What is a PICU Nurse? Everything You Need to Know

4 Min Read Published February 5, 2024
What is a PICU Nurse? Everything You Need to Know

What is a Pediatric ICU (PICU) Nurse?

A Pediatric Intensive Care Unit (PICU) nurse is a Registered Nurse (RN) with advanced training and skills who takes care of the sickest pediatric patients in the hospital. Specifically, PICU nurses specialize in treating and caring for toddlers, children, and adolescents. 


$72,262 or $34.55 an hour, per Payscale 

Time to Become

4-6 years

Career Outlook

6% growth from 2022 to 2032, per the BLS


What Does a PICU Nurse Do? 

PICU nurses are similar to other RNs in that they care for patients while they are hospitalized. However, PICU nurses are tasked with a much more difficult task of caring for critically ill and even dying pediatric patients. 

Specific responsibilities of a PICU nurse include, but are not limited to these: 

  • Administering medication and treatments
  • Assessing critically ill pediatric patients 
  • Creating nursing care plans for patients
  • Helping perform diagnostic tests ordered by medical providers
  • Monitoring vital signs
  • Using advanced medical equipment
  • Coordinating with other healthcare professionals 
  • Observing behaviors and recording observations
  • Recording symptoms and medical histories
  • Taking blood and urine samples
  • Keeping electronic medical records up to date
  • Participating in daily patient rounds
  • Responding to emergencies and code situations
  • Managing PICU advanced equipment such as dialysis, ventilators, and ECMO machines
  • Performing CPR and life-saving procedures

How to Become a PICU Nurse

To become a PICU nurse, you must first graduate from an accredited nursing program. As PICU positions are highly competitive, it is important to secure nursing externships while in your undergraduate program and take additional classes in IV placement, and blood draws. Next, you’ll apply for PICU positions, which will generally be nurse residency programs as a new graduate.

Step One: Graduate from an Accredited BSN Nursing Program 

Those who aspire to become a PICU nurse will want to graduate from either a BSN or ADN program from an accredited university. 

Step Two: Become an RN 

Successfully pass your NCLEX and then apply for state licensure. 

Step Three: Gain Experience 

It is possible to start your career immediately upon graduation in a PICU. However, you might need to gain two or three years of pediatric medical-surgical experience. With the increase in the number of pediatric residency programs, new graduates can seamlessly transition into the PICU. 

Step Four: Get Certified 

Becoming certified illustrates your advanced knowledge and clinical skills as a PICU nurse. There are several certification options available. There are currently three organizations that offer peds nursing certification: 

  1. Pediatric Nursing Certification Board (PCNB)
  2. American Nurses Credentialing Center (ANCC)
  3. National Certification Corporation (NCC) 

Each certificate has its own exam, renewal requirements, and eligibility criteria.

Step Five: Continue Your Education

While not required to become a PICU nurse, after gaining valuable experience, you may want to consider advancing your education and earning your Pediatric NP degree focusing on critical care. 

Where Do Pediatric ICU Nurses Work?

Unlike other RN positions and specialties that can work in a variety of locations, PICU nurses are very specialized. Therefore, they are limited in their work environments. PICU nurses work in hospitals that have pediatric ICU units. 

PICU Nurse Salary

The U.S. Bureau of Labor Statistics (BLS) reports an average annual salary of $81,220 per year or $39.05 per hour. The BLS does not differentiate between different nursing specialties. 

Payscale reports an average annual salary for PICU nurses as $72,262 or $34.55 an hour. 

PICU Nurse Salary by Years of Experience

Specifically, PICU nurses can earn a higher annual salary with increased years of experience.

  • Less than 1 year of experience earns an average hourly rate of $26.67 
  • 1-4 years of experience earn an average hourly rate of $31.77
  • 5-9 years of experience earn an average hourly rate of $34.25
  • 10-19 years of experience earn an average hourly rate of $38.88
  • 20 years and higher years of experience earn an average hourly rate of $50

Pros and Cons of Becoming a PICU Nurse

With any nursing position, there are pros and cons. PICU nursing is high-stress and high-intensity. There is rarely any downtime, especially in large PICUs, so this is important to consider when determining if this is the best specialty for you. 

Pros of Becoming a PICU Nurse

  • Develop a unique skill set of advanced nursing skills
  • Work with children
  • Job security
  • High paying position
  • Increased clinical abilities and knowledge
  • Marketability 
  • Increased job satisfaction

Cons of Becoming a PICU Nurse

  • Emotional toll of caring for critically ill toddlers, children, and adolescents and their families
  • Exposure to death and dying
  • High-stress environment
  • Bedside burnout
  • Physically demanding work
  • Emotional attachment to patients and their families
  • Workplace exposure to communicable disease
  • Ongoing education responsibilities 


  • Is it Hard to Be a PICU Nurse?

    • PICU nursing is challenging both emotionally and physically. It is demanding and can lead to high stress and burnout. Despite this, it is a very rewarding nursing career. 
  • What Certifications Does a PICU Nurse Need?

    • PICU nurses are not required to have any additional certifications. However, this will also depend on the unit and work environment. Consider speaking with your HR department or manager for further information about the unit. 
  • Are PICU Nurses in Demand?

    • PICU nurses are in HIGH demand. As children are exposed to more diseases, the number of hospitalized sick children will continue to increase, and the need for PICU nurses will continue to grow. 
  • How Many Years Does it Take to Become a PICU Nurse?

    • After graduating from an accredited BSN nursing program, you can immediately start your career in the PICU after a lengthy orientation process. Most can become a practicing PICU nurse roughly one year after graduation. 
  • What is the highest level of PICU?

    • Level 1 PICU is considered the highest level of care for the most critically ill toddlers, children, and adolescents. 
Kathleen Gaines
Kathleen Gaines
News and Education Editor

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

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