Critical care nurses are a specialized group of registered nurses (RNs). They care for patients with the most complex and life-threatening medical issues. Critical care nurses perform basic nursing duties related to patient assessment and treatment, but also have the advanced skills required for attending to acutely/critically ill patients. These are patients who have experienced catastrophic events including surgery, heart attacks, strokes or burns. Critical care nurses are sometimes called ICU nurses because they work with patients who typically are in the Intensive Care Unit (ICU) of a hospital or healthcare facility.
No two days are alike for a critical care nurse. Daily responsibilities depend on the needs of the patients under their care. Sometimes, a critical care nurse may have just one patient because the care required is so significant. As patients’ physical conditions change, so do their needs. Healthier patients are moved to areas where standard acute nursing care is appropriate to make room for patients who require the most intensive type of care. Each patient has different needs, which also adds to the fact that a critical care nurse’s responsibilities are always changing.
Daily responsibilities of a critical care nurse can include:
- Assess a patient’s condition and the need for intervention
- Recognize and respond to situations requiring emergency life-saving interventions
- Plan and implement patient care plans
- Monitor advanced life support (ALS) equipment, including ventilators, tracheotomy tubes, chest tubes and catheters
- Administer medications orally, intravenously, by injection and through gastric tubes
- Treat wounds resulting from trauma or surgery
- Assist physicians in performing procedures such endotracheal intubation or bronchoscopy
- Measure and record patient vital signs and data from specialized equipment
- Order diagnostic tests
- Work cooperatively as a member of the critical care team
- Advocate for patients’ changing needs
- Provide education, support and patient updates to families of patients
Every RN isn’t suited to become a critical care nurse. Critical care nurses possess a specific set of personal characteristics that enable them to succeed. As a result, they are able to apply their advanced skills and knowledge to tend to the most seriously ill patients.
The ideal candidates for critical care nursing have the following characteristics:
- Decisive in situations when an immediate decision can be life-saving
- Confident in skills to take a leadership role in life or death situations
- Ability to remain composed and focused in a fast-paced, stressful environment
- Analytical of patient needs, even when patients are unconscious or unable to communicate
- Detail-oriented when following care plans and administering multi-faceted treatments
- Adaptable to handle multi-tasking while meeting the changing needs of patients
- Cooperative and able to work well with other professionals in the critical care team
- Physically fit to endure long hours of standing, bending and lifting
- Inquisitive about new procedures and technologies used in critical care
- Empathetic nature to support patient families
Jobs for critical care nurses exist in a wide range of work environments. There also are opportunities to work in units that specialize in the care of specific patient populations or treatments. The skills of a critical care nurse are in demand in work environments in which continuous nursing care and complex therapies are necessary.
Critical care nurses are employed in the following work environments:
- Adult intensive care units (ICUs)
- Pediatric ICUs
- Neonatal ICUs (NICUs)
- Cardiac care units
- Emergency units
- Post-operative recovery rooms
- Patient flight transport units
- Home health services
- Outpatient surgery centers
- Nursing homes
The career outlook for critical care nurses is very promising. With an anticipated growing need for services, critical care nurses will be in higher demand. Critical care nurses have a more specialized skill set than many other nurses, which can give them an advantage in competing for advancement opportunities and new positions. Due to the advanced education and experience required to do their jobs, critical care nurses typically have higher earning potential than traditional nurses.
The U.S. Bureau of Labor Statistics 2016-17 Occupational Outlook Handbook reports there are 2,751,000 RN jobs in the United States. Job growth for RNs was predicted to increase at 16 percent in the years leading to 2024, more than twice the 7 percent average predicted for all occupations during that period. Growth is attributed to several factors, including the increase of wellness and prevention programs; higher numbers of patients with chronic conditions such as obesity and diabetes; and the growing population of aging baby boomers who are living longer.
Critical Care Nurses
Projected Job Growth for RNs: 2014 – 2024
Source: Bureau of Labor Statistics, Occupational Outlook Handbook, January 2017
Metropolitan Areas with Highest Numbers of RNs Employed
NEW YORK –
New York | White Plains | Jersey City
Los Angeles | Long Beach | Glendale
Chicago | Naperville | Arlington Heights
Houston | The Woodlands | Sugar Land
Boston | Cambridge | Newton
Source: Bureau of Labor Statistics, Occupational Outlook Handbook, January 2017
The average annual wage for registered nurses was $71,000 in May 2015, according to the Bureau of Labor Statistics. However, factors such as experience, location and demand can affect the paycheck of critical care nurses. Since critical care nurses typically have a specialized skill set and more education than traditional nurses, they can demand higher salaries.
In 2015, the Society of Critical Care Medicine (SCCM) reported that the average base salary for critical care nurses nationally was $97,990 and the average base salary for critical care nurse practitioners was $105,200.
States with the Highest Average Annual Salaries for RNs
|State||Average Annual Salary|
Top Paying Metropolitan Areas for RNs
|Metropolitan Area||Average Annual Salary|
|San Francisco-Redwood City-South San Francisco, CA||$133,650|
|San Rafael, CA||$123,940|
|Santa Cruz, CA||$123,250|
To become a critical care nurse, you must first become an RN. To do this, you must complete an accredited nursing program and take the National Council Licensure Examination – RN (NCLEX-RN) in your state. You may need to gain experience in an acute care setting before acquiring a job in critical care. After working for two years in critical care, you can qualify to earn certification in critical care nursing.
While you may qualify to take the NCLEX-RN with a nursing diploma in your state, most employers require that critical care nurses have advanced education. Nursing degrees will prepare you for a variety of challenges you’ll face as a critical care nurse. The requirements typically include the completion of:
- Associate’s degree in nursing (ADN)
- Bachelor’s degree in nursing (BSN)
A graduate of one of these programs must take the NCLEX-RN to qualify for employment as a RN. The criteria required to qualify to take the NCLEX-RN varies by state.
Before enrolling in an education program for nursing, check to ensure that the program you choose will allow you to qualify for the licensure exam in your state. Schools accredited by the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing have undergone a voluntary process to validate that the institution maintains specific program standards. However, your state nursing board determines the schools that are acceptable as criteria to take the NCLEX-RN there.
Once you are working as a critical care nurse, you’ll also have the following educational options:
Master’s degree in Nursing (MSN)
PhD in Nursing
Doctor of Nursing Practice (DNP)
Critical care nurses can earn Critical Care Registered Nurse (CCRN) certification from from the American Association of Critical-Care Nurses (AACCN). While nurses do not need CCRN certification to work as a critical care nurse, certification proves that you’ve achieved a standard of knowledge and experience in the field. It can be helpful in career growth and promotions.
CCRN certification is available to nurses who possess a current, unencumbered U.S. RN or Advanced Practice Registered Nurse (APRN) license and one of the following types of experience:
A minimum of 1,750 hours in direct care of acutely/critically ill patients during the two years prior, with 875 of those hours earned in the most recent year before the test
Five years of experience with at least 2,000 hours in direct care of acutely/critically ill patients, with 144 of those hours accumulated in the most recent year preceding the test
Depending on education level and individual experience, critical care nurses can become certified in specific specialties and subspecialties:
- administering care to subspecialties in: Adult, Pediatric, Neonatal
CCRN and other certification lasts three years. Certification is renewable by retaking the CCRN exam or earning the required 100 continuing education points in specified study categories during the three-year period. The CCRN nurse also must maintain a position working with acute/critically ill patients for 432 hours within an ICU setting, with 144 hours in the 12 months leading to renewal period.
Is a Critical Care Nurse Career for You?
Now that you understand the importance of critical care nurses in the hospital and elsewhere, have you decided if this is the right nursing career for you? If you have what it takes to help people in life-threatening situations, give us a little information about yourself and we’ll connect you with schools that offer critical care nursing degree programs.
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