Nursing is a career that is continually growing, challenging, and always in demand. There are various specialties in the field, so nurses can decide what areas to focus on when it comes to helping patients and working with doctors.
As Baby Boomers age and the population increases, the demand for nurses will continue to grow for several years. If you’re interested in becoming a nurse, you can choose from over 100 specialties, including ICU nursing.
ICU nurses work in the hospital’s intensive care units (ICUs) and provide critically injured or ill patients the treatment interventions and highly specialized monitoring they need. Since ICU nurses must have specialized skills, their salary is typically higher than that of other nurses.
ICU nurses need to have technical competencies such as knowing how to work with ventilators, administering potentially hazardous medications, managing code blues, and more. In addition, they must be team players who have excellent time management and critical thinking skills.
ICU nurses will need to know how to perform a variety of tasks that will vary in the healthcare system. However, they will usually be responsible for performing the following work:
Yes, but this will depend on the healthcare system and its needs. Generally, most ICUs will only hire a nurse with several years of medical-surgical experience or one from another ICU. However, there are ICUs that will hire new graduates, so don’t be discouraged if you’re a new nurse looking to work in the ICU.
When it comes to becoming an ICU nurse, there are three major steps:
Before becoming an ICU nurse, you need to become a registered nurse (RN). To do this, you can either graduate with a BSN or an ADN from an accredited program. Afterward, you need to pass the NCLEX exam.
If your goal is to become an ICU nurse, then you’ll need to have at least 2 years of nursing experience under your belt – preferably in a position that focuses in intensive care nursing.
ICU nurses usually obtain the Certification for Adult Critical Care Nurses (CCRN) awarded by the American Association of Critical-Care Nurses. To be eligible to take the CCRN exam, you need to meet one of the two requirements below:
According to the CCRN website, eligible clinical practice hours need to meet these requirements:
The exam costs $344 and people have a 90-day window to schedule their exam at an ANCC-approved center (there are more than 300 in the country). You’re not required to take the exam in your home state since this is a national certification, not a state-specific certification.
About 15% of the country’s 3.8 million RNs work in ICUs, including neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and intensive cardiac care units (CCUs). According to the Kaiser Family Foundation, there are over 85,000 ICU beds in the U.S.
The COVID-19 pandemic has shown how in demand these life-saving units are and that it’s essential to have them running, even as excess hospital capacity. According to the Bureau of Labor Statistics, the country will need a 9% increase in the RN workforce to keep up with current demand.
Since demand for ICU nurses fluctuates, it’s harder to quantify. However, one study suggests that demand for ICU nurses increased by 186% in 2020 compared to pre-pandemic times. The higher demand is likely to lead to higher ICU nurse salaries.
Because of the current nursing shortage, some analysts estimate that the U.S. will need 1.2 million new nurses by 2030 to meet the country’s demands. Some of the states with the highest demand for ICU nurses include Delaware, Hawaii, Illinois, Minnesota, and New Jersey.
Demand for ICU nurses is not only increasing due to the COVID-19 pandemic but also because of the aging Baby Boomer generation. In fact, about 28% of hospitalized patients between the ages of 65 and 84 go through the ICU at least once during their hospital stays. Because of the high demand, the future outlook for ICU nurse salaries is good.
Most ICU nurses work in hospital critical care units like ICUs, CCUs, PICUs, and NICUs. However, some work in specialty hospital wards (e.g.: emergency rooms, surgical operating theaters), specialty clinics, and physicians’ practices.
While ICUs, NICUs, and PICUs generally use the same types of equipment and procedures, some may be modified to fit the needs of the patients. For example, ventilators and infusion pumps in NICUs and PICUs will deliver smaller volumes to accommodate the needs of the unit’s younger and smaller patients.
Furthermore, because the average ICU stay costs between $7,000-$11,000 per day (usually billed to the patient’s insurance), insurance companies will occasionally hire ICU nurses to look through a patient’s medical records and ensure that the ICU stay was the appropriate treatment option.
To alleviate the effects of the severe nursing shortage, hospitals began changing to the 12-hour shift model in the 1970s. Currently, 75%-81% of ICU nurses work 12-hour shifts (either from 7 a.m. to 7 p.m. or from 7 p.m. to 7 a.m.). Full-time employment consists of three 12-hour shifts per week. Because of swing-shift and night-shift differentials, the salary for ICU nurses working from 7 p.m. to 7 a.m. is generally higher than the one for ICU nurses working from 7 a.m. to 7 p.m.
Because of their responsibility to provide lifesaving nursing care to patients on the brink of death, ICU nursing is one of the most demanding nursing careers – both physically and mentally.
ICUs are high-stress environments that are associated with high incidences of burnout. In fact, a study that appears in the 2018 issue of The International Journal of Nursing Studies shows that there is a 56% job satisfaction among ICU nurses.
Moreover, a survey by the American Association of Critical-Care Nurses found that 66% of ICU nurses considered abandoning their profession due to the COVID-19 pandemic. Relatively high salaries may be used as incentives to keep ICU nurses.
When studying to be a nurse, it’s important that you choose an institution that will prepare you to be a well-educated and competent nurse. When researching different nursing programs, ask yourself the following questions:
If the answer to all these questions is “yes”, then you’re likely looking at a high-quality nursing program that will help you start your career with the best foot forward.
ICU nurses and RNs have the same continuing education requirements, which will vary by state. Unless an ICU nurse has an advanced certification (e.g.: CCRN), there are no specific CEU requirements.
Typically, a nurse will need to do the following to renew their RN license:
Since every state has its own specific requirements, you will need to check with your state’s board of nursing before applying for renewal.
Because of the responsibilities that ICU nurses need to carry out, such as making critical decisions in split seconds and taking care of critically ill patients, hospitals require certifications to make sure their nurses are of the highest quality. ICU nurse certifications prove that the nurse is up to date on the latest nursing and medicine information.
ICU certifications make a nurse more hirable and better equipped to deal with the demands of an ICU. Moreover, ICU nurses who are certified generally have higher average salaries. If you want to further your career as an ICU nurse, consider getting certified.
The American Association of Critical-Care Nurses offers various certification programs. While there are many options to choose from, there are four specialties that constitute nursing in critical care conditions: CCRN (Adult), CCRN (Pediatric), CCRN (Neonatal), and CMC (Adult).
Before you take a certification exam, you need to meet a few primary requirements. These requirements include:
First, you need to graduate from a nursing program to obtain your RN or APRN license and pass the NCLEX, which can last between three to five years. Second, your license must be unencumbered, which means nurses can’t have any current disciplinary measures on their records.
Finally, you must achieve the clinical hours minimum. To meet these hours, you can choose to take the two-year plan or the five-year plan found in our section titled, “How can I become an ICU nurse?”
While it is possible to work as an ICU nurse without getting certified, there are two main reasons to consider getting your certification: higher chances of getting hired and a higher salary.
Some hospitals require ICU certification to work in their critical care unit. Therefore, if you have an ICU certification, your chances of finding a job at a hospital you like go up. It also makes you a stronger candidate compared to other applicants who don’t have a certification.
In a 2018 survey by Advance Healthcare, researchers found that there is a 16% jump in pay for ICU nurses that become certified. Of course, this pay increase comes with more responsibility and a better understanding of nursing and medicine in general. Since ICU nursing is one of the more stressful nursing specialties, being as prepared as you can be will make a difference when it comes to making critical life-saving decisions.
In addition to the ICU nurse certifications, you can help advance your career by getting other certifications as well. Two of these additional certifications include the CCRN-K certification and the CSC certification.
The CCRN-K certification allows for any nursing position that doesn’t work directly with critically ill patients. These include management positions, directing positions, academia, clinical educator, and other roles outside traditional nursing. The CCRN-K certifications have similar specialties to the traditional CCRN certification, including Adult, Neonatal, and Pediatrics.
The CSC certification is for nurses interested in Cardiac Surgery Care. Nurses with this certification can work in post-anesthesia, cardiovascular, or cardiothoracic surgery care units. While it focuses on cardiovascular disease like a CMC certification, it also involves post-operative care.
On average, the ICU nurse salary in 2022 is $33.85 per hour. However, this will vary depending on the nurse’s level of experience and the hospital’s demand for ICU nurses. For instance, ICU nurses who have five to nine years of experience will earn about 19% less than ICU nurses who have 10 to 19 years of experience.
Also, keep in mind that there is a lot of variation in ICU nurse salaries from state to state. California offers the highest salaries for ICU nurses. Critical care RNs can expect to male an average of $51.01 per hour. In contrast, ICU nurses in Alabama (the state with the lowest salaries for ICU nurses) make an average of $25.49 per hour.
Hourly pay rates depend heavily on industry compensation for professionals in a similar line of work. For instance, while the average hourly pay rate for non-ICU nurses in California is $31.41, the average hourly pay rate for non-ICU nurses in Alabama is $26.26.
Another factor to consider is membership in a nurse union. While most nurses in Alabama don’t belong to a union, California’s nurse union is one of the biggest ones in the country. Even though the average hourly pay rate in California refers to unionized and non-unionized hospitals, hospitals with ICUs are generally in the state’s urban centers where the California Nurses Association is particularly strong. As a result, ICU nurses can expect higher salaries if they work in California.
Here’s a quick breakdown of the hourly ICU nurse salary based on experience:
The starting salary of an ICU nurse in 2022 is about $47,010 per year, which is about 33% less than the average salary of an ICU nurse. When broken down to a per hour pay, it comes down to $22.60 per hour. Moreover, many hospitals impose a 90-day probationary period for newly hired ICU nurses in which they don’t have access to benefits.
Because of the highly specialized set of skills that an ICU nurse needs to perform their duties, an RN cannot learn these while working in a physician’s practice or in a non-critical care hospital ward. Furthermore, training a new RN costs an estimated $44,375, and this doesn’t include the additional training for ICU nurses. Because of how expensive it is to train nurses, hospitals and medical centers will seek to recoup a portion of the training costs by offering low entry-level salaries.
In addition, entry-level salaries will depend on the job market and how much demand exists for the position. Because of the COVID-19 pandemic, there is a high demand for ICU nurses as many seasoned ICU nurses leave their jobs due to burnout. As a result, entry-level ICU nurse salaries may rise over the near future as a way to incentivize RNs into this specialty.
Here’s a quick breakdown of the starting ICU nurse salary:
There are multiple ways you can improve your earnings and earn more than the base ICU nurse salary. Consider these tips:
While being an ICU nurse is a specialty in and of itself, nurses can also specialize within the ICU field. For example, ICU nurses can work in various ICUs and related units, including:
Keep in mind that not all hospitals and medical centers have multiple ICUs. In these cases, patients in need of ICU-level care will be in the same unit.
The average ICU nurse salary in 2022 is $33.85 per hour. While this is 41% less than the average annual salary of a nurse practitioner, it is in the same range as the average annual salary of an ER nurse, NICU nurse, or hospice nurse.
Average salaries depend on a variety of factors including cost of living, number of nurses available, competition for open positions, and job availability. In 2021, almost two-thirds of U.S. hospitals had an RN vacancy rate of about 8%. Based on anecdotal evidence, the vacancy for ICU nurses is even higher. Because of the nursing shortage, there are many jobs available as hospitals and medical centers turn to travel nurses to staff their ICUs. While traveling nurses don’t receive the same benefits as an RN, their salaries are significantly higher.
Another thing to keep in mind is the higher cost of living in areas that pay more. For example, California’s cost of living is 50% higher than the average cost of living throughout the U.S. As a result, they have to pay their nurses more so they can afford to live in their state. In fact, California’s ICU nurse salary is 51% higher than the average ICU nurse salary throughout the U.S.
Here’s a quick breakdown of the average ICU nurse salary:
In addition to salaries, ICU nurses receive benefits that are separate from base salaries and wages. They fall into two categories: mandated benefits and unmandated benefits. Mandated benefits include:
Unmandated benefits are provided at the employer’s discretion and can include:
ICU nurses also frequently receive specialized benefits like reimbursement for professional development activities and liability insurance. Because of the additional benefits you may receive, it’s important to consider them along with your salary when it comes to choosing your best option. For instance, ICU nurses working in state and local government have an average salary of $71,970 per year but the cash value of their benefits can equal $44,298, making their total compensation package about $1166,268 per year. Generally, a private sector ICU nurse can expect their benefits to average 30% of their total compensation, while a public sector ICU nurse can expect their benefits to average 38% of their total compensation.
Here’s a quick breakdown of some of the benefits ICU nurses can expect and what their cash value would be:
Like with other jobs, experience is rewarded in the ICU nurse field. In other words, the longer you work as an ICU nurse, the more you’ll earn. Usually, ICU nurses will hit the average salary mark sometime during their seventh year.
To compare, ICU nurses who have between one to four years of experience will earn salaries that are 15% higher than the nurses who are just starting out. Moreover, having between five to nine years of experience can result in a 22% jump in pay, and ICU nurses with 10 to 19 years of experience can expect a 24% jump from that. Finally, ICU nurses with 20+ years of experience will make 24% more money than their colleagues with 10 to 19 years of experience. Since staff turnover is an issue with ICUs, increasing the compensation for experienced ICU nurses can help keep them on the job.
Here’s a quick breakdown of the ICU nurse salary based on level of experience:
ICU nurses can expect to earn their highest salaries by working in Level 3 ICUs. In contrast, they can expect to earn their lowest salaries by working for insurance companies or the federal government doing utilization reviews.
ICU nurses can expect to earn the highest salaries by working in the state of California (about $106,110 per year). Other high-paying states include Hawaii ($92,260 per year), Massachusetts ($84,710 per year), and Oregon ($84,690 per year).
When it comes to the lowest salaries for ICU nurses, Alabama comes out on top at $53,010 per year. Other low-paying states include South Dakota ($53,650 per year), Mississippi ($53,910 per year), and Iowa ($55,070 per year).
Here’s a quick breakdown of the ICU nurse salary based on the top 10 states that pay the highest and the lowest: