What It Takes to Become a Critical Care Nurse

Is patient care your passion? If you thrive in dynamic, fast-paced environments, critical care nursing may be right for you.

nurse listening to patients heart
nurse listening to patients heart

Critical care nurses are the everyday superheroes helping patients heal from life-threatening illnesses and injuries. To get started in this highly skilled role, you’ll need to be a registered nurse with at least a two-year nursing degree. But the qualifications go beyond education. Critical care nursing is intense by definition and requires critical thinking, adaptability, and compassion for patients and their families.  

What Does a Critical Care Nurse Do?

Because critical care nurses provide intensive patient care, they’re often called ICU (intensive care unit) nurses. But there’s an important distinction to be made here: While all ICU nurses are critical care nurses, not all critical care nurses work in the ICU.

As skilled healthcare professionals trained to care for critically ill and injured patients, critical care nurses also work in burn centers, trauma centers, operating rooms, emergency departments, neonatal intensive care units, pediatric units, and other medical settings where patients require intensive care.

While all ICU nurses are critical care nurses, not all critical care nurses work in the ICU.

“Critical care refers to the level of care required by a patient rather than where the patient is physically located,” says Mary A. Stahl, MSN, RN, CCNS, CCRN-K, a clinical practice specialist and past president of the American Association of Critical-Care Nurses (AACN) board of directors. “It’s all about the needs of the patient. These patients are either unstable or likely to become unstable and therefore require specialized care in terms of the frequency and type of nursing assessments, care interventions, and often, equipment needed.”

General Job Duties

Caring for medically fragile patients means paying attention to details large and small. During a typical shift, a critical care nurse might monitor a patient’s ventilator, insert a catheter, perform diagnostic tests, administer medications, or assess and treat an injury. Other daily tasks could include:

  • Treating wounds and injuries
  • Stabilizing patients experiencing medical emergencies
  • Administering intravenous (IV) fluids
  • Working with physicians, physical therapists, and other members of a patient’s care team
  • Communicating with a patient’s family members
  • Coordinating a patient’s transfer to another unit or facility
  • Performing administrative or managerial duties

Where You’ll Work and the Patients You’ll See

Critical care nurses care for the most severely ill, high-risk patients at every stage of life, inside and outside the ICU. These patients may be experiencing severe respiratory distress, recovering from surgery, or struggling with chronic illness.

As a critical care nurse, you can choose to specialize in an area of nursing suited to your interests and goals. Critical care nurses can work with:

  • Vulnerable newborns in neonatal intensive care units
  • Seniors in skilled nursing facilities
  • Cardiac patients in post-surgical units
  • Burn patients in trauma centers
  • Critically injured patients on transport flights
  • Patients in long-term, acute-care hospitals
  • Patients in progressive care units
  • Surgical patients in recovery units

Critical care nurses can also travel to areas affected by healthcare emergencies and natural disasters to care for critically ill or injured patients. Some travel nurses even travel abroad to help in the aftermath of disasters.

“During a pandemic, or any crisis, nurses may be working in their assigned unit, reassigned to an area of the hospital with a greater need or working in a different hospital—or even a different city,” says Stahl. “They may be registered with a disaster registry that helps deploy nurses to other places of need or may respond to a call for assistance through a professional association that connects them with areas of need.”

What’s It Like Working as a Critical Care Nurse?

nurse checking on icu patient

Because critically ill patients require constant care, critical care nurses are always in motion. Working in a fast-paced environment like an emergency room means that no two shifts are the same—on any given day you could help stabilize victims of a car accident, intubate a patient in respiratory distress, or assess a patient experiencing chest pains.And because extremely ill patients may not be able to communicate with their care providers, critical care nurses often serve as patient advocates. With more patient contact than most other healthcare providers, critical care nurses help ensure continuous, high-quality care.

“Nurses have the most frequent contact with the patient, are most present to see how the patient is responding to treatment, and are best able to determine when additional resources are necessary for a changing patient condition,” says Stahl.

Because critically ill patients may not be able to communicate with their care providers, critical care nurses often serve as patient advocates.

Qualities of a Successful Critical Care Nurse

It takes certain skills and qualities to specialize in this type of nursing. Nurses who excel at critical care are:

  • Adaptable: You’ll work in a dynamic environment that can change rapidly.
  • Tech savvy: Critical care nurses use sophisticated medical equipment to monitor patients.
  • Caring: You’ll help patients and family members experiencing trauma and life-threatening illness.
  • Collaborative: Working with physicians, nurse navigators, and other members of a patient’s care team takes a confident communicator.
  • Intuitive: As a critical care nurse, you’ll work with patients who may not be able to communicate their needs and wants.
  • Resilient: Caring for critically ill patients means working through difficult scenarios and bouncing back from tough days.

In recent years, the explosion of new knowledge, technology, and medical treatments available means nurses need to respond to an ever-changing work environment, notes Stahl. “This continual evolution puts increasing demands on nurses, who must stay agile in learning new information and skills and applying them to patient care.”

How Do You Become a Critical Care Nurse?

At a minimum, you must be a registered nurse (RN). This requires an Associate Degree in Nursing (ADN), which usually takes two years to complete, or a Bachelor of Science in Nursing (BSN), a four-year degree. Because critical care requires a specialized skillset, many hospitals prefer to hire nurses with BSN degrees.

When you choose a program, make sure it and the school you’ll be attending are accredited. If they aren’t, your state regulatory groups may not recognize your degree, and employers may decline to hire you.

Subjects You’ll Study

Nursing degree programs include liberal arts classes, nursing coursework, and clinical hours. Liberal arts coursework could include classes such as:

  • English composition
  • Psychology
  • Biology
  • Chemistry
  • Communications
  • Sociology
  • Human anatomy and physiology
  • Statistics

Both an ADN and a BSN will build on that foundation with basic nursing courses. The BSN will also include advanced medical studies and classes in nursing leadership and management. Coursework for both could include:

  • Microbiology and immunology
  • Medical and surgical nursing
  • Health assessment
  • Introduction to the nursing profession
  • Family nursing
  • Public health
  • Psychosocial nursing
  • Maternal-newborn nursing

What Are Clinical Hours, and How Many Are Required?

While theoretical coursework provides knowledge for nursing students, clinical hours are where nursing skills are honed and developed. Clinical hours are on-the-job training hours in clinics, hospitals, and other healthcare centers. These hours provide hands-on, real-world learning and opportunities to observe and practice clinical skills, patient care, and community relations.

Most undergraduate students complete an average of 700 clinical hours, depending on the requirements of their program. This training may include helping to create public health programs in local clinics or community centers, giving presentations, working in labs, or participating in clinical rotations.

Can You Get a Degree Online?

Do you need to work or care for family members while earning your nursing degree? Online degree programs are increasingly appealing, especially for students who need flexible hours or don’t live near a physical campus.

But such programs still require in-person clinical hours, which must be completed on site at a hospital, lab, or clinic. This training is essential for critical care nurses, who spend most of their time with patients.

Looking for a Career Change?

Those with a bachelor’s degree in a field outside of nursing can pursue a BSN in an accelerated or direct-entry nursing program. These programs allow you to use your previous general education and liberal arts courses to meet non-nursing coursework requirements, so you can make your career change sooner. These programs take about two years to complete and, like traditional BSN programs, still require candidates to pass licensure exams.

What Licensing and Certification Do You Need?

At a minimum, you’ll need an RN license, which you can get after completing your ADN or BSN coursework. To become licensed, you’ll need to pass the NCLEX-RN, a standardized test that all states use to determine whether a candidate is prepared to be a nurse.

The National Council of State Boards of Nursing (NCSBN) can provide specific information about the NCLEX and other possible state requirements.

While certification for critical care nurses is optional, it could mean more pay, help you advance, or help you stand out in a crowded field of job applicants.

Prospective critical care nurses can choose to pursue a Certified Critical Care Nurse (CCRN) credential. This certification is awarded by the American Association of Colleges for Nursing. To qualify, an RN or advanced practice registered nurse (APRN) must have at least two years of work experience and pass the CCRN exam.

While certification is optional, it could mean more pay, help you advance, or help you stand out in a crowded field of job applicants.

Critical care nurses can also be certified in a specialty or as a knowledge professional in a specialty field. Certification as a knowledge professional can be used to pursue a leadership role in teaching, nurse management, or administration. Here are some examples of certifications offered through the AACN.

Critical Care Nurse Certifications

CredentialWho This Certification Is Best For?
CCRN (Adult)
Acute/Critical Care Nursing
Critical care nurses caring for adult patients
CCRN (Pediatric)
Acute/Critical Care Nursing
Critical care nurses caring for pediatric patients
PCCN-K (Adult)
Progressive Care Knowledge Professional
Critical care nurses caring for critically ill adults outside ICU
Cardiac Medicine Certification
Critical care nurses caring for adult cardiac patients
CCRN-K (Adult)
Acute/Critical Care Knowledge Professional
Critical care nurses in leadership, management, or administration

Career and Salary Outlook

doctor and nurse looking at chart next to patients bed

Critical care nursing candidates can expect rich job prospects in a growing field, according to the U.S. Bureau of Labor Statistics (BLS). Employment opportunities for RNs are projected to grow 7% through 2029, faster than the average for other jobs.

With an aging baby boom population requiring more healthcare and increased demand for specialized nursing, it’s not hard to see why critical care nurses are in demand. Because some seniors and critically ill patients prefer to receive care at home or in residential care settings, critical care nurses also are needed outside of hospitals and clinics.

What’s the Salary Range?

According to the BLS, the average salary for an RN is $77,460, with a range of $52,080 to $111,220. The BLS doesn’t break out salaries for RN specialties, but critical care nurses can expect to earn a salary that aligns with their level of education, years of experience, and degree of specialization within their field.

Where you work also can be a factor, according to the BLS, which lists the following RN salaries by workplace:   

Outpatient care centers$84,720
Nursing care facilities
(also called skilled care facilities)

Salaries of Similar Healthcare Occupations

As a critical care nurse, your salary will stack up well against other healthcare careers that require at least an associate’s degree:

Dental hygienists$76,220
Diagnostic medical sonographers$68,750
Respiratory therapists$61,330
Source: U.S. Bureau of Labor Statistics, 2019

How to Stay Informed in this Field

Working as a critical care nurse means staying current on developments in global public health, ongoing education and licensure requirements, and healthcare industry news. In addition to the AACN, here are some associations and resources to keep you informed, engaged, and inspired:

  • The American Journal of Critical Care
  • Intensive Nurse Blog
  • Critical Care Nursing: Medscape
  • American Association of Respiratory Care
  • American Burn Association
  • Wound Ostomy and Continence Nurses Society

Is This the Right Specialty for You?

As a dynamic, rapidly growing field, critical care nursing is a good fit for lifelong learners who want to make a difference in patient care. By helping patients through some of life’s toughest moments, you’ll do meaningful work that makes a lasting impact. Emotionally resilient, energetic, caring individuals with strong communication skills make great critical care nurses.  

Nurses stand at the forefront of patient care, notes Stahl. “Especially in times of crisis, nurses must rely on their assessment skills to help identify patient needs,” she says. “Nurses depend on their broad understanding of physiologic, psychologic, and sociologic needs to meet the patient wherever they are, provide care and reassurance, and ensure the patient’s needs are met.”

malia jacobson

Written and reported by:

Malia Jacobson

Contributing Writer

mary stahl

With professional insight from:

Mary A. Stahl, MSN, RN, CCNS, CCRN-K

Clinical Practice Specialist, American Association of Critical-Care Nurses (AACN)
Past President, AACN National Board of Directors