Pursuing a Career as an ICU Nurse

Nurse Types / ICU Nurse

Intensive care unit (ICU) beds in the United States already number more than 20 per 100,000 residents and are only expected to increase over time. With this growing need, the demand for nurses to care for these patients is also quickly rising.

Read on to learn more about the field of ICU nursing, and how to pursue a career as an ICU nurse.

In this article, we will explore:

• What is an ICU nurse?
• What do ICU nurses do?
• Where do ICU nurses work?
• What are specific types of ICU nurses?
• How do you become an ICU nurse?
• What are the additional requirements for ICU nurses?
• What are the salary and career outlooks for ICU nurses?
• FAQs

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What is an ICU nurse?

ICU nurses or critical care nurses are highly specialized and trained healthcare personnel who provide nursing care to patients with life-threatening illnesses or conditions. They provide specialized experience, knowledge, and skills that patients need to survive or de-escalate care.

ICU nurses are trained to make split-second decisions and act quickly when a patient’s status changes. Their primary work environment in the hospital is in specialized care units. Typically, ICU patients need a high level of care, and most of them are admitted to the hospital. 

What do ICU nurses do?

ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty to provide lifesaving care to patients fighting for their lives. They are highly trained to provide exceptional care for patients who depend on 24/7 nursing care. A patient in ICU is often ventilated, intubated, and can be on several life-saving machines and medications.

ICU nurses are at the top of their game and well-versed with all aspects of specialized care to restore their patients’ health and wellness. Some of the specific responsibilities of ICU nurses include:

• Evaluate and monitor of patient’s progress and identification of any sudden or subtle changes in the patient’s medical condition
• Administer medications by routes of intravenous injection, intramuscular injection, gastric tubes, sublingual, transdermal, subcutaneous, and by mouth (PO).
• Assist in intubation, bedside procedures and Code Blues
• Deliver regular updates of patient’s progress to doctors, patients, and their families
• Perform approved diagnostic or therapeutic procedures according to the patient’s clinical status
• Respond to health emergencies when called upon and alert appropriate doctors
• Evaluate patient’s laboratory data and vital signs to determine emergency intervention needs
• Care for patient needs throughout their recovery journey in ICU
• Advocate for patients’ and families’ needs
• Provide emotional support to patients and their families
• Set up and monitor medical equipment and devices like medical ventilators, oxygen delivery devices, transducers, and pressure lines.
• Assess a patient’s pain level and sedation requirements
• Maintain patient records

Where do ICU nurses work?

As the name suggests, critical care nurses primarily work in the ICU departments of health care facilities. ICUs are well sanitized and properly lit units with strict adherence to health and safety.

ICU nurses typically work on their designated unit but may float to other units, commonly other ICUs. They typically follow a standard shifting schedule that features morning, afternoon, and night timetables. There are also other shifting schedules, depending on the hospital and region.

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What are specific types of ICU nurses?

The following are the different types of critical care nurses: 

• Cardiothoracic or cardiac care ICU nurses – These nurses work with patients suffering from severe heart conditions. They handle a maximum of 2 patients.
• Medical ICU nurses – Medical ICU RNs mostly care for patients that have a critical disease process not usually involving surgery, such as sepsis, critical cases of cirrhosis of the liver, Acute Respiratory Distress Syndrome, Diabetic Ketoacidosis/ Hyperosmolar Hyperglycemic State, or critical cases of COVID.
• Neonatal ICU nurses – Neonatal nurses work with newborn babies who face a life-threatening disease or condition.
• Neuroscience ICU nurses – Neuro ICU RNs mostly care for patients that have had a stroke via a blood clot in the brain or a bleed in the brain. They also care for patients who may be detoxing from various substances (drugs/alcohol) or who have had new or prolonged seizures. They also work with patients with traumatic brain injuries who require ICU level care, acute/sudden trauma to the central nervous system (motor vehicle accidents, or tree limb falling on head), brain aneurysms (both ruptured and in-tact), or patients having a sudden onset of changes in their baseline neurological status.
• Pediatric ICU nurses – These nurses work in pediatric intensive care units and provide care to critically ill or injured children.
• Surgical/Trauma ICU – Surgical/trauma ICU RNs mostly care for patients that are critically ill and unstable as they are in emergent need of surgery. They also care for patients who are post-op from procedures like abdominal or urological procedures, procedures related to motor vehicle accidents, or procedures related to acute traumatic incidents or transplant patients (except for heart. Those patients go to a cardiac ICU).

Closely Related Types of Nurses

• Flight nurses– These nurses work with critically ill patients who need to be evacuated by air in order to receive specialized treatment.

3 steps to becoming an ICU nurse

Step 1: Become a registered nurse

The first step to becoming an ICU nurse is to be a registered nurse (RN). Before you become a registered nurse, you have to graduate with a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN) from an accredited nursing program. Afterward, you must pass the NCLEX examination.

There are bridge programs that allow you to advance your education level in less time. One example is the ADN to BSN program. To become a more attractive candidate you may consider obtaining an advanced degree like an MSN. There are bridge programs to help cut down on time on school. There are programs such as the BSN to MSN and RN to MSN (if you are already a licensed RN).

Step 2: Accumulate experience

Generally, you will need at least two years of nursing experience in a position specializing in intensive care nursing to become an ICU nurse.

But some ICUs are open to new nursing school graduates. Also, some ICU managers will look for experience in Med-Surg or Intermediate Care if an experienced nurse is looking to transfer within a hospital.

Step 3: Obtain ICU certifications

Because of the challenges and responsibility that come with operating in an ICU, hospitals require various certifications that guarantee they are hiring the best quality nurses. Many nurses who want to advance their careers are now turning to certifications. Additionally, certifications are a great way to increase ICU nurse salaries. Four certifications specifically constitute nursing in critical care conditions:

• CRRN (Adult) – Nurses with this certification can provide adequate care for critically ill adult patients. With this certification, you can work in general ICUs, surgical ICUs, trauma units, transport and flight operations, and cardiac care units.
• CCRN (Adult) – This specialty certification is for nurses who provide direct care to acutely/critically ill adult patients.
• CCRN (Pediatric)- CCRN for pediatrics offers critical care for children. You can work in ICUs, trauma units, transport, and logistics.
• CCRN (Neonatal) -This is a certification for nursing related to newborn critical care. You are certified to work in ICUs, trauma units, transport, and logistics.
• CMC (Adult) – CMC unit certifications are required for nurses involved in cardiac care. These nurses are certified to work in electrophysiology units, heart failure clinics, general ICUs, and home care.

According to the AACN website, eligible clinical practice hours must be completed in a US-based or Canadian-based facility, or any other facility determined to be comparable to US standards of critical care nursing practice.

Note: RNs don’t usually sit for certification until they have at least 2 years of experience in their specialty. Many certifications require a nurse to work a certain number of hours to qualify.

What are additional requirements for ICU nurses?

Continuing education

Once you get a license to practice as a critical care nurse, you should also complete continuing education units. These courses will equip you with the latest knowledge, skills, and medical industry trends. Many employers require you to maintain ongoing education to retain your position.

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What are the salary and career outlooks for an ICU nurse?

According to the Bureau of Labor Statistics, employment for registered nurses is projected to grow 6% between 2021 and 2031. This rate is a fast as the average for all occupations.

The growth is fueled by increasing rates of chronic conditions such as obesity and diabetes and an increase in emerging diseases like the current coronavirus pandemic. The average salary for an ICU nurse is $90,855, according to data from Incredible Health.

FAQs

Key Takeaway

ICU nursing career is one of the most rewarding callings with excellent job growth prospects and higher pay as enumerated above.  According to the Bureau of Labor Statistics, there were 3,080,100 registered nurses in the US in 2020. It is projected that by 2030, there will be a need for an additional 276,800 nurses, and with the aging population and recent COVID 19 pandemic, the number is expected to be higher.