Is Being an ICU Nurse Right for You?
A beeping IV pump informs you that a life-saving drip is on the verge of running dry, but there’s no one to watch your patient while you replace it. You make a run for the med room, a vent alarm sounding in the distance. Here’s hoping your patient’s still intubated when you return.
If this scenario gives you a twinge of anxiety and a spark of excitement, you might be ready to pursue a nursing role in the intensive care unit (ICU). There’s much more to the ICU than drips and machines — and, in this article, we take you into the world of ICU nursing to help you decide if it’s a fit for your career. Find out what it takes to become an ICU nurse and how to reach your goal of becoming one.
What Is an ICU Nurse?
The ICU is an area of the hospital where critically ill patients go to recover from serious illness or injury. This specialized unit provides closer monitoring and a higher level of support than other hospital wards. Healthcare providers use their expert judgment to identify clinical criteria that determine if a patient needs to be admitted to the ICU. A number of factors are considered, such as a patient’s age, anticipated quality of life, coexisting disease, and severity of illness.
Intensive care nurses, also called critical care nurses, see patients with various medical needs, from routine surgeries to rare diseases. Examples of conditions they may treat include:
- Central nervous system depression
- Respiratory failure
- Heart attacks
- Strokes
- Gastrointestinal bleeds
- Sepsis
- Multisystem organ failure
- Acute exacerbations of chronic conditions
- Burns
- Traumatic injuries
Depending on the location or size of a hospital, intensive care units may be separated by specialty. A critical care nurse could work in a general ICU or a specialized unit such as a:
- Medical intensive care unit (MICU)
- Surgical trauma intensive care unit (STICU)
- Medical-surgical intensive care unit (MSICU)
- Cardiothoracic or cardiovascular intensive care unit (CTICU or CVICU)
- Neuroscience intensive care unit (NSICU)
- Pediatric intensive care unit (PICU)
- Pediatric cardiac intensive care unit (PCICU)
- Neonatal intensive care unit (NICU)
Critical care nurses are expected to function within the scope and practice standards for critical care outlined by the American Association of Critical Care Nurses (AACN). AACN’s scope and standards for critical care nurses encompass a combination of nursing skills, knowledge base, and technology required to care for critically ill patients.
What Do ICU Nurses Do?
Intensive care nurses are responsible for keeping critically ill patients alive — and so much more. They work within a multidisciplinary team to meet goals and collaborate on ways to improve outcomes for patients in serious or critical conditions. Many of their daily tasks are the same as nurses on general hospital wards, such as administering IV medications, giving blood transfusions, and drawing labs.
However, patients in the ICU require intense monitoring and interventions that can only be performed by healthcare providers with specialized training. Critical care nurses may perform advanced skills such as:
- Setting up hemodynamic monitoring
- Obtaining blood samples from arterial or central lines
- Managing ventilators
- Intracranial pressure (ICP) monitoring
- Pupilometer assessments
- Administering hemodynamic drips
- Titrating insulin drips
- Interpreting telemetry or 12-lead EKGs
- Performing continuous renal replacement therapy (CRRT)
- Running extracorporeal membranous oxygenation (ECMO) circuits
On a given shift, critical care nurses typically have one or two patients. This depends on a patient’s severity of illness and how closely they need to be monitored. For more insight, check out this ICU nurse resume to review the duties and accomplishments of RNs in this specialty.
Other levels of nurses — nurse anesthetists, nurse practitioners, licensed practical/vocational nurses, nursing assistants — work in the ICU and perform various duties according to their scopes of practice. Click on some of the jobs for the following roles to get a sense of the work.
ICU vs. ER Nursing
While both types of nurses receive extensive training to treat patients with critical needs, a nurse in the emergency department tends to see a wider variety of problems, although not all of their patients will be critically ill. An ICU nurse, on the other hand, deals only with the highest acuity patients.
For example, in a single shift, an ER nurse might see a patient who suffered a massive heart attack, and then treat a patient who sustained a deep laceration thanks to a knife slip while preparing dinner. The heart attack patient may be transferred from the ER to the ICU for care.
Qualities of an Intensive Care Nurse
Critical thinking is one of the most important ICU nursing skills necessary for the role. This is essential when reviewing orders, interpreting labs, and anticipating interventions based on diagnostic tests. Critically ill patients are often intubated and sedated or too sick to tell healthcare providers how they feel. For this reason, providers must combine expertise with problem-solving skills to provide effective treatments.
Patients in the ICU can decompensate quickly, frequently requiring nurses to respond to emergencies. A successful ICU RN acts quickly in an emergency and uses clinical judgment to escalate concerns. To be successful in the intensive care unit, a nurse should also be:
- Compassionate
- Organized
- Focused on family-centered care
- Comfortable with death
- Motivated to pursue continuing education
- Able to multitask while maintaining focus
- Responsive to alarms and careful not to succumb to alarm fatigue
- Ready to respond to emergencies
Curious about other characteristics that are typical of an ICU nurse? Check out a sample cover letter for someone pursuing this specialty area.
How to Become an ICU Nurse
Getting ICU experience opens the door to many interesting advanced nursing roles within a healthcare organization. Experienced nurses may join the Rapid Response Team (RRT) or ECMO team, providing advanced nursing care in various units in the hospital. You may also consider working in the ICU to pursue a goal of becoming a flight nurse or certified registered nurse anesthetist (CRNA).
Whichever route you choose, every ICU RN needs to start somewhere. Here are the steps to becoming a critical care nurse.
1. Complete Nursing Education
The first step to becoming a critical care nurse is to complete nursing education. To become an RN, nurses must complete either an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). Many organizations require RNs to have a BSN degree to work in the hospital, so check the requirements in your area.
2. Gain RN Licensure
After nursing school, registered nurses must pass the NCLEX-RN exam to obtain state licensure. This allows you to practice in the state (or states) included in your RN license.
3. Get Certified
Intensive care nurses frequently respond to medical emergencies in the hospital. For this reason, certification in Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) are required for employment in the ICU. These training courses prepare nurses to respond to emergencies following protocols on CPR, defibrillation, and drug administration during a code blue.
Critical care nurses may also choose to take the Critical Care Registered Nurse (CCRN) certification exam. This involves an in-depth study of physiology and medical conditions that nurses may see when caring for ICU patients.
Additional related certifications include:
- Certified Ambulatory Perianesthesia Nurse (CAPA) certification
- Certification Board for Sterile Processing and Distribution (CBSPD) certification
- Certified Medical-Surgical Registered Nurse (CMSRN)
- Certified Perioperative Nurse (CNOR)
- Medical-surgical nursing certification (MEDSURG-BC)
- Registered cardiovascular invasive specialist (RCIS)
4. Get Hospital Experience
Depending on the healthcare organization, nurses may need a few years of hospital experience before joining a specialized ICU. If this is the case, consider getting experience on an acute care floor — like in ER nursing — prior to applying to the ICU. This allows nurses to master essential nursing skills like time management and patient prioritization before specializing. However, it’s possible to get a job in the ICU as a new graduate nurse, so check with a facility if you’re interested in starting your career there.
How Much Does an ICU Nurse Make?
The average annual ICU nurse salary is around $85,600. Critical care nurses may get pay increases for taking charge nurse positions, becoming unit leaders (such as nurse educators), or joining the RRT. Salaries often depend on your level of education, years of experience, facility, and geographic location.
Some of the states that have the highest RN salaries include:
Do You Have What It Takes to Become an ICU Nurse?
If you find the path to working as intensive care nurse an attractive one, take the next step. IntelyCare can match you with personalize nursing job matching in acute care. Learn more today.