Each year, more than 5 million patients are admitted to intensive care units (ICUs) in the U.S. These patients receive care administered by trained physicians and critical care nurses (CCNs) for life-threatening conditions.
Due to the complex nature of these conditions, it is crucial that there are qualified healthcare professionals who can provide their expertise to help with critical care responsibilities. One such role is critical care nurse.
Provided within this career guide is an overview of critical care nursing, critical care nurse requirements, and ways to pursue a CCN career.
What Is a Critical Care Nurse?
A career as a critical care nurse means providing care to patients who have immediate, life-threatening illnesses or injuries. They work in fast-paced environments such as ICUs, pediatric ICUs, and cardiac care or telemetry units. CCNs can also work in cardiac catheterization labs, progressive care units, emergency departments, and postanesthesia care units.
Duties carried out by critical care nurses include:
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Steps to Becoming a Critical Care Nurse
Becoming a critical care nurse starts with earning either an associate degree in nursing (ADN) or bachelor of science in nursing (BSN) degree. Prospective nurses must then pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
After gaining experience as a nurse, aspiring critical care nurses can then become a certified critical care registered nurse holding the credential of CCRN through the American Association of Critical-Care Nurses (AACN). However, critical care nurses can earn other certifications as well.
Specific program guidelines and licensure requirements may vary depending on the state and/or employer.
Earn an ADN or a BSN
An ADN provides students with the knowledge and critical skills needed in the field of nursing. An associate program typically takes two years to complete.
A BSN program is for those planning to advance within the profession or who need to meet the requirements of their state (like New York). Most employers prefer BSN-holders. The program typically takes four years to complete. ADN nurses can earn their BSN in two years.
Pass the NCLEX exam
The NCLEX assesses a nurse’s ability to apply their knowledge and analyze nursing practice scenarios rather than simply recalling information. The exam is broken down into four categories: safety and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.
Gain experience in critical care nursing
Once becoming a licensed RN, nurses may pursue entry-level positions in critical care nursing such as an ICU nurse. RNs generally work for two years gaining experience with patients who have a range of conditions. After supplementing their knowledge with experience, RNs have the opportunity to become a certified critical care nurse.
Consider certification in a critical care speciality or becoming a certified critical care RN
Though not necessary, CCRN certification can open doors to other opportunities like being a code nurse or a flight nurse. Also, Magnet hospitals typically encourage certification to maintain its Magnet status. Other certifications in critical care offered by AACN include cardiac medicine, progressive care, and teleICU.
Certification affirms that the nurse has met AACN requirements and passed the necessary exam. It highlights that they have achieved an advanced level of clinical knowledge.
Find employment
With the U.S. Bureau of Labor Statistics (BLS) estimating that there will be a 9% increase in nursing positions between now and 2030, there are many potential employment opportunities. Open positions can be found on career websites, such as Indeed and Glassdoor, or on the AACN website. Checking the websites of local hospitals and healthcare facilities can also provide information on job opportunities.
Critical Care Nurse Education
There are a variety of educational paths and nursing programs for those interested in becoming a critical care nurse. While earning an ADN is the minimum needed to work as a critical care nurse, some employers prefer their employees to hold a BSN.
Nurses interested in the nurse practitioner role may earn their master of science in nursing (MSN) degree in a nurse practitioner program. Nurse practitioners can specialize their MSN degree in critical and acute care and become certified as acute care nurse practitioners.
ADN Degree
An ADN is best suited for those who want to start working in the field within a short amount of time. The shorter length also makes the ADN program more affordable. While an associate degree is the minimum requirement for the NCLEX and to receive RN licensure, a BSN may be preferred or even required by some employers.
- Admission Requirements: Prospective ADN students must have a high school diploma with a minimum GPA of 2.0. Students can also be admitted if they have earned their GED certificate.
- Program Curriculum: Curriculum usually consists of microbiology, anatomy, pharmacology, nursing principles, psychology, and clinical experiences. The program mainly focuses on clinical skills and lab training.
- Time to Complete: Two years
- Skills Learned: Like BSN learners, students will be able to identify basic medical terminology, understand legal and ethical issues in healthcare, measure a patient's vital signs, administer medication, and perform various medical procedures.
BSN Degree
Completing a BSN program provides prospective nurses with a wider range of RN job options upon graduation, which also leads to positions with higher salaries. As nursing continues to progress technologically and new techniques are being developed, earning a BSN becomes increasingly beneficial in the long term.
A BSN is also an option for nurses who have already received an ADN, as they only need to attend two additional years of schooling to earn the more advanced degree.
- Admission Requirements: BSN programs require applicants to have a high school diploma and proficient ACT and SAT scores. Some programs also require applicants to provide a writing sample and letters of recommendation.
- Program Curriculum: BSN programs offer many of the same courses as an ADN. However, the more advanced degree also offers courses in management, public health, nursing theory, and informatics. Like the ADN, the BSN helps students build clinical skills; however, the curriculum also includes training in research, management, and leadership.
- Time to Complete: Four years (two for ADN-holders)
- Skills Learned: Students can assess patients, manage acute care situations, plan treatment, effectively communicate with patients and their families, and carry out patient care plans. While ADN nurses share the same skills, BSN nurses generally graduate with more clinical hours.
RN Licensure and Critical Care Nurse Certification
To work as a critical care nurse, prospective nurses must first earn their RN license after completing an associate or a bachelor's program. Upon graduating, students can earn their license after passing the NCLEX. Nurses are typically expected to work as an RN for two years before completing the necessary steps to earn critical care certification.
To be eligible for an RN license, nurses must first earn an ADN or a BSN. Upon completion of the program, they typically are eligible to take the NCLEX. It is best to check with the state's nursing regulatory board to determine if there are additional requirements.
According to Kaplan Nursing, the NCLEX includes multiple choice, multiple response, fill in the blank, hot spots, chart/exhibit, and drag and drop questions. The exam mainly focuses on applied practice and the analysis of various healthcare scenarios.
Test-takers must register for the exam about six weeks before graduation. The test is available year round and costs $200.
To become certified in critical care, the AACN requires nurses to have an active and unencumbered RN license and meet one of the following critical practice hour options:
- Minimum of 1,750 hours caring for critically ill patients within their last two years of service, with half of those hours completed within the most recent year
- Minimum of 2,000 hours caring for critically ill patients within their last five years of service, with 144 of those hours completed within the most recent year
Clinical hours must have been completed in either a United States or Canadian facility, and they must be verified by a clinical supervisor. Certification costs $245 for AACN members and $360 for nonmembers.
Working as a Critical Care Nurse
According to the BLS, RN positions are expected to increase approximately 9% by 2030, which means an additional 194,500 openings each year. The position also has a median salary of $75,330, with the top 10% earning $116,230. With an aging population and the arrival of COVID-19, the need for healthcare professionals should continue to rise.
To find a job as a critical care nurse, prospective nurses can check the AACN website or visit local hospital websites. Job searchers can also visit job board sites such as Indeed or Glassdoor to look for positions that are available nationally.
While the responsibilities of a critical care nurse are similar regardless of where they work, some duties may differ based upon the setting:
Pediatric ICU
- Care for critically ill children (under 18)
- Meet children's physical needs
- Cater to the developmental and emotional needs of children
- Collaborate with parents and guardians
Neonatal ICU
- Provide specialized care that helps premature or sick newborns progress
- Monitor infants' progress and recovery
- Teach parents about their baby's condition and how to care for them
Burn Care Unit
- Treat and monitor burn wounds
- Stabilize acutely burned patients
- Assess physical, emotional, and psychological trauma
- Educate patient's family on ongoing care
Becoming a Critical Care Nurse: FAQs
What degree is best to become a critical care nurse?
When deciding to become a critical care nurse, the best degree depends on the person's professional goals. While an ADN program can be completed within a two-year timeframe, earning a BSN provides nurses with more professional opportunities and higher salaries.
How can you gain experience in critical care nursing?
To gain experience in critical care, nurses should seek employment in a general ICU or a specialty ICU in a clinical area that interests them. Doing so provides them with the background needed to deal with the treatment of patients in critical or terminal conditions.
Can you earn a BSN or an ADN online?
It is possible to earn an ADN or a BSN online; however, it is important to verify that the online program is fully accredited. Visit the Accreditation Commission for Education in Nursing and the Commission on Collegiate Nursing Education to find accredited nursing programs.
Is certification required to become a critical care nurse?
No. Certification is optional but can be beneficial. The CCRN is one option, but there are many certifications CCNs can get depending on their specialty. For example, if a critical care nurse works in a neurosurgical ICU, they might want to become a certified neuroscience registered nurse.
Reviewed by:
Shri Deshaies MSN, RN, CCRN, is a nurse educator with over 20 years of teaching experience. She is a certified critical care nurse and has worked in various surgical intensive care units, including cardiovascular, trauma, and neurosurgery. Her passion for health equity led her to becoming a community home health nurse. She is a founding member of Nurses Serving our Neighbors which advocates for the homeless population. Deshaies recently completed a course to become a faith community nurse.
Shrilekha Deshaies is a paid member of our Healthcare Review Partner Network. Learn more about our review partners.
