Find out how to become a Critical Care or ICU Nurse! The complete guide to critical care nurses and how to keep patients safe.

How to Become a Critical Care Nurse ICU Nurse Guide
How to Become a Critical Care Nurse ICU Nurse Guide

Table of Contents

Quick Summary

Critical care nurses are also known as intensive care unit (ICU) nurses. They both provide round-the-clock highly specialized medical care to patients that have deadly or potentially deadly illnesses and injuries.

Critical care nursing could be viewed as an intense nursing specialty and is one of the faster-paced nursing careers.

Degree needed to practice: Bachelor of Science (BSN)

License Needed: Registered Nursing License

Certification: Critical Care Registered Nurse (CCRN) certification

How much do Critical Care Nurses| ICU Nurse make?  The Median annual salary for critical care nurses is $67,962*


What does a Critical Care Nurse| ICU Nurse do?

The best way to understand what a critical care nurse or an ICU nurse does is to think about a baby or even a toddler or elderly family member.

Now let’s say that baby or toddler you’re in charge of keeping close watch of is critically ill, most likely you’re not going to leave that baby or toddler alone or alone for too long.

You are going to make sure the baby or toddler is not far from you, and you are going to keep a close watch over him/her to make sure the baby or toddler’s fever is not spiking. And you are going to do your best to try to keep the baby or toddler as stable and comfortable as possible.

This is to prevent the child or baby’s condition from getting worse.

Critical care nurses and ICU nurses are responsible for ensuring that patients and the patient’s families receive the best care possible by providing them with close attention.

The idea of intensive care nursing borrowed its roots from Mrs. Florence Nightingale the mother and founder of modern nursing. Mrs. Nightingale placed patients who were severely ill close to the nurse’s station to ensure closer and better observation of care was provided.

Admittedly, deciding to pursue a career in the intensive care unit (ICU) can be a bit intimidating. The ICU is a noisy and busy place with nonstop alarms, and beeping of machines constantly going off. As a critical care nurse, you can decide to become an employee in the Intensive Care Unit (ICU) unit or work in another specialty care unit for specific patient populations such as pediatrics or geriatrics.


Common Critical Care| ICU Nurse Duties

  • Provide the highest quality patient care both to patients and families
  • Bathing cleaning up patients in all forms, offering bed linens, cleaning feeding tubes. (Some hospitals may have a CNA to help with this.)
  • Take vital signs, check blood sugars, take temperatures.
  • Draw blood for lab work, order and interpret lab tests.
  • Provide patient medication as well as monitor the patient for any adverse effects.
  • Modify patient treatment plans with any changes within the patient’s progress or lack of progress.
  • Consult with other health care team members.
  • Report any symptoms of the patient’s condition to a physician or nurse practitioner.
  • Computer charting.

The critical nurse or the ICU nurse provides close attention because patients that have been classified by a physician as critically ill frequently have complex health conditions. These patients’ health is being unstable and unpredictable.

Some patients may be entirely dependent on you and cannot take care of themselves in any way. Some patients are powerless and not capable of making their decisions. One minute the patient can be okay and the next minute the patient’s condition changes from bad to worse. Critically ill patients require constant care and close monitoring.

This is also, why the patient and nurse ratio is low in comparison to other nursing specialties. Within this career field depending on which level of the ICU or emergency department you will work in the nurse-patient ratio can be one nurse to 1 patient, or 1 nurse assigned to 2 patients.

Transfers and patient admissions can frequently happen so many times that a nurse begins with may not be the patient the end with.

Many shifts are unique and can be highly unpredictable.

The nurse-patient ratio will depend greatly on the hospital’s budget to be able to staff enough critical care nurses along with their geographic location.

However, remember critical care nursing and ICU nursing always has a low patient-to-nurse ratio to ensure patients receive the best nursing care possible.

Additionally, this is a benefit that draws many aspiring nurses to this profession is the low nurse-to-patient ratio.


Critical care nursing can be a juggling game.

Some critical care nurses may be assigned patients that may have multiple illnesses or injuries such as lung disease, severe pneumonia that suffers from diabetes. This medium may be a bit complicated in trying to keep this patient stable and ensuring the patient is responding to the medications and treatment provided.

As a critical care nurse, you will need to be ready to treat patients that may have multiple injuries and illnesses with the ability to stay calm without sacrificing quality.

Critical care and ICU nurses are confronted with emergencies that may require them to respond immediately patient’s behalf to ensure the patient receives the best care possible.

Sounds easier than done but this is what makes critical care nursing and ICU nursing an intense and demanding specialty and is reserved for those who are drawn to adrenaline and thrive in intense and sometimes challenging environments.

Nonetheless, this career can be both frustrating and filled with roadblocks yet exciting! As you move through providing patient care one minute to the next!

This career is for those that are ready to challenge themselves and welcome taking their nursing to the next level. Critical care nursing essentially is providing patient care in all its forms!

Deciding to pursue a career as a critical care nurse or ICU nurse will require you to keep up with the latest research and medical technology.

The majority of patients that survive today would not have survived let us say 10 or even 20 years ago. This is in part due to the latest advancements in medical technology.

As technology moves forward what may have worked in the past may not be the best route today, and you must know what the latest advances are for your particular patient population.

Becoming a member of the American Association of Critical-Care Nurses could additionally help keep you abreast of educational resources, new technologies, and networking resources.

Pursuing this career there will be something for you to learn every day and you will need to know how to operate high-tech machines without feeling intimidated.

Critical care nurses have to be very flexible and be ready to deal with a variety of illnesses and injuries. Some of the most common Critical Care Unit (CCU) injuries include:

  • Provide close medical watch and treatment of patients that may have Gunshot wounds
  • Traumatic injuries that could be a result of a car crash or someone slipping and falling
  • Cardiovascular diseases that could include heart failure
  • Patients that have come out of surgery – post-surgery patients or post-anesthesia patients
  • Patients in a coma or comatose
  • Respiratory disorders that could include acute respiratory failure
  • Cancers that could include lung or even gastric cancer
  • Patients that have gone into shock – such as septic shock

Critical care nurses manage the patient’s illness and they keep a close watch for any signs that the patient has distressed, or the patient’s illness is deteriorating.

Some patients that may experience physical pain may not be able to speak, and their blood pressure may dangerously drop.  Or they suddenly will be fighting to breathe it will be up to you the critical care nurse to respond quickly with the ability to, “quickly react and think on your feet,” at a moment’s notice.

Without the patient having the necessary and adequate amounts of oxygen to their brain, patients could begin to die within a matter of minutes.

If the patient’s condition is deteriorating, the Critical Care or ICU Nurse will notify the doctor immediately this is to help prevent the patient’s condition from worsening.

According to a recently published health policy located on the University Of San Francisco website, the ICU has the highest mortality rates within the United States.

Every year there are about 4 million admissions to the ICU with about half a million deaths a year occurring within the ICU.

This fact alone proves why Critical Care and ICU nurses are so important in helping play a role in keeping patients’ condition stable and having the right nursing knowledge with helping nurse them back to health.


What type of person are ICU and Critical Care nursing for?

  • Type, “A,” personalities –this personality could be characterized as someone who has an exaggerated sense of urgency. One who is competitive by nature with plenty of drive and ambition. This person likes overachieving and can handle multitasking.
  • Those that can make independent and confident decisions
  • One who can be empathetic towards patients and help ease their fears
  • Those who can stay calm as well as be level headed even when the stress level rises
  • One that can have great attention to details
  • Those that are assertive with excellent nursing judgment
  • Those who are meticulous when charting and documenting records.
  • Being outspoken is a plus, as you have to be a great patient advocate and not be afraid to speak up if needed.
  • Great team players- Working in the ICU can be tough, and you will need to know how to work with others to provide better patient care.


What institutions hire Critical Care Nurse| ICU Nurses Work?

Critical Care and ICU nurses can work in any unit that treats critically ill patients. A vast majority of critical and ICU nurses can be found employed and working in specialty units of a hospital:

  • Emergency Room Departments (ER)
  • Neonatal & Pediatric Intensive Care Units
  • Intensive Care Units (ICU) – Level 1, 2, or 3. ICU levels can vary between hospitals
  • Operating Rooms (OR)
  • Burn Units
  • Post Anesthesia Recovery units – patients that have come out of surgery


Can Critical Care and ICU nurses have specialties?

Yes! Critical care nurses and ICU nurses can specialize in working with specific patient populations.

Many critical care nurses and ICU nurses specialize in:

  • Adults
  • Pediatrics
  • Neonatal
  • Geriatrics

Having critical and ICU nursing is a great stepping-stone to prepare you for a career working in various critical care specialties.

If you enjoy working with children and adolescents that have life-threatening conditions then working in the Pediatric Intensive Care Unit (PICU) may be a great fit for you.

If you find your heart more drawn towards working with babies that are critically ill and feel you can make a difference in helping babies get the best possible care then perhaps you may consider working in the Neonatal Intensive Care Unit (NICU).


How can I advance my career as a Critical Care Nurse | ICU Nurse?

Typically critical care nurses who would like to promote their careers work for larger hospitals and more important medical centers that are located in the main cities.

There are two ways to advance your career as a critical nurse or ICU nurse. The two forms are gaining more experience and obtaining more education. By staying in your current position and gaining more experience the higher, your payment will be.

Many critical care nurses who earn more experience and more education and certifications within this specialty go on to obtain supervisory, management, and teaching positions.

Getting a supervisory, management, or instructor position could mean the difference between just making it and taking home a comfortable salary as a critical care/ICU nurse or being able to retire comfortably, or having the extra money for your family. The choice is yours.

Another option to advance your career as a critical care nurse or ICU nurse is to become a Critical Care Nurse Practitioner. It just makes sense at some point or another if you already have the years of experience within this specialty to move your critical care nursing career to new heights.

According to the Bureau of Labor and Statistics Nurse Practitioners make $97,990* or $47.11 per hour!


Why are nurses and nursing students drawn towards this career?

Many nursing students and current nurses are attracted to the critical care nursing specialty because they love the adrenaline rush of the ICU environment, others enjoy the challenge while some nurses feel as if they are making a difference in a patient’s life.


Is becoming a Critical Care Nurse | ICU Nurse for you?

This career could be for you if you enjoy lifelong learning and work in a fast-paced environment. This job can be at times extremely intense. Working within this nursing field, you should be able to make critical decisions intelligently and quickly. As new medical technology emerges and is developed, you will need to be technically inclined to be able to implement and use this new technology.

You should know how to operate medical equipment without feeling scared. In addition to becoming a critical care nurse or intensive care nurse, you will need to be able to deal with life and death crises.

Therefore, to work within this specialty, you will need to be able to display understanding patients, and most importantly your composure. Often working within the specialty you will have to interact with the patient’s family, a lot of times the victim’s family are frightened scared and nervous insight may find it hard to deal with their loved one’s illness.


What education will I need to become a Critical Care/ICU Nurse?

To become a critical care nurse or ICU nurse, you must first become a registered nurse before you can start working. As an aspiring nurse, you must first complete one of the three kinds of educational nursing programs and pass the NCLEX-RN licensing examination to become a Registered Nurse (RN).

There are three ways to become an RN

  1. A two-year associate’s degree program could be located at a junior or a community college
  2. A three-year hospital diploma program that is located in a hospital.
  3. Or a bachelor’s degree program that is located at a college or university. This takes years to complete.

Some of your nursing classes will include anatomy, humanity, psychology, human growth, and development.

As part of your nursing program, you will be required to complete several nursing internships or clinical rotations. The clinical rotations are set up at the college or university you are attending.

Typically the college or university you are attending will start up these clinical rotations at a hospital or healthcare facility that is close to the school. Once you have completed your nursing program, you will become eligible to take the NCLEX-RN and obtain your nursing license.

The school you decide to enroll in can help assist you with signing up and provide you with test dates and locations where you will take your licensing exam.


Credentials/Certifications available

The American Association of Critical-Care Nurses (AACN) offers a specialty certification called the Critical Care Registered Nurse (CCRN) certification for Critical Care Nurses.

The CCRN certification is voluntary. However, some institutions do require their critical care and ICU nurses to become certified.

The CCRN certification is for nurses that provide bedside patient care for patients that are critically ill. This includes adults, neonatal and pediatric patients. The majority of nurses who hold this certification work in trauma units, surgical ICUs, intensive care, or even cardiac care units.


Career Outlook

As hospitals continue to have nursing shortages, the demand for competent nurses will arise rise. This is partially right for the need for critical care nurses who have experience as well as specialized skills.

The highest demand for critical care and ICU nurses will be those who specialize in specific areas.  By learning to specialize in specific patient populations and working in various specialized units, you can gain more advantages over competition thus becoming more in-demand with employers and institutions and creating a brighter outlook for your career.

The Department of Labor predicts employment of all RNs will continue to become greater throughout the year 2025 making the job outlook for critical nurses exceptionally bright.


Read also – How to Become a Registered Nurse (RN) Guide

Check out our other Nursing School Guides.