How to Become an Intensive Care Unit (ICU) Nurse

ICU nurses are highly trained Registered Nurses that work with patients who have life-threatening illnesses or conditions. They provide specialized experience, knowledge, and skills that patients need in order to survive or de-escalate care. Their patients receive intense interventions and require complex care. Find out what an ICU nurse does, what it takes to become one, and more in this complete career guide.

Intensive Care Unit (ICU) nurses work in a complex and challenging field in the nursing profession. These nurses provide life-saving care to patients that are extremely sick and often fighting for their lives. Nurses in this field are at the top of their game and take care of patients that require 24/7 nursing care.

Patients in the ICU are often intubated, ventilated, and on multiple live saving medications. ICU nurses are well versed in all aspects of care to restore wellness. ICU nurses will work with a variety of adult patients from diverse backgrounds. The specific population will depend on the area of employment.

Without ICU nurses, healthcare systems would be unable to accept trauma patients, end-of-life patients, and others that require highly specialized care. These nurses are specially trained and often cannot be replaced unless an individual has similar training and credentials.

The average annual ICU nurse salary is $116,900 as of 2022, per Salary.com. Whereas ZipRecruiter reports that ICU nurses in the U.S. earn a average annual salary of $92,568 annually or $45 per hour. 

ICU nurses are often paid higher than other nurses within a healthcare system because of their specialized training. 

Most health care systems pay nurses on an hourly scale while others have a fixed annual salary. Those paid on an hourly scale are able to earn overtime pay whereas salary employees would need to discuss that with the hiring committee. As with all jobs in the nursing field, earning potential increases with additional education and experience. Nurses typically are awarded a raise during annual employee performance reviews. Certifications can give nurses an additional bump in their paycheck. 

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Step 1: Become a Registered Nurse

To become an ICU nurse, you must first become a registered nurse (RN). You can either graduate with a BSN or an ADN from an accredited nursing program. You’ll then need to pass the NCLEX examination

Step 2: Gain Experience

In order to continue down the path of becoming an ICU nurse, you’ll need to gain at least 2 years of nursing experience in a position that specializes in intensive care nursing

Step 3: Obtain ICU Certification

The most popular certification for ICU nurses is the Certification for Adult Critical Care Nurses (CCRN) awarded by the American Association of Critical Care Nurses.

To be eligible to sit for the CCRN exam, nurses must meet the following criteria:

• Practice as an RN or APRN for 1,750 hours in direct care of acutely/critically ill pediatric patients during the previous two years, with 875 of those hours accrued in the most recent year preceding application

OR 

• Practice as an RN or APRN for at least five years with a minimum of 2,000 hours in direct care of acutely/critically ill pediatric patients, with 144 of those hours accrued in the most recent year preceding application

According to the CCRN website, eligible clinical practice hours have to meet the following criteria:

• Must be completed in a U.S.-based or Canada-based facility or in a facility determined to be comparable to the U.S. standard of acute/critical care nursing practice.
• Are spent actively providing direct care to acutely/critically ill pediatric patients or spent supervising nurses or nursing students at the bedside of acutely/critically ill pediatric patients, if working as a manager, educator, preceptor or APRN. The majority of practice hours for exam eligibility must be focused on critically ill patients.
• Are verifiable by your clinical supervisor or professional colleague (RN or physician). Contact information must be provided for verification of eligibility related to clinical hours, to be used if you are selected for audit.
• Nurses that work in intensive care units, cardiac care units, combined ICU/CCUs, medical/surgical ICUs, trauma units or critical care transport/flight are eligible to take the exam. If you are unsure if your unit qualifies, discuss the requirements with your unit nurse educator or nurse manager. 

The Exam is $344 and individuals are given a 90 day window to schedule the exam at an ANCC approved center. There are over 300 in the country. Depending on your location, you may have to travel to the closest center. You do not have to take the exam in your home state. This is a national certification and not state specific.

Currently, there is no exact data on the growth for ICU nurses. However, according to the BLS, in 2022 there were 3,172,500 Registered Nurses in the United States. By 2032, there will be a need for an additional 177,400 nurses, which is a projected growth of 6%. With the aging population, this number is expected to be even higher.

ICU nurses will always be in demand because there will always be car accidents, gunshot victims, oncology patients, etc. who require life-saving measures. These highly specialized trained nurses will always be able to find positions especially as technological advances in medicine continue.

ICU nurses perform a variety of tasks and have numerous job responsibilities. These will vary depending on the healthcare system but generally, ICU nurses perform the following specific duties:

• Collaborate with health care professions to provide holistic care to patients.
• Educate patients and their families on diagnosis, medications, and other information
• Cleaning and bandaging patient wounds
• Tracking life support equipment
• Immediately responding to changes in the patient’s condition.
• Evaluating vital signs such
• Administering medications
• Acting as a patient’s advocate
• Provide comfort and prevent suffering
• Infusing blood products and monitoring patients for reaction
• Caring for the patient’s body immediately after death
• Identifying patient’s needs according to their age and level of consciousness and creating a care plan to meet them
• Complete paperwork prior to transferring or discharging a patient
• Respond to medical emergencies on the unit
• Supporting a compassionate and therapeutic environment for critically ill patients

Nurses can specialize within the ICU field. ICU nurses often can provide care in various ICUs and related units:

• Cardiothoracic ICU
• Oncology ICU
• Neurocare ICU
• Surgical ICU
• Medical ICU
• Coronary ICU
• Psychiatric ICU

Not all healthcare systems will have multiple ICUs. Patients requiring ICU level care will all be in the same unit.

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ICU Nurses are generally limited in where they can work because of their highly specialized training. The on-the-job training for ICU nurses makes them highly sought after for a variety of nursing positions; however, ICU nursing is very limited in their job location opportunities. ICU nurses can work in the following areas:

• Hospitals
• Cardiac Catheter Labs
• Surgical Departments
• Progressive Care Units
• Outpatient Surgery Center
• Post-operative Care Units

ICU nurses have the same continuing education requirements as other RNs. This will vary on a state-by-state basis. There are no specific CEU requirements for ICU unless they have obtained advanced certification such as the CCRN.

Generally, in order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements, and it is important to check with the board of nursing prior to applying for license renewal.

A detailed look at Continuing Nurse Education hours can be found here.

To find out more information about ICU nursing, check out these websites:

American Association of Critical-Care Nurses

American Nurses Association 

American Academy of Nursing 

National League of Nursing 

Society of Critical Care Medicine 

American Journal of Critical Care 

Critical Care Nurse Journal 

ICU nurses work in a fast-paced and dynamic environment that often requires very high levels of mental and physical strength. Nurses are tasked with providing life-saving measures to patients while ensuring they receive the best care possible. It is a highly rewarding career within the nursing profession and one that most never leave once they become a part of. 

FAQs

• What is an ICU Nurse?
  • Intensive Care Unit (ICU) nurses are Registered Nurses that specialize in critical care nursing to provide care for patients with life-threatening medical conditions.
• What Does an ICU Nurse Do?
  • ICU nurses utilize specialized skills and extensive knowledge of disease pathology and pharmacology to provide life-sustaining interventions.
• How Much Does an ICU Nurse Make?
  • The average annual ICU nurse salary is $116,900 as of 2023 according to Salary.com. 
• Is Being an ICU Nurse Hard?
  • ICU nursing is one of the most demanding nursing careers, both physically and mentally. ICU nurses are often tasked with providing lifesaving nursing care to patients on the brink of death.
• ICU Nursing vs ER Nursing
  • ER nurses act quickly to stabilize patients so that they can move to their next destination which might be home or an ICU. ER nurses are typically focused on transitioning a patient to the next level of care. On the other hand, ICU nurses focus on restoring a patient’s wellness and their outcomes.
• Can a New Nurse Work in the ICU?
  • Yes, a new nurse can work in the ICU but this will vary based on the healthcare system. Ideally, most ICUs will only hire nurses either from another ICU or with several years of medical-surgical experience. But don’t be discouraged if you are a new nurse. Just keep looking for the ICUs that will hire new grads!

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