How to Become an ICU Nurse: New Grad Challenges

Are you a new nursing grad curious about getting your feet wet in the ICU? It may seem unsafe, but working in an ICU can be one of the most rewarding and challenging roles for any registered nurse.

In this blog post, we’re here to tell you everything you need to know – what skills are required to work as an ICU Nurse, how to ace your interview process, and even some tips on managing the unique workplace culture throughout your shifts.

So if you’re ready for an adventure into the high-stakes world of intensive care medicine — let’s get started.

What is an ICU Nurse?

An ICU nurse, or intensive care unit nurse, is a specialized healthcare professional trained to provide acute and critical care to patients who require immediate and intensive medical attention due to severe illnesses or injuries. These nurses work in a hospital setting and are responsible for monitoring and assessing vital signs, administering medications, managing life support equipment, and communicating with physicians and other medical staff.

For those interested in pursuing a career as an ICU nurse, it’s essential to understand the complexity and demands of this field. ICU nurses are responsible for providing life-saving care to critically ill patients. With patients often intubated, ventilated, and on multiple medications, these nurses must be well-versed in the latest medical practices and technologies.

Without the invaluable work of ICU nurses, healthcare systems could not provide specialized care for trauma patients, end-of-life patients, and more. These nurses possess special qualifications and knowledge, which can only be substituted if an individual has similar training and credentials. Thus, their role is critical in ensuring the efficient functioning of healthcare services.

Can a New Nurse Work in the ICU?

Yes, new nurses are allowed to work in the ICU. However, because of this role’s highly specialized and demanding nature, it’s essential for any new nurse who wants to pursue a career in the ICU to establish a strong foundation in primary nursing care before taking on an ICU position. Additionally, employers may place some restrictions on new nurses seeking ICU jobs, so it’s essential to research and determines the requirements before applying.

Things Keep In Mind When to Join ICU As a New Nurse

Here are some things you need to keep in mind about trying to work in the ICU as a new nurse.

  1. Check Hospital Policy on New Grads Working in the ICU: Ask the hospital you are applying to if they allow new nurses in the ICU. Some hospitals may require experience with a certain number of years before allowing recent grads to work in the ICU.
  2. Research & Analyze: Before applying, research and learning as much as possible about the ICU is essential. This will help you understand the type of work you’ll be doing, your challenges, and what it takes to succeed in this role.
  3. Be Prepared for Challenges: Working in the ICU can be rewarding and challenging. It is essential to be prepared for the challenges that come with this role, such as working with critically ill patients and dealing with high-stress environments.
  4. Work On Your Skills: As a new nurse, you should know your skills and abilities before entering the ICU environment. Knowing what you are good at and where you need help will make adjusting to the ICU lifestyle easier.
  5. Seek Mentorship: As a new nurse in the ICU, it is essential to seek mentors who can provide guidance and resources when needed. A good mentor can help you navigate challenging times and give a sense of support during your early ICU career.

Where New Grad Nurses Typically Start Out

New grad nurses typically start in lower-acuity areas such as medical/surgical ICUs, step-down, or telemetry units. This is a more gradual introduction to critical care nursing, allowing new grads to gain experience before taking on higher acuity roles within an ICU. After a few years of experience, they can move to more specialized ICUs such as medical/pulmonary or neuro ICUs.

How Do You Become an ICU Nurse? – Step-by-Step Guide

Below are some essential steps to becoming a critical care unit nurse (ICU):

Step 1: Become a Registered Nurse

To become an ICU nurse, you must earn a BSN or an ADN from an accredited nursing program and pass the NCLEX exam.

Step 2: Gain Experience

To become an ICU nurse, you must have acquired at least two years of nursing experience in an intensive care position.

Step 3: Obtain ICU Certification

The most common certification for ICU nurses is the CCRN (Certification for Adult Critical Care Nurses), awarded by the (AACN) American Association of Critical Care Nurses.

  • To be eligible to participate in this exam, You need to have worked as an R.N. or APRN in direct care for critically ill pediatric patients for 1,750 hours in the past 2-years. Plus, 875 of those hours need to be from the previous year.


  • You can have practiced as an R.N. or APRN for at least five years and obtain a minimum of 2,000 hours in the direct care of acutely/critically ill pediatric patients, with 144 hours earned in the most current year preceding the application.

According to the CCRN website, eligible clinical practice hours have to meet the following criteria:

  • All eligible clinical practice hours must have been completed at a U.S.- or Canada-based facility or one deemed comparable to U.S. standards for acute/critical care nursing practice.
  • They must have been obtained actively by providing direct care or supervising nurses or nursing students at the bedside of acutely/critically ill pediatric patients.
  • Must have been verifiable by a clinical supervisor or professional colleague (RN or physician).
  • Nurses who work in ICUs, cardiac care units, combined ICU/CCUs, medical/surgical ICUs, trauma units, or critical care transport/flight are eligible to take the exam.
  • If you need clarification on whether your unit meets the criteria, talk to your unit’s nurse educator or manager about the requirements.

The CCRN exam costs $344 and can be taken at any ANCC-approved center located in the U.S.; there are over 300 centers in total. You do not have to take the exam in your home state as this is a national certification. You will have 90 days to schedule the exam.

Step 4: Receive ICU Certification

Once you have successfully passed the CCRN exam, you will receive your ICU certification and be qualified to start working as an ICU nurse. With this certification, you can access many specialized nursing areas in the ICU field.

You can also increase your salary potential and advance in the nursing field. Being certified is just the beginning of a lifelong journey, and you should stay up-to-date on the latest advances in critical care nursing. Use any available resources that help you stay current with new developments and stay ahead of the competition.

Step 5: Maintain Your Certification

Maintaining your certification is essential to ensure you can keep working as an ICU nurse. The CCRN certification must be renewed every three years and requires the completion of 60 continuing education credits — 30 of which must be in critical care.

You can quickly complete these requirements by taking online courses related to advanced assessment, pharmacology, evidence-based practice, or quality improvement. You should also attend ICU conferences and seminars to stay informed on current patterns and trends in the ICU field.

By keeping up with your certification requirements, you can remain a valuable critical care team member for years to come.

What Specialties Exist for ICU Nurses?

Nurses can specialize within the ICU field. ICU nurses can often provide care in various ICUs and related units:

  • Cardiothoracic ICU
  • Oncology ICU
  • Neurocare ICU
  • Surgical ICU
  • Medical ICU
  • Coronary ICU
  • Psychiatric ICU

Where Do ICU Nurses Work?

ICU Nurses are generally limited in where to work because of their highly specialized training. The on-the-job training for ICU nurses makes them highly sought after for various nursing positions; however, ICU nursing is very limited in job location opportunities. ICU nurses can work in the following areas:

  • Hospitals
  • Cardiac Catheter Labs
  • Surgical Departments
  • Progressive Care Units
  • Outpatient Surgery Center
  • Post-operative Care Units

Entry-Level ICU Nurse Salary In 2023

In 2023, ICU nurse salaries per hour can vary depending on experience. In 2023, the hourly wage for ICU nurses is $36.22) or $75,329.50 on average. However, the salary amount may differ depending on the nurse’s experience level.

For instance, entry-level critical care RNs earn 13% less than those with one to four years of experience. Those with five to nine years of experience make 19% less than nurses with 10 to 19 years of practice.

The pay rate for ICU nurses varies significantly by state. California is the highest-paying state, with an average hourly rate of $51.01, whereas Alabama has the lowest payment at only $25.49 per hour.

It is important to note that these numbers are averages and may not reflect your specific situation or salary level as an ICU nurse. It would help if you researched the salary levels of ICU nurses in your area before committing to a position. With the proper knowledge and negotiation skills, you can ensure you get paid what you deserve for your hard work.

What Is ICU Residency Program?

If you’re a new graduate nurse interested in working in the ICU, residency programs are available to help you transition into this specialty. The ICU residency program is designed to bridge the gap from student nursing to professional nursing practice in a critical care unit.

An ICU Residency Program aims to prepare nurses for the demands of critical care nursing by providing an immersive learning environment that includes didactic, hands-on, and clinical practice experiences. These residency programs are typically one year long and involve a combination of classroom instruction, simulated labs, and preceptorships in the ICU setting to provide real-world experience.

By completing an ICU Residency Program, you will gain the knowledge and skills to be successful as an ICU Nurse. And upon completion, you’ll be eligible to take the CCRN exam (see above).

Reputable ICU Nurse Residency Programs in the USA

  • * Johns Hopkins Hospital ICU Nursing Residency Program
  • * Duke University Medical Center ICU Nurse Residency Program
  • * Mayo Clinic Critical Care Nursing Residency Program
  • * UNC Health Care System ICU Nurse Residency Program

Tips For Working in an ICU as a New Grad Nurse

Working in the ICU can be a daunting experience, especially as a new graduate nurse. Here are some tips to help you make the transition smoother:

  • Manage your stress levels – The ever-changing environment of the ICU can cause your stress levels to skyrocket. Take some time each day to de-stress and recharge.
  • Ask questions and seek help – Don’t be afraid to ask questions. You are expected to make mistakes; it is part of the learning process.
  • Stay organized – Being organized helps you stay on top of your tasks and keep track of patient progress.
  • Develop good communication skills – Communication is critical in the ICU. Communicating effectively with patients, physicians, and other staff members would be best.
  • Take care of yourself – Take time outside of work. Eating healthy, exercising regularly, and getting enough sleep reduces stress levels and improve overall well-being.

What is the Career Outlook for an ICU Nurse?

Currently, there is no exact data on the growth of ICU nurses. However, As per the BLS, in 2021, there were 3,130,600 Registered Nurses (RN) in the U. S. 

In 2031, there will be a need for an additional 195,400 nurses, which is a projected growth of 6%. With the aging population, this data is expected to be even higher.

Where Can I Learn More About ICU Nursing?

To find out more details about ICU nursing, check out these websites:

  • American Association of Critical-Care Nurses
  • American Nurses Association
  • American Academy of Nursing
  • National League of Nursing
  • Society of Critical Care Medicine
  • American Journal of Critical Care
  • Critical Care Nurse Journal

ICU nurses work in a fast-paced and dynamic environment that often requires very high mental and physical strength levels. Nurses are tasked with providing life-saving measures to patients while ensuring they receive the best care possible. It is a gratifying career within the nursing profession and one that most never leaves once they become a part of it.


Is Being an ICU Nurse Hard?

The role of an ICU nurse is one of the toughest in the nursing profession, requiring physical and mental strength. ICU nurses are called upon to care for critically ill patients and often close to death.

What is The Difference Between ER vs. ICU Nursing?

ER, nurses typically act quickly to stabilize patients so they can move on to their next destination, home or an ICU. Their primary focus is transitioning a patient to the next level of care. In contrast, ICU nurses work to restore patients’ health and ensure good outcomes for them.

Can New Nurses Work in the ICU?

The answer to this question depends on the particular healthcare system. Generally, ICUs prefer to hire nurses with experience from another ICU or several years of medical-surgical nursing experience. However, many hospitals hire new graduates, so don’t become discouraged if you are a new nurse. You should keep looking for ICUs that will take you on!

Final Thoughts

Working in the ICU is a rewarding and challenging experience. If you’re a new graduate nurse looking to leap into this specialty, it’s essential to understand the responsibilities involved, have realistic expectations, and be willing to put in the work.

By following these steps and tips, you will have an easier transition and be well on your way to becoming a successful ICU nurse.

Wishing you the best of luck on your journey as an ICU Nurse! It’s a rewarding field that will bring many challenges, making it a fulfilling career. With dedication, hard work, and the right attitude, you will excel as an ICU Nurse.



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