under the best of circumstances. The parents they talk to have good reason for concern, and they tend to express it at length. 

Though neonatal nurses treat only the child, they may begin to feel like the entire family is their patient. The relationship between parent and nurse can be a good one, but it is also a stressful one. It’s hard dealing with worried parents who – sometimes very accurately – believe that their entire family life is on the line.

That’s a weighty burden, one not everyone is ready to live with. 

Another thing to keep in mind: Parents are sometimes part of the care plan. If the new mother is breastfeeding, they will need to be involved routinely with the care.

This is, of course, a good thing. Breastfeeding is excellent for new babies and most neo-natal nurses are glad to help facilitate this aspect of the child’s nutrition. It does, however, create a uniquely symbiotic relationship between the nurse and the family that doesn’t exist in other healthcare settings. 

And though the mother is not the neo-natal nurse’s patient, she has her own health considerations to deal with. Giving birth is physically traumatic. It also creates the conditions for post-partum depression and other difficult complications. 

These circumstances may further complicate the work, as the child and mother’s health needs must be considered and met. 

The losses are devasting

Nurses deal routinely with losing patients. It is always sad. For many, that heartbreak never improves no matter how many years they spend on the job. The situation is possibly hardest in neonatal care. 

It’s not only that neonatal nurses often see babies linger in this world only for a matter of hours or days. It’s that they have a front-row seat to a level of suffering that very few families experience. That’s a big emotional burden,  one that neonatal nurses need to be ready to deal with at the drop of a hat. 


Perhaps unexpected to those who have never worked in healthcare – monotony is the other side of the same coin when it comes to nursing challenges. On a hospital floor, nurses may spend most of their shifts fighting off boredom. Then, there will be a few moments of extremely urgent activity. Then, more boredom.

This may sound like a good (or at least not unbearable) problem to have. However, it can be hard. In situations of stress, the human brain releases high levels of cortisol and adrenaline. This stress response creates the “fight-or-flight”, effect in our brains.

We can handle small, occasional amounts of cortisol and adrenaline. However, when they become regular, unpredictable aspects of our daily lives, it can be hard on our mental and emotional health. 

How to become a neonatal nurse

Not scared away by the unique challenges of the work? Good. While being a neonatal nurse can be hard, many people find it deeply rewarding. The first step to entering this career path is to become a registered nurse. You do this by completing a BSN program and then passing the NCLEX. 

Once you have done that, you will need to complete additional certification requirements. 

To become a neonatal nurse you will need to:

  • Gain experience in a neonatal intensive care unit (NICU) or pediatric setting to familiarize yourself with the unique needs of newborns and infants. 
  • Consider pursuing a certification in neonatal nursing, such as the RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC) offered by the National Certification Corporation (NCC). 
  • Apply for neonatal nurse positions at hospitals, clinics, or other healthcare facilities that have a NICU or specialize in neonatal care.

If you would like to go the nurse practitioner route, you will need to complete a master’s program with a concentration on neonatal care. This will extend the amount of time it takes to get certified. However, it will also allow you to pursue a higher-paying career. Neonatal nurse practitioners command six-figure salaries and play a more strategic role in care plans. 

The amount of time it takes to become a neonatal nurse can vary depending on what role you want to play. A college freshman who wants to become a nurse practitioner may have eight years of education ahead of them. Naturally, if you already have your degree, the timeline will be faster. 

Though neonatal nursing is not easy work, it is rewarding. For every challenging loss, there is an inspiring success story. For people who love the idea of working with babies and can handle a high-pressure environment, it may be a great career path to consider.

Samantha Green, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.

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