When many people think about becoming nurses, they do so because they want to work with patients who are critically ill or suffering life-threatening injuries. For many, this level of care is the pinnacle of nursing – the advanced level of care that only critical care nursing can provide.
Critical care nurse practitioners are also known as ICU nurses. They work in the intensive care units of a hospital, such as the ICU, neonatal ICU or pediatric ICU. They can also work in the emergency room step-down unit, progressive unit, telemetry unit, a recovery room or cardiac care unit, or catheter lab. In fact, a significant number of nurses (37 percent) work in a hospital setting.
Critical care nurses can also work in managed care centers or outpatient surgery centers, as well as doctor offices or in a patient’s personal residence. Regardless of the work setting, critical care nurses are called upon to work with complex patient cases. They assess patients, monitor patients and provide intense therapies and interventions.
Critical care nurses are often working in life-threatening situations, so they must remain calm under pressure. Patients and families are under extreme stress, so these nurses must be strong and at the same time compassionate during these situations.
Nurses must make tough decisions while remaining caring and must have a “thick skin” to brush off negative comments and personal attacks from patients and family members suffering from the stress of the situation. Critical care nurses must be able to work with patients of all ages and cultural backgrounds, so they need to have excellent communication skills.
Ever since the nation’s first ICU department was established in the 1950s, critical care nurses have worked alongside doctors, surgeons and other healthcare professionals to provide the best service in patient care. Today, the critical care nurse’s original ICU role has expanded into non-traditional healthcare settings like outpatient centers and ambulatory surgical centers.
These nurses often act as a patient advocate to support patients who are critically ill or injured. Furthermore, critical care nurses fill a crucial role in American hospitals, clinics and other healthcare facilities.
The United States has a physician shortage, particularly in rural and other underserved areas and specialty areas like critical care are particularly hard hit. For this reason, critical care nurses fill a void and an all-important role for patients in these areas of the country.
As you might imagine, critical care nurses require specialized training to effectively perform their positions. Here are the basic steps on the path to becoming a critical care nurse.
First, you must earn your Bachelor of Science in Nursing (BSN) degree, an intensive degree plan that encompasses the study of anatomy, physiology, microbiology, nutrition and public health. Nurses will learn how to have an evidence-based practice. The BSN helps nurses fulfill a standard nursing role, and the BSN is a good foundation for further specialized training. In addition to classroom learning, BSN degree candidates participate in extensive clinical observations to gain real-world experiences about real-life patient care situations.
Many RNs who have an associate degree (ADN) desire to have a BSN. Furthermore, many healthcare employers are now requiring nurses to have a four-year BSN degree. Fortunately, colleges and universities around the nation have responded to this need by offering several degree pathways for these students. Programs have been designed to account for the students’ various points of academic entry. For many RNs who have already been licensed to practice, an RN-to-BSN bridge program can help them achieve a BSN in one or two years.
Accelerated programs are also available and can help a person who desires to become a nurse but has a bachelor’s degree in another field. These fast-track programs help students earn a BSN in just 12 to 18 months.
After completing the BSN coursework, students must pass the National Council Licensure Examination (NCLEX-RN). This exam is a requirement for any nurse who wants to be licensed to work in the United States. The National Council of State Boards of Nursing (NCSBN) administers the computer-based examination. NCSBN works in conjunction with state nursing and regulatory boards to maintain high standards in the nursing profession in every state.
The NCLEX-RN exam tests your knowledge in the foundations of nursing practice. The test has four main categories and six sub-categories that span a wide range of topics related to competency in nursing, including:
Following successful completion of the NCLEX-RN exam, a nurse must work as a general RN for a minimum of two years before pursuing a critical care nursing specialty. Many nurse educators strongly recommend that during the initial two years, nurses work with special populations like children and geriatrics to gain critical care nursing experience.
Critical care nurses are required to hold a master’s degree from an accredited program that offers a master’s in nursing. Students can pursue an MSN with a specialty focus in either ICU or critical care nursing.
Upon completion of the master’s degree, critical care nursing certification is required. The Critical Care Registered Nurse (CCRN) certification is provided by the American Association of Critical Care Nurses (AACN). AACN has rigorous standards for establishing this certification and requires individuals to demonstrate their baseline knowledge of providing nursing care for critically ill and injured patients.
There are other certifications offered by other organizations, but be sure to check your state regulations to determine what endorsements are acceptable. Many CCRNs will continue to pursue higher education to keep current with the technology and teachings in their field of specialty.
There are currently just under three million registered nurses in the United States and by 2024, the U.S. Bureau of Labor Statistics (BLS) projects there will be 3.2 million RNs. In fact, RNs make up the largest sector of the nursing workforce and have a projected job growth rate of 16 percent. Needless to say, the career outlook for RNs is very good and it’s growing at a much faster rate than employment as a whole.
The aging of the U.S. population is driving the need for more RNs, as is the wider availability of healthcare services available to Americans. In particular, there is tremendous opportunity for entry-level RNs, as one-third of current RNs are approaching retirement age. With the sharp rise in chronic illnesses like obesity and diabetes, more RNs are needed for patient diagnosis, treatment and education.
When nursing shortages occur, specialty areas like critical care nursing are particularly hard hit and suffer more loss than general RN positions. This highlights even more need for skilled and experienced critical care nurses in today’s healthcare environment.
According to the BLS’s latest data from May 2018, RNs can expect to earn on average about $71,000 per year, or roughly $34 per hour. At the top of the salary band, experienced and specialty RNs can earn nearly $100,000 annually, with government jobs paying the highest salaries. RNs in physician offices tend to make the lowest salaries at around $60,000 per year.
Critical care nurses salaries can range from $78,000 to $150,000. The outlook for employment as a critical care nurse is especially good, according to the BLS.
Although the number of U.S. physicians is shrinking, this is certainly not the trend for critical care nurses, whose numbers are growing. Data shows that nearly 70 percent of healthcare organizations have increased their advanced nursing workforce within the last year, and that trend is expected to continue through 2019 and 2020. Critical care nurses also have increasing opportunities for locum tenens (temporary) work. In fact, locum tenens numbers have tripled since 2013.
While hospitals still employ the majority (61 percent) of RNs, nurses no longer necessarily need to work just in a hospital setting. The employment trends show that the largest growth is in facilities other than hospitals, such as ambulatory surgical centers, outpatient clinics and long-term care facilities.
After obtaining the CCRN certification from the AACN, many nurses want to further their education, skills and career prospects by choosing an area of specialty.
CCRN specialties tend to focus on special populations like neonatal, pediatric, adult or geriatric patients who are critically ill. CCRN-K nurses work to influence care in these populations, while CCRN-E nurses work with patients in remote locations. A nurse can become an ACNPC-AG nurse to help very sick adult-gerontology patients. Critical care nurses can specialize in providing care to critically ill cardiac patients (CMC) or cardiac surgery patients (CSC).
Here are some of the most frequently asked questions about critical care nurses.
How do I become a critical care nurse? At a minimum, you must have a BSN and an MSN in nursing and pass both the NCLEX-RN exam and the critical care (CCRN) certification.
What is an accelerated BSN program? These accelerated programs are for RNs with experience who wish to earn a 4-year bachelor’s BSN degree in nursing. Students typically have different points of academic entry, so schools are often able to accommodate these by offering flexible and online programs. For example, if you are an RN who has not earned a BSN degree, many programs offer this ability through a combination of online and hybrid classes.
A bridge program helps students bridge the gap between the Associate Degree in Nursing (ADN) and the BSN degree. Some programs allow RNs to earn the BSN and then immediately start the MSN coursework for a master’s degree in nursing.
If I am not an RN, can I still earn a BSN? Yes, many schools offer direct entry or accelerated programs for individuals who hold a bachelor’s degree in another subject. This is a great track for professionals interested in making a career change into nursing. Most direct-entry programs allow you to become an RN and a credentialed BSN degree-holding nurse in as little as two years.
What are some of the nursing duties I can expect to perform as a critical care nurse?Critical care nurses typically perform these duties:
As a critical care nurse, can I further specialize in the profession?Yes, critical care nurses can specialize in working with special populations such as neonatal, pediatric, adult or geriatric critically ill patients, and can also specialize in caring for critically ill cardiac or cardiac surgery patients. An interesting area of critical care nursing is working with critically ill patients in remote locations. For these specialties, nurses must obtain additional training and certifications which must be renewed every three years.
You can learn more about registered nurses and critical care nurses associations by following these great resources:
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If you are looking for an in-demand, versatile role in the nursing industry, strongly consider becoming a CCRN. This career is rewarding and impactful and is the pinnacle of a nursing career.
Nurses are the heart of healthcare, but nursing on the front lines is not the easiest job. There are long hours, difficult people and time away from home. You’ll experience stress and frustration of dealing with people who are in critically ill situations, but you’ll be able to use your advanced degree and nursing experience and certifications to fulfill a challenging role.
Contact us today if you have any questions about how you can enter the field of critical care nursing.