How to Become an Intensive Care Unit (ICU) Nurse

Intensive care unit (ICU) nurses are highly trained registered nurses (RNs) who treat patients with life-threatening illnesses or conditions. These patients often need intense interventions and complex care. ICU nurses apply their specialized experience, knowledge, and skills to de-escalate care and ensure their patient's survival. 

If you're interested in joining this challenging and rewarding nursing specialty, you're in the right place. This career guide will teach you how to become an ICU nurse, including education requirements, salary expectations, career outlook, and more. Read on to take the next step toward your dream nursing career.

Intensive Care Unit (ICU) nurses work in a complex and challenging field in the nursing profession. These nurses provide life-saving care to patients who 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 life-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 who require highly specialized care. These nurses are specially trained and often cannot be replaced unless an individual has similar training and credentials.

The median annual ICU nurse salary is $85,205 as of January 2024, per ZipRecruiter. However,  Indeed reports that ICU nurses earn an average salary of $121,588 annually or $70.63 per hour based on 211.9k reported salaries.

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

Most healthcare systems pay nurses by the hour, while others have a fixed annual salary. Hourly nurses can 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 paychecks. 

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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 Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN) from an accredited nursing program. You’ll then need to pass the NCLEX examination.

Step 2: Gain Experience

After becoming an RN, you'll need at least two years of relevant experience in an ICU environment. Take advantage of opportunities to work in a position that specializes in intensive care nursing at your place of employment.

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

Criteria for CCRN-Applicable Clinical Hours

• 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.
  
  
• Hours 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.
  
  
• Hours 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 who 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. Depending on your location, you may have to travel to the closest center, but you don't have to take the exam in your home state if another testing center is more convenient.

Currently, there is no exact data on the growth of ICU nurses. However, according to the BLS, in 2022, there were 3,172,500 RNs 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 Nurse Growth Opportunities

ICU nursing can also lead to new career growth opportunities within the critical care field. For example, experience in the ICU can prepare nurses to join rapid response teams (RRTs). As an RRT nurse, you would work on a medical emergency response team, which responds to rapidly deteriorating situations on non-emergency units. You may also continue your career path and gain more education to become an acute care nurse practitioner.

ICU nurses perform several varying tasks and have numerous duties. These will vary depending on the healthcare system, but generally, ICU nurse responsibilities include the following:

• Collaborate with healthcare professionals 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 in 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

Keep in mind that not all healthcare systems will have multiple ICUs. At these facilities, 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. Although their on-the-job training makes ICU nurses highly sought after for various positions, they have few workplace location options. 

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 leaves once they become a part of it. 

• What is an ICU Nurse?

  • Intensive Care Unit (ICU) nurses are Registered Nurses who 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 $121,588 as of 2024, according to Indeed. 

• 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!

$70,000 - $90,000 Associate Bachelors Bedside RN ICU