ICU Nurse with a patient in the hospital

Intensive Care Unit (ICU) nurses work in a challenging environment in the nursing profession. Such nurses offer life-saving care to patients in critical conditions, often fighting to stay alive.

ICU nurses must remain on top of their game since the patients require care and monitoring 24/7. They understand all aspects of nursing to assist the ventilated and intubated patient on multiple vital medications.

ICU nurses have special training and are irreplaceable unless by a nurse with similar credentials, experience, and training. They can work in various specialties, but this field's staff-to-patient ratio is very low. 

ICU nurses dedicate time to one or two patients and rarely more at the same time. With more than five million patients in the US getting admitted to ICUs, the demand for these nurses is always high.

Recommended Reading - What Is An ICU Nurse?

What Are the Steps to Becoming a Qualified ICU Nurse?

As an ICU nurse, you must have an extensive understanding of disease pathology. This knowledge helps you offer medical interventions and sustain the life of your patients.

Working in the ICU requires an advanced set of skills. Therefore, your career path as an ICU nurse will start with becoming a registered nurse.

1) Attend Nursing School

There are various educational paths to becoming an ICU nurse. You can attain your nursing degree through a Bachelor of Science in Nursing (BSN) or an associate degree in nursing (ADN) program.

ADN programs are most suitable if you desire to start your career in the nursing field in the shortest time possible. These programs generally take two years and are therefore more affordable. 

You can enroll in an ADN program with a GED or a high school diploma with a GPA of 2.0 and above. The main focus of course work is lab training, nursing principles, clinical skills, and experiences. In addition, you can expect to learn more about pharmacology, psychology, anatomy, and microbiology.

By graduation, you will have the knowledge and skills to perform different medical procedures, take vital signs and administer medication. In addition, you’ll be aware of legal and ethical issues in healthcare and basic medical terminology.

Although an ADN is a minimum requirement to become a registered nurse, some employers prefer ICU nurses with a BSN.

Graduating from a BSN gives you a wider variety of job opportunities and possibly a higher salary. In addition, if you already have an ADN, joining a BSN program allows you to achieve an advanced degree within two years.

You'll need a high school diploma and excellent SAT and ACT scores without an ADN. You may also need to write an essay and a few recommendation letters.

BSN programs take four years to complete, and you'll cover more advanced coursework than an ADN program. For example, it covers ADN courses, public health, informatics, nursing theory, and management.

By graduation, you'll have adequate clinical, leadership, management, and research skills to start your ICU nursing career. You'll also cover more clinical hours and be able to implement patient care plans and handle acute care situations.

Various bridge programs allow you to achieve your degree in less time. For instance, you can enroll in ADN to BSN programs, BSN to MSN, and RN to MSN programs.

2) Study and Pass The NCLEX-RN Exam

Once you achieve your nursing degree, the next step is sitting for the NCLEX-RN to get your license to work as a registered nurse. This standardized, computer-generated exam evaluates your knowledge and how you use critical thinking to make nursing decisions. 

The National Council of State Boards of Nursing (NCSBN) administers the exam and collaborates with regulatory and nursing boards to maintain quality standards in nursing. 

The NCLEX-RN tests the processes and procedures that lay the foundation of the nursing profession. 

The exam evaluates nursing competency under four main categories, including

  • Health Promotion and Maintenance

  • Safe and Effective Care Environment

  • Physiological Integrity

  • Psychosocial Integrity

Passing the NCLEX-RN proves to employers, the public, and patients that you have adequate nursing knowledge that meets national standards. In addition, it shows your dedication to patient safety, qualifying you for state licensing. 

3) Obtain a State Registered Nurse License

Different states have varying requirements for an RN license, but the primary two are proof of passing the NCLEX-RN and your nursing degree.

You’ll apply for your license through the state board of nursing in your home state or the state where you prefer practicing. 

Some states are part of a mutual recognition model called the Nurse Licensure Compact (NLC). If you live or plan to work in a compact state, you don’t need to apply for a license in any other state that’s a member of the NLC. 

Some states require you to submit your license application before graduation though you’ll receive your license after. Other states issue a temporary permit that allows you to work briefly as a graduate nurse before the results of the NCLEX. 

You can also acquire an RN license through endorsement in some states. If you have a permit and remain active in one state, you can obtain a permit without repeating the significant processes in another.

However, if you were inactive for an extended period, you’ll have to finish a refresher course before you get your RN license in the other state.

4) Gain Bedside Experience in the Intensive Care Unit

Transitioning from a registered nurse to an ICU nurse requires advanced skills to handle delicate medical interventions such as:

  • Administering intravenous sedation

  • Mechanical ventilation

  • Intubation

You’ll gain these skills through extensive clinical experience handling critically ill patients in an ICU or similar setting for two to five years.

5) Study and Pass an ICU Nursing Certification

The ICU has various challenges and responsibilities. Hospitals and employers, therefore, require ICU nurses to have specific certifications. It's also a great way to advance your career and earn a better salary. 

Most ICU nurses start with the Certification for Adult Critical Care Nurses (CCRN), issued by the American Association of Critical-Care Nurses (AACN). 

To qualify for the CCRN exam, you must meet either of these criteria working as an RN or APRN:

  • You must have at least 1750 active hours caring directly for critically or acutely ill patients in the last two years of practice. Before submitting your application, you should ensure you attain half of these hours in the past year.

  • You must have at least 2000 active hours caring directly for critically or acutely ill patients in the last five years of practice. At least 144 hours should be in the past year before submitting your application.

These clinical hours must be in a Canadian or US facility, and a clinical supervisor must verify. If you're not a member of the AACN, certification will cost you $360 or $245 for members.

Other certifications necessary for nursing in critical care conditions include

Certified Rehabilitation Registered Nurse (CRRN)

This certification allows you to care for patients with various disabilities and chronic illnesses to help them achieve the highest level of function possible. You can work in cardiac care units, general ICUs, transport and flight operations, trauma units, and surgical ICUs. 

CCRN (Neonatal)

CCRN (Neonatal) certification allows you to care for critically or acutely ill newborns in any location. You can work in critical care transport, cardiac care units, trauma units, medical or surgical ICUs, combined ICUs, or CCUs and NICUs.

CMC (Adult)

CMC certification allows you to care for critically or acutely ill adult patients with cardiac issues. You can work in:

  • Heart failure clinics

  • Medical ICUs

  • Heart failure clinics

  • Electrophysiology units

  • Telemetry

  • Interventional cardiology

  • Home care

Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) are mandatory.

Can You Become an ICU Nurse Online?

It's possible to achieve a nursing degree online as both ADN and BSN are available. However, verifying that the online program you intend to join has full accreditation is essential. 

You can confirm via the Commission on Collegiate Nursing Education and the Accreditation Commission for Education in Nursing.

What Is the Difference Between an ICU Nurse and an ER Nurse?

ICU and ER nurses care for patients with life-threatening, severe, or urgent medical conditions. Most duties and responsibilities overlap, but the ICU and emergency room are two significantly different settings. 

ICU vs. ER Nurse- Work Style

ER nurses flourish in chaotic environments and have personalities that thrive amidst disorganization. Since there's no way to predict who will walk through the doors, these nurses depend on intuition and teamwork to manage the challenging workflow.

ICU nurses are the opposite, as they dislike chaos. These nurses work like well-synchronized machines without the disorder associated with ERs.

ICU nurses prefer well-organized and structured shifts to ensure they handle all duties without difficulties.


ICU nurses are often meticulously organized and work with checklists. They know precisely which medications are necessary, what's compatible, the intake and output of fluids, and other detailed aspects. As a result, each nurse knows everything about their patients' care. 

The ER nurses' environment is entirely different since they can't afford the time to offer detail-oriented care to every patient. Instead, they only have the time to evaluate, react to stabilize the patient and proceed to the next person. 

ER nurses are quick to act, adaptable, adrenaline seekers, remain calm in emergencies, and thrive in organized chaos. 

ICU nurses are planners, methodical, meticulous, masters of the detailed level of care, and exceptional multi-taskers. 

What Positions Can You Progress to From Being an ICU Nurse?

There are various ways you can progress your career as an ICU nurse. You can specialize in a particular area such as pediatrics, cardiac care, neonatal care, or transplant surgery. 

You can also transition into leadership positions where you supervise other nurses to ensure quality standards in patient care. For instance, you can become a clinical nurse manager, charge nurse, or head nurse. 

Acquiring additional certification in your specialty will give you a competitive edge, give you access to more job opportunities and earn you a higher salary. 

Do Your ICU Nurse Exam Qualifications Expire?

As an ICU nurse, you must maintain your CCRN certification, which remains valid for three years. You can renew the certificate by retaking the exam or through Continuing Education Recognition Points (CERPs).

You must achieve 100 CERPs within the three years when your certification remains valid. The CERPs should cover different categories, including 60 points in inquiry education and clinical judgment modules.

Categories B and C, advocacy or caring and collaboration, should have ten points each. The remaining twenty points can be in any of the three categories.

You should also work with critically ill patients in an ICU for at least 432 hours during the three years. One hundred forty-four hours should be in the last 12 months before your renewal application. 

How Much Do ICU Nurses Make?

ICU nurses often earn more than other nurses due to their specialized training. However, your earning potential depends on your experience, education, specialty, and location.

On average, ICU nurses in the US earn $84,281.06 per year, equivalent to $40.52 per hour.

Recommended Reading - How Much Do Critical Care Nurse (ICU Nurse) Make?

How Long Does It Take to Become an ICU Nurse?

Generally, it takes approximately five to six years of training and education to become a practicing ICU nurse. ADN programs take two years, while BSN programs take four years. 

Once you graduate and pass the NCLEX-RN exam, you’ll need at least two years of clinical experience to qualify for certifications.

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