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November 2020 - Volume 15 - Issue 6

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Guest editorial.

Let's take care of one another

Nursing Critical Care. 15(6):5, November 2020.

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Looking at Labs

Erythrocyte sedimentation rate.

Nursing Critical Care. 15(6):31, November 2020.

Name That Strip

Nursing Critical Care. 15(6):35-36, November 2020.

Identify this ECG strip

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Critical Issues

Do a surrogate decision-maker's motives matter?

Nursing Critical Care. 15(6):39-42, November 2020.

Nursing Critical Care. 15(6):44, November 2020.

Innovations

Honor Guard: A ritual honoring patients and families who choose organ donation

Nursing Critical Care. 15(6):45-46, November 2020.

Honoring patients and families who choose organ donation

Quality of life in patients with atrial fibrillation: An intervention

Nursing Critical Care. 15(6):7-11, November 2020.

Atrial fibrillation (AF) is one of the most common cardiac dysrhythmias. This study aimed to determine the quality of life of patients with AF referred to the Al Zahra Heart Hospital in Shiraz, Iran. The authors used an AF-specific questionnaire to measure patients' responses regarding three specific dimensions of these patients' quality of life.

• Abstract Abstract

Managing noncompressible torso hemorrhage with REBOA

Nursing Critical Care. 15(6):12-17, November 2020.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has reemerged as a treatment for noncompressible torso hemorrhage. This article discusses indications and contraindications for REBOA, describes the procedure, and reviews critical care nursing considerations for patients undergoing REBOA.

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Essential critical care skills 1: what is critical care nursing?

18 October, 2021

Critical care nurses provide highly skilled, expert care for the most severely ill or injured patients. This introduction - part one of a six-part series – provides an overview of their role

In this first article of a six-part series on critical care nursing, we introduce the role and what it involves, as well as looking at how critical care nurses can support the whole patient, from a physical and psychosocial perspective. The importance of rehabilitation, assessment of risk of ongoing morbidity and delirium are also discussed. Part 2 describes the assessment of the critically ill patient.

Citation: Credland N et al (2021) Essential critical care skills 1: what is critical care nursing? Nursing Times [online]; 117: 11, 18-21.

Authors: Nicki Credland is reader in critical care, University of Hull; Louise Stayt is senior lecturer, Oxford Brookes University; Catherine Plowright is professional adviser, British Association of Critical Care Nurses; David Waters is associate professor, Birmingham City University.

• This article has been double-blind peer reviewed
• Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser)
• Click here to see other articles in this series

Introduction

Critical care nurses provide expert, specialist care to the most severely ill or injured patients in intensive care units and the wider hospital. They are highly trained and skilled safety-critical professionals working as part of a multidisciplinary team. Critical care is classified using four levels of patient acuity, as outlined in Table 1. Updated guidelines for the provision of intensive care services (Faculty of Intensive Care Medicine, 2019) recommend that level-3 patients should have a minimum registered nurse–patient ratio of 1:1 and level-2 patients must have a minimum nurse–patient ratio of 1:2.

To deliver highly skilled care, critical care nurses undertake postgraduate study and ongoing training. The Step Competency Framework underpins critical care nurse education; it recognises that, to be able to deliver high-quality care to patients, staff need the knowledge and skills so they can work at the highest level, with standardisation across all critical care units. Step 1 for adult critical care begins when a nurse with no previous experience of the specialty starts working in intensive care medicine. Steps 2 and 3 should be incorporated into academic intensive care programmes.

Critical care nurses also lead many outreach teams that identify, monitor and initiate timely treatment to prevent clinical deterioration, and support ward nurses (Department of Health, 2000). They offer advanced system assessment and rescue before irretrievable deterioration and cardiac arrest takes place.

This article is the first in a six-part series on essential critical care skills, which aims to explore essential critical care nursing competencies.

Managing organ dysfunction

Admission to a critical care unit is usually because of organ dysfunction or organ failure. Respiratory failure alone leads to around 100,000 annual admissions to critical care in the UK (FICM, 2019). The goal is to correct or provide support to these dysfunctional organs. Technological and medical advances over the past few decades have meant significant growth in treatments and interventions, and more-effective management of patients who need organ support.

The interventions most commonly used include mechanical ventilators, infusion devices and renal replacement therapy. Table 2 outlines the interventions used for different physiological systems.

Patient monitoring and documentation

It is crucial to gather accurate data on physiological parameters – such as oxygen saturation (SpO2), heart rate and fluid balance – at the bedside of the patient who is critically ill. Typically, each patient will have their own monitor that will display a range of clinical factors (Box 1) and provide real-time feedback to help evaluate critical care interventions, and detect any deterioration or emergency situations promptly.

Box 1. Clinical factors recorded by bedside monitors

• Heart rhythm
• Oxygen saturation
• Respiratory rate
• Exhaled carbon dioxide concentration/partial pressure
• Non-invasive blood pressure
• Arterial blood pressure
• Central venous pressure
• Temperature

Critical care nurses need technical skill and knowledge to effectively use and interpret bedside monitors. A further common technical resource is the clinical information system (CIS), which can record and process large amounts of data, such as:

• Patient physiological observations;
• Care or interventions delivered;
• Medication plans.

The FICM (2019) highlights how a CIS can not only improve efficiency, but also reduce errors and improve compliance with standards or guidelines.

Psychosocial care

Holistic patient-centred care – as outlined by Jasemi et al (2017) – is vital in critical care, with effective psychosocial care, and cultural, spiritual and family care being of particular significance. Immediately on admission to a critical care setting, patients are subjected to an onslaught of physical and psychosocial stressors including:

• Physical pain;
• An unfamiliar environment; equipment and treatments;
• Sensory disturbances;
• Isolation from family;
• Loss of autonomy;
• Impaired communication;
• Fear for their life (Kiekkas et al, 2010).

It can lead to severe emotional distress and the development of delirium, anxiety, depression and post-traumatic stress disorder (PTSD) (Hatch et al, 2018) – all of which may persist long after the patient’s physical recovery and discharge from hospital (Ewens et al, 2018).

Psychosocial care is often considered the touchstone to person-centred care and, in this setting, refers to supportive interventions that may mitigate the stressors associated with critical illness. Evidence-based measures that may all help include:

• Providing information and explanations;
• Regularly orientating the patient to date, time and place;
• Reassurance;
• Empathetic touch;
• Early mobilisation;
• Family visits;
• Maintaining clear night and day routines;
• Minimising noise (Bani Younis et al, 2021; Alaparthi et al, 2020; Parsons and Walters, 2019).

Delirium is of particular concern in patients who are critically ill, and has an incidence range of 45-87% (Cavallazzi et al, 2012). It is characterised by the acute onset of cerebral dysfunction, with a change or fluctuation in baseline mental status, inattention, disorganised thinking or an altered level of consciousness (NICE, 2019). Delirium is associated with significant increases in mortality, morbidity and hospital stay, as well as having long-term ramifications such as cognitive impairment, PTSD, anxiety and depression (Cavallazzi et al, 2012) so the prevention, early recognition and effective management of it is of paramount importance. The ABCDEF bundle of care may help:

• A ssessment, prevention and management of pain;
• Awakening the patient and doing a spontaneous B reathing trial;
• C hoice of sedation and analgesia;
• Assessment, prevention and management of D elirium;
• E arly mobilisation;
• F amily engagement (Marra et al, 2017) .

Cultural and spiritual care

A patient’s cultural and spiritual background influences many aspects of nursing in critical care, such as patient and family roles, communication, nutrition, values and beliefs towards health, care and treatments, and end-of-life care. Careful assessment of the patients’ health beliefs, communication needs, social networks and family dynamics, dietary requirements, religious practices and values, is essential to plan and deliver culturally sensitive and spiritual care that contributes to the quality of life, care and satisfaction of patients as well as their families (Willemse et al, 2020).

Family care

Family members of patients who are critically ill can play an important part – often acting as surrogate decision makers – and be essential in providing emotional and social support. However, relatives may experience extreme stress, fear and anxiety, both during and after the patient’s admission. Relatives are also vulnerable to ongoing psychological illnesses such as PTSD, anxiety and depression (Johnson et al, 2019). Nurses need to develop a collaborative relationship with them to effectively identify and address their immediate needs, as well as prepare them to cope with their loved one’s discharge and ongoing rehabilitation. Families need honest and timely information, assurance, proximity, comfort and support (Scott et al, 2019).

Rehabilitation

Critical illness can cause significant long-term physical and non-physical problems for patients, and rehabilitation is important to improve recovery. National guidelines, such as those by the FICM (2019) and the National Institute for Health and Care Excellence (2017), have supported this, with the aim of improving these patients’ physical, psychological and cognitive outcomes.

Patients should be assessed at the following key stages:

• Within four days of admission to a critical care unit, or earlier if being discharged;
• Just before discharge to ward-based care;
• When receiving ward-based care;
• Before discharge to their home or community care;
• Two to three months after discharge from the critical care unit.

Rehabilitation should be patient centred, involve the whole multidisciplinary team and occur throughout the patient pathway, with plans updated as the patient’s condition changes (FICM, 2019). Physiotherapists, occupational therapists, dieticians, speech and language therapists, critical care nurses and doctors, as well as patients and their families, all have a role.

Short clinical assessments should be done with all patients in critical care to identify their risk of physical and non- physical morbidity. A short clinical assessment is applicable for patients who are expected to recover quickly, despite requiring initial level-3 care, and should assess a range of factors (Box 2). If the patient is deemed at risk, a comprehensive clinical assessment should be undertaken; this will also assess physical and non-physical risk (Box 3).

Box 2. Short clinical assessment

The following may indicate that the patient is at risk of physical/non-physical morbidity and needs further assessment:

• Unable to get out of bed independently
• Anticipated long duration of critical care stay
• Obvious significant physical or neurological injury
• Lack of cognitive functioning to continue exercise independently
• Unable to self-ventilate on 35% of oxygen or less
• Presence of pre-morbid respiratory or mobility problems
• Unable to mobilise independently over short distances

Non-physical

• Recurrent nightmares, particularly if the patient reports trying to stay awake to avoid them
• Intrusive memories of traumatic events that occurred before admission (for example, road traffic accidents) or during their critical care stay (for example, delusion experiences or flashbacks)
• New or recurrent anxiety or panic attacks
• Expressing a wish not to talk about their illness or changing the subject quickly

Box 3. Comprehensive clinical assessment

This assessment should be undertaken for all patients identified as being at risk of physical or non-physical morbidity.

Physical issues

• Breathlessness
• Tracheostomy
• Artificial airway
• Swallowing issues
• Poor nutritional state
• Minor assistance needed
• Major assistance needed
• Full assistance needed
• Visual changes
• Hearing changes
• Altered sensations
• Sedated/pain
• Difficulties in speech
• Changes in voice quality
• Difficulty writing
• Poor wound healing

Non-physical issues

• Palpitations, irritability or sweating
• Hallucinations, delusions
• Flashbacks, withdrawal, traumatic memories of critical care
• Loss of memory
• Attention deficit
• Sequencing problems
• Lack of organisational skills
• Disinhibition
• Low self-esteem
• Low self-image
• Relationship difficulties
• Difficulty sleeping

During the assessment of these patients, a range of tools may be used including the following:

• Hospital Anxiety and Depression Score (Zigmond and Snaith, 1983);
• Barthel Activities of Daily Living Index (Wade and Colin, 1988);
• Chelsea Critical Care Physical Assessment Tool (Corner et al, 2013).

Many critical care units provide follow-up services for patients after discharge, giving them access to a range of health professionals, including critical care nurses, to assess physical and non-physical recovery (NICE, 2017). If these are not available, patients can be directed to ICU Steps (www.icusteps.org), which can help to support patients and families affected by critical illness.

This article aims to provide an overview of critical care and the critical care nurse role. The following articles in this series will explore in more detail key issues relating to the management of patients who are critically ill.

• Critical care nursing is highly skilled, and requires postgraduate study and training
• Critical care nurses provide outreach to support ward nurses who are caring for patients at risk of deterioration
• Care of patients on critical care units often involves organ system support and close monitoring is needed
• A holistic view of the patient – which takes into account physical and psychosocial matters – is vital, as is supporting families

Also in this series

• Essential critical care skills 2: assessing the patient
• Essential critical care skills 3: arterial line care
• Essential critical care skills 4: airway assessment and management
• Essential critical care skills 5: management of fluid balance
• Essential critical care skills 6: arterial blood gas analysis

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Practice specialties, critical care nursing.

Critical care nursing, or intensive care unit (ICU) nursing, is a specialty focused on the care of unstable, chronically ill or post-surgical patients and those at risk from life-threatening diseases and injuries.

What do critical care nurses do?

What do critical care nurses need to know.

• an understanding of human anatomy and physiology.
• sharp clinical assessment skills.
• vast knowledge about diseases and conditions.
• ongoing education related to recommended ICU treatment options.

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Critical Care Nursing Certification Review Course

Use this Critical Care Nursing Certification Review Course to study for the critical care nursing specialty certification from the American Association of Critical-Care Nurses (AACN), which grants the credential CCRN ® (Adult).

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How to Become a Critical Care Nurse

What is a critical care nurse.

• How to Become
• Career Outlook

Critical care nurses work with patients who are facing life-threatening or potentially life-threatening issues. These vulnerable patients are generally found in hospital intensive care units and step-down units, trauma units and emergency rooms, and surgery centers and recovery rooms, though critical care nurses may also work in other settings. No matter where they work, critical care nurses rely upon their knowledge and training to help acutely ill patients.

A career as a critical care nurse offers the ability to work with either a wide range of patients or with patients suffering a specific type of condition such as those found in cardiac care units or neonatal intensive care. If you are considering becoming a critical care nurse, this guide will answer many of your preliminary questions about this rewarding career.

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Critical care nurses provide care for patients ranging from newborns to geriatric who have one thing in common: they are in dire physical condition or suffering from life-threatening medical conditions or injuries. In their role, these professionals apply highly specialized technical skills, assessing and monitoring their patients’ conditions to help restore them to health. In addition to providing hands-on bedside care, critical care nurses are also their patients’ advocates -- speaking for or representing them when necessary.

Because the patients they care for have such acute needs, most critical care nurses work with only one or two patients at a time and generally collaborate with a team of healthcare professionals that includes physicians, other nurses, and allied healthcare professionals.

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What Do Critical Care Nurses Do?

During their daily job responsibilities, critical care nurses provide one-on-one care to patients who have suffered serious illness or injury. They provide all typical bedside care with the enhanced responsibilities that are inherent in vulnerable patients who are suffering from extremely acute conditions. Their responsibilities include problem-solving and making quick decisions, as well as tasks such as:

• Assessing patients as they are admitted to the critical care unit to identify their needs and create an appropriate care plan
• Diagnosing patient illnesses and injuries
• Monitoring, recording, and evaluating vital signs, including heart rate, respiratory rate, and body temperature
• Tracking the operation and output of life support equipment, including heart monitors
• Cleaning and bandaging wounds
• Administering medications orally, through injection, via an intravenous or gastric tube, or through other methods depending on the patient’s needs and condition
• Infusing blood products
• Monitoring patients for reactions to medication
• Responding to changes in the patient’s condition
• Collaborating and communicating with other members of the care team
• Providing education and guidance about the patient’s condition and care needs to both the patient and their family and caregivers
• Acting as an advocate for the patient
• Assisting families as they make important decisions regarding life support and end-of-life issues
• Addressing the patient’s body after death, including making arrangements for transport to the morgue, hospital, or burial facility

Patients who are in critical care settings are experiencing physical and emotional stress, and so are their family members. Critical care nurses require understanding, patience, and empathy in the face of heightened emotions and are frequently called on to act with compassion when family members and loved ones are grieving. They also must face their own emotions in the face of patients who die or end up in debilitating conditions.

What is the Average Salary of a Critical Care Nurse?

Salary.com estimates that critical care nurses earn an average of  $85,500 annually or $41 per hour, but their earnings depend on geographic location, experience, education, and more. These reports are comparable to the average RN salary, which is $86,070 annually or $41.38 per hour, according to the Bureau of Labor Statistics (BLS).

Critical care nurses who work in major metropolitan areas such as Los Angeles, California, can earn more than $100,000 per year, and significant increases in compensation come with additional professional experience. 

Beyond their salary, critical care nurses are generally offered attractive benefits and perks, including paid vacation time and sick leave, personal ties, and coverage for health, dental, vision, and prescription insurance. Facilities in competitive markets may also offer childcare and tuition reimbursement as well as the opportunity to earn additional income by working overtime hours or shift differentials. 

How Do You Become a Critical Care Nurse?

Critical care nurses possess a combination of knowledge, skills, experience, and compassion. They must be able to make decisions on behalf of their patients quickly and with confidence, and this level of competence begins with their education. 

The total timeline expected for becoming a critical care nurse is:

• 2-5 years to earn an ADN, BSN, or MSN degree
• Pass NCLEX-RN exam
• 2 years working in clinical patient care

Step 1: Become a Registered Nurse

Begin by becoming a Registered Nurse, and though this can be achieved by earning an Associate Degree in Nursing, most facilities today require a minimum of a Bachelor of Science in Nursing and prefer that candidates have their Master of Science in Nursing . After earning this degree, they will be required to pass the NCLEX-RN in order to receive licensure and work in the United States.

Step 2: Gain Experience

Then, you’ll need to work for at least two years, preferably with a wide range of patients, in order to ensure their comfort with a diverse range of conditions as well as their competence with critical thinking, problem-solving, and communication.

Step 3: Get Certified

Nurses who wish to establish themselves as specialists in critical care can demonstrate their knowledge by working in and demonstrating knowledge within several areas and pursuing certifications offered by the American Association of Critical Care Nurses . These include:

• CCRN (Adult, Pediatric or Neonatal), providing direct care to critically ill patients
• CCRN-K (Adult, Pediatric or Neonatal), influencing but not providing direct care to critically ill patients
• CCRN-E (Adult), providing care for ill patients from a remote location
• PCCN-K (Adult), influencing but not providing direct care to critically ill patients
• CMC (Adult), providing care to critically ill cardiac patients
• CSC (Adult), providing care to critically ill cardiac surgery patients
• ACNPC-AG (Adult-Gerontology), providing care for very sick geriatric patients

These certifications will verify your qualifications and help you work as an  RRT nurse , ICU nurse, or another type of critical care nurse.

What are the Continuing Education Requirements for Critical Care Nurses?

Critical care nurses who have earned specialty certifications can demonstrate their dedication to excellence in their fields through the renewal of those certifications. These certification renewals are offered by the American Association of Critical-Care Nurses , and each has its own specific requirements. All encompass a broad range of learning topics and activities and require completion of Continuing Education Recognition Points in different categories of study and clinical practice hours spent working with acutely critical patients. Read more about continuing education requirements for nurses here . 

What is the Career Outlook for Critical Care Nurses?

In light of the national nursing shortage , nearly every type of nursing position is seeing tremendous demand, and critical care nursing is no exception. In fact, critical and acute care nursing sees a significant share of those currently in the workplace leaving the specialty area for various reasons , making the need for these professionals even greater. 

According to statistics provided by the Bureau of Labor Statistics , employment of registered nurses will grow by 6% between 2022 and 2032, and that growth is attributed to an increased emphasis on preventative care, increasing rates of chronic conditions, and the aging of the population. When you add to that the specific stressors driving critical care nurses to retire early, hospitals and other facilities are working hard to recruit additional staff.

Where Can I Learn More About Becoming a Critical Care Nurse?

Critical care nursing is both a demanding career and a rewarding one. Nurses who are interested in learning more about the profession are advised to start by investigating the resources available through the American Association of Critical-Care Nurses’ website , where they can find information on clinical resources, continuing education, and the benefits of membership. Other organizations that support critical care nurses include the World Federation of Critical Care Nurses and the Society of Critical Care Medicine . 

You can also find articles of interest on the Nurse.org website, including:

• Life in the Intensive Care Unit
• Acute Care Nurse Salary and Career Opportunities
• How to Become an Intensive Care Nurse

From the first assessment of a newly arrived patient to providing end-of-life care, critical care nurses are an integral part of life-saving treatments and actions. They combine their education, empathy, experience, and skill to provide hands-on care for their patients’ physical needs and support and comfort for their emotional needs. The high stress of the specialty provides even higher levels of reward.

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Critical care nurse faqs.

• A critical care nurse provides care for patients who are either recovering from a serious medical condition or procedure or who are in critical condition.

What does a Critical Care Nurse do?

• Critical care nurses assess, monitor, and provide care for patients in extremely vulnerable conditions. They make essential decisions, administer medication, and operate life-support systems, as well as explain medical procedures and treatment to patients and their loved ones.

How much money does a Critical Care Nurse make?

• Critical care nurse salaries vary greatly depending on geographic location, experience, education, etc. However, the national average salary for the position is $85,500 , with a range of between $69,345 and $69,345 .

What units are considered critical care?

• Critical care settings within a hospital include the intensive care units, cardiac care, pediatric and neonatal intensive care units, step-down units following surgery, trauma, and burn units as well as emergency rooms. 

 How do I become a Critical Care Nurse?

• Becoming a critical care nurse begins with earning an Associate's or a Bachelor's Degree in Nursing and passing the NCLEX to earn your registered nurse license. Then, you'll need at least two years of experience working as an RN. Earning a Master of Science in Nursing and certifications will make you a more competitive candidate for open positions.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

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How to Become a Critical Care Nurse

Critical care nurses provide nursing care for critically ill patients, as well as pre- and postoperative patients. They work in hospital intensive care units (ICUs), specialized critical care units, emergency departments, and emergency transport. Critical care patients require continuous monitoring and treatment for life-threatening conditions related to injuries, long-term illness, and other medical events, such as heart attacks and strokes.

If you’re wondering how to become a critical care nurse, the journey entails meeting rigorous education requirements, receiving on-the-job training, and earning certification. Additionally, you must meet the ongoing training requirements defined by the American Association of Critical-Care Nurses (AACN). Maryville University’s  RN to BSN online  program helps students gain the skills needed to advance into a critical care  nursing career .

What Does a Critical Care Nurse Do?

A critical care nurse provides specialized care to patients who are critically ill or suffer from life-threatening injuries that require advanced care in ICUs, emergency rooms, neonatal ICUs, pediatric ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive units, and recovery rooms. Critical care nurses work alongside other healthcare professionals, including doctors, surgeons, nurse practitioners, clinical nurse specialists, nurse researchers, nurse educators, and healthcare case managers.

In addition to hospitals, work settings for critical care nurses include patients’ personal residences, outpatient surgery centers, private physicians’ offices, managed care centers, and nursing schools. Critical care nurses perform complex patient assessments, implement intensive interventions and therapies, and monitor patients. A critically ill or injured patient’s condition can worsen quickly without warning, so critical care nurses must be able to immediately change a current care plan and provide emergency care.

The duties of a critical care nurse often include cleaning and bandaging a patient’s wounds, tracking life support equipment, and immediately responding to changes in a patient’s condition. These nurses may also serve as advocates, supporting and respecting the basic rights, values, and beliefs of critically ill or injured patients. Acting as patients’ representatives, critical care nurses find additional resources outside of the immediate care setting to assist in their patients’ recovery.

Critical care nurses work with patients and families experiencing extreme stress. Providing serious medical care for patients requires that these professionals be empathetic, sensitive, and compassionate while coping with major medical and life-or-death situations. Critical care nurses should be prepared to handle a wide range of emotions resulting from interactions with patients and their families. Often, critical nurses will have to make tough, objective decisions while remaining calm and caring.

Critical Care Nurse Education Requirements

Because working in a critical care department requires advanced skills, critical care nurse education requirements often include earning a bachelor’s degree in nursing. To become a critical care nurse, a health professional must first become a registered nurse, which requires a bachelor’s or associate degree. Registered nurses can advance to the critical care nursing profession after earning a critical care certification and state license and gaining one to five years of on-the-job experience caring for acutely or critically ill patients. After earning a bachelor’s degree, some critical care nurses may pursue a master’s degree to take on leadership positions in the critical care nursing field.

Critical Care Nurse Skills

Critical care nurses need strong decision-making and leadership capabilities to function in a high-stress, fast-paced environment such as an ICU or emergency trauma unit. Health professionals working in critical care settings also need to be familiar with complex medical equipment such as respirators and cardiac monitors. Some of the skills a critical care nurse needs include:

• Communication:  Critical care nurses are vital communication links for patients, families, and doctors.
• Critical thinking:  Emergency situations require nurses to make important medical decisions quickly to serve critical patient needs while paying close attention to detail to avoid errors.
• Physical endurance:  Nurses in critical care settings must perform strenuous tasks and often remain on their feet for entire shifts.

Other characteristics of a critical care nurse include:

• Resiliency:  Nurses need emotional strength, as nursing can be a mentally demanding and emotionally challenging profession.
• Confidence:  Nurses must be confident in their knowledge and decisions to ensure proper patient treatment.
• Compassion:  Nurses should maintain empathy for and sensitivity to patients and families.

Types of Critical Care Nurses

Critical care nurses can pursue certification in several specialties, including:

• Acute/Critical Care Nurse-Adult (CCRN-Adult) : Nurses provide direct care for acutely or critically ill adults in a variety of locations, including ICUs and cardiac care units.
• Acute/Critical Care Nurse-Pediatric (CCRN-Pediatric) : Nurses care for acutely or critically ill children in many settings, including ICUs and trauma units.
• Acute/Critical Care Nurse-Neonatal (CCRN-Neonatal) : Nurses care for newborns and premature infants in critical or acute conditions, typically in NICUs and other specialty care units.

Other career options open to critical care nurses include:

• TeleICU Nurse:  These nurses specialize in providing bedside remote care via audiovisual communication and computer equipment. TeleICU professionals typically work from a central or remote location.
• Transport/Flight Nurse:  These nurses provide care to critically injured or ill patients during ambulance, helicopter, or plane transports.
• Head CCU Nurse:  These nurses lead critical care departments such as ICUs, NICUs, and trauma units. Duties include staff supervision, quality monitoring, and inventory management.

Steps to Become a Critical Care Nurse

If a nursing career with an emphasis on taking care of severely ill or injured patients sparks your interest, you’ll need to know the education, certification, and experience requirements for becoming a critical care nurse.

The path toward becoming a critical care nurse begins with launching a career as a registered nurse. Because of the demands and complexity of administering critical care, many employers require a prospective critical care nurse to have a  RN to BSN online . Nurses often learn the advanced skills to become a critical care nurse through field training in a hospital setting.

Critical care nurses need to have the CCRN credential offered through the American Association of Critical-Care Nurses (AACN). The skills required to become a critical care nurse are similar to those required to become a registered nurse.

Step 1: Earn a Bachelor of Science in Nursing

You must have a formal nursing education to legally qualify for registered nursing positions.  Maryville University’s online BSN  may lead to a wide range of options for beginning or continuing a career in the healthcare industry. With a BSN, you can work for major hospitals, private practice clinics, home-care services, and nursing care facilities. It is possible to begin your nursing career with an associate degree, but your career options may expand with a BSN.

BSN graduates often work as nursing managers, nursing specialists, nurse educators, nursing informatics specialists, geriatric nurses, public health nurses, and critical care nurses. The bachelor’s degree in nursing is a launching point to start a career as a critical care nurse, working in intensive care units, emergency departments, and recovery rooms. Most employers will require you to have between one and two years’ experience prior to becoming a critical care nurse.

Step 2: Pass the National Council Licensure Examination (NCLEX)

After you have earned a  bachelor’s degree in nursing , you must pass the National Council Licensure Examination (NCLEX-RN), a requirement for any nurse who wishes to work in the United States. The NCLEX-RN is a computer-generated exam created by the National Council of State Boards of Nursing (NCSBN). The NCSBN works with nursing and regulatory boards to help maintain standards in nursing and promote the profession across the country.

The NCLEX-RN is designed to cover the processes that make up the foundation of the nursing practice. The test is divided into four categories, with six subcategories that span a range of topics designed to assess nursing competency.

Passing this exam is a mark of excellence. With board certification, you demonstrate to patients, employers, and the public that you have a high level of nursing knowledge that reflects national standards and demonstrates your commitment to patient safety. Passing the NCLEX-RN qualifies nurses for state licensing, which may have additional requirements such as a background check.

Once you earn a BSN, pass the NCLEX-RN, and earn a state license, you are a registered nurse. You may be able to find entry-level employment as an RN in the critical care unit of a hospital or trauma center. However, some employers prefer job candidates with prior nursing experience.

Step 3: Earn a Master of Science in Nursing

Critical care nurses who earn a  Master of Science in Nursing  (MSN) may significantly expand their career options and be prepared to take on a wider range of responsibilities in the workplace. The MSN curriculum includes additional theory- and evidence-based courses, building on the foundation established in a BSN program.

Master’s in nursing  students receive instruction and complete clinical hours, both of which offer the medical knowledge and skills they will need to treat critically ill patients. They learn how to take a leadership role in their positions, as well as how to apply theoretical learning in the real-life scenarios encountered in hospital settings.

An MSN provides critical-thinking, problem-solving, and communication skills and training that help you prepare for situations you will encounter on the job, including interactions with patients, families, and doctors. You will also learn how to effectively cope with the emotional and physical challenges that you will face as a critical care nurse.

Step 4: Get Certified by the AACN

An important step in pursuing this specialized area of nursing is becoming a certified critical care nurse through the American Association of Critical-Care Nurses. The CCRN certification from the AACN Certification Corporation establishes a baseline of knowledge for nursing critically ill or injured patients. CCRN is a service mark of the AACN and does not stand for “critical care registered nurse,” as AACN does not guarantee that a certification holder is an RN, which is a license regulated by each state — though nurses must have an RN license when they apply for CCRN certification.

Possessing the CCRN certification demonstrates your commitment to advancing your career and continually improving your skills and nursing expertise. Critical care nurses can be certified in various specialized medical areas. The specialized certification is valid for three years and must be periodically renewed.

Critical care nurses can attain other types of certifications from different organizations. If you seek certification from another organization, check credentialing requirements before pursuing the endorsement. Requirements for renewal may differ from those stipulated by the AACN.

Continuing Education and Growth for Critical Care Nurses

Employers usually require that their critical care nurses attend continuing education classes to retain their positions. Continuing education helps critical care nurses perform effectively in the workplace, stay up to date with the most current teachings in the field, and master the latest technology. Keeping their skills current also helps critical care nurses perform as leaders and raises the bar to ensure excellent patient care at each facility.

Additional training and academic achievements can help facilitate career progression. For example, critical care nurses may want to consider enrolling in one of  Maryville University’s  graduate degree programs in healthcare and science.

Critical Care Nurse Salaries

The median salary of a registered nurse was $73,000 in 2019, according to the U.S. Bureau of Labor Statistics (BLS). The exact salary depends on level of education, years of experience, and size of the hospital or healthcare facility, among other factors.

Future Growth of Critical Care Nurses

The employment of registered nurses is projected to increase by 12% between 2018 and 2028, much faster than the average growth for all occupations, according to the BLS. There are numerous reasons for this growth, including an increased emphasis on preventive care; growing rates of chronic conditions, such as diabetes and obesity; and the demand for healthcare services from baby boomers as they live longer and more active lives.

Explore Advanced Nursing Careers

In today’s medical environment, patients are released from hospitals with complex medical needs that require the skills of critical care nurses with specialized training and experience. Critical care nurses frequently provide care to the critically ill and injured at patients’ homes and rehabilitation facilities. So in addition to helping critical nurses develop skills in hospital settings, an advanced nursing career also calls for skills in serving patients after they leave.

Begin your journey toward becoming a critical care nurse by enrolling in the  RN to BSN online  program offered by  Maryville University .

• Master of Science in Nursing
• Doctor of Nursing Practice

American Association of Critical-Care Nurses (AACN), “Get Certified”

National Council of State Boards of Nursing, “NCLEX & Other Exams”

PayScale, “Critical Care Nurse”

Salary.com, “Head Nurse CCU Job Description”

U.S. Bureau of Labor Statistics, “Registered Nurses”

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HEALTHCARE CAREER GUIDES

Critical Care Nurse Career

What is a critical care nurse.

If you’ve ever been seriously ill or visited someone in the hospital who was, you’ve likely encountered a critical care nurse. Often called ICU nurses because of the unit they commonly work in, critical care nurses are highly trained to understand and provide care for people of all ages who are recovering from life-threatening illnesses or injuries. 

Today, there are more than  half a million  critical care nurses working in the United States. But despite that number, critical care careers continues to be in high demand thanks to the recent registered nursing shortage.

If you’re thinking about getting into critical care nursing, you should know it’s both a demanding career and a rewarding one. From a patient’s first assessment to end-of-life care, you’ll be a vital part of lifesaving treatments and actions. You’re also caring for people who are at their very worst, physically. For this reason, it takes a special kind of nurse to work in critical care units.

RESPONSIBILITIES

What Does A Critical Care Nurse Do?

Critical care nursing involves working with doctors and specialists to assess, treat, and monitor critically ill patients while also providing their basic care.

A typical shift as an ICU nurse can include things like assessing a patient’s condition and starting treatment, taking vital signs, communicating with patients and their families, setting up IVs, and administering medication. Many times, patients in the ICU are ventilated or have multiple IV drips. For this reason, registered nurses in critical care unites (also known as intensive care units or ICUs) need more knowledge of equipment and charting than other registered nurses.

• Assessing and treating patients. It’s fairly common that a patient sees a nurse in the ICU before a doctor, so ICU nurses will be expected to assess a patient’s condition and start treatment. This could include everything from taking vital signs to dressing wounds. They'll also be in charge of monitoring a patient’s progress and reporting back to the physician. 
• Ordering diagnostic tests. Many of the critical care patients you will see on a day-to-day basis will be suffering from some kind of injury or illness, which means they’ll need diagnostic testing. It’s often up to the critical care nurse to send orders for x-rays, EKGs, or CT scans and then go over those results with the doctor to decide on a treatment plan. 
• Acting as a patient advocate. When critical care patients are physically at their worst, the nurse's role is to be there to provide support, education, and empathy. This is done in several different ways—from helping patients make informed decisions about their health, to translating complex medical terms, to acting as a liaison between patients and their doctor.  
• Monitoring medical equipment. Many critical care patients will be set up on cardiac monitors or ventilators, so their nurse will be the one in charge of setting up those machines and regularly monitoring and tracking a patient’s progress. 

EDUCATION & BEST DEGREES

How to become a critical care nurse.

Step One: Become a registered nurse.

The first step in becoming a critical care nurse is completing a  bachelor’s degree  in nursing. Most programs take four years for full-time students to complete. However, students who’ve already completed an associate nursing degree can apply to RN-to-BSN programs that let working nurses earn bachelor’s degrees in less time.

Step Two: Earn your critical care nursing licensure.  

After earning your degree, you’ll be required to pass the NCLEX-RN exam and meet your other  state’s other requirements  to be eligible for nursing licensure. This exam is a computer-generated test that’s offered by the American Association of Critical Care Nurses (AACN). The NCLEX-RN is divided up into four categories and six subcategories that cover the foundations of nursing practice and measure nursing competency.

Step Three: Get certified as a critical care nurse.

Nurses who want to establish their knowledge for nursing critically ill or injured patients should obtain the CCRN certification from the AACN. To be eligible for this exam, you’ll need to meet one of the following:

Practice as an RN or APRN (advanced practice registered nurse) for 1,750 hours in direct care of acutely or critically ill patients during the past two years. 875 of these hours must be accrued in the year preceding application.

Practice as an RN or APRN for at least five years with a minimum of 2,000 hours in direct care of acutely or critically ill patients. 144 of these hours must be accrued in the year preceding application.

Step Four: Explore additional certifications and education.

After working as a critical care nurse, you might decide to pursue a  master’s degree  or post-master's certificate in nursing. Or you may choose to earn specialty certifications depending on what type of patients you enjoy working with most. 

These additional certifications could include: 

CMC: providing care to critically ill cardiac patients

CSC: providing care to critically ill cardiac surgery patients

ACNPC-AG: providing care for very sick geriatric patients

Best Degrees for a Critical Care Nurse

Nursing (Prelicensure) – B.S.

A one-of-a-kind nursing program that prepares you to be an RN and a...

A one-of-a-kind nursing program that prepares you to be an RN and a baccalaureate-prepared nurse:

• Locations:  Due to in-person clinical requirements, students must be full time residents of Arkansas, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin to enroll in this program. The coursework in this program is offered online, but there are in-person requirements.
• Tuition:  $8,755 per 6-month term for the first 4 terms of pre-nursing coursework and $8,755 per 6-month term for the remaining 4 terms of clinical nursing coursework.
• Time:  This program has a set pace and an expected completion time of 4 years. Certain coursework may be accelerated to finish faster.
• WGU offers the prelicensure program in areas where we have partnerships with healthcare employers to provide practice sites and clinical coaches to help teach you and inspire you on your path to becoming a nurse.
• If you don't live in one of our prelicensure states or don't qualify to apply, consider getting our  Bachelor's in Health and Human Services  instead. This degree allows you to work inside the healthcare industry, while also working directly with patients who need help.

Skills for your résumé that you will learn in this program:

• Community Health
• Women's and Children's Nursing

Nursing – Leadership & Management (BSN-to-MSN) – M.S.

For registered nurses with a bachelor's degree who are ready for...

For registered nurses with a bachelor's degree who are ready for additional career opportunities.

• Time:  61% of grads finish within 23 months
• Tuition: $5,035 per 6-month term
• Courses : 15 total courses in this program

This program is ideal for current RNs who have a BSN and are ready for the next step in their education.

Skills for your résumé you will learn in this program:

• Quality Outcomes in a Culture of Value-Based Nursing Care
• Nursing Leadership and Management
• Advanced Pathopharmacological Foundations
• Informatics for Transforming Nursing Care

Compare degrees

This program is not the only degree WGU offers designed to create leaders in the field of healthcare. Compare our health leadership degrees.

Nursing (RN-to-BSN Online) – B.S.

An online BSN degree program for registered nurses (RNs) seeking the added...

An online BSN degree program for registered nurses (RNs) seeking the added theoretical depth, employability, and respect that a bachelor's degree brings:

• Time:  The program is designed to be completed in 1 year.
• Tuition:  $5,325 per 6-month term.
• Courses : 23 total courses in this program.
• Transfers: Students can transfer up to 90 credits.
• Healthcare Policy and Economics
• Information Technology in Nursing Practice
• Anatomy and Physiology
• Applied Healthcare Statistics

If you don't currently have an RN and don't qualify for your nursing prelicensure program, consider getting our Bachelor's in Health and Human Services  instead. This degree allows you to work inside the healthcare industry in a unique way.

Nursing Leadership and Management – Post-Master's Certificate

A certificate for registered nurses with a master's degree in nursing who...

A certificate for registered nurses with a master's degree in nursing who are ready for greater responsibility in a leadership and management role.

• Time:  Students typically finish this program in 12 months.
• Tuition:  $5,035 per 6-month term. The cost to sit for the NAHQ Certified Professional in Healthcare Quality (CPHQ) exam is included in tuition.
• Courses : 8 total courses in this program.
• Strategic Planning
• Resource Management
• Business Case Analysis
• Evaluating Healthcare Improvements

Nursing – Leadership & Management (RN-to-MSN) – M.S.

This program for RNs includes a BSN component and is a substantial leap...

This program for RNs includes a BSN component and is a substantial leap toward becoming a nurse leader.

• Time: 62% of RN-to-MSN grads finish within 37 months.
• Tuition:  $5,325 per 6-month term during undergraduate portion and $5,035 per 6-month term during graduate portion.
• Courses : 32 total courses in this program.

If you're driven to lead, this online nursing degree will provide you everything needed to make that career a reality. This program is ideal for current RNs who are interested in earning both their BSn and MSN in an accelerated program.

How Much Does a Critical Care Nurse Make?

Critical care nurses are often paid higher than other nurses because of their specialized training. The U.S. Bureau of Labor Statistics (BLS) reports that the median average salary for RNs was  $81,220  in 2022.

What Is the Projected Job Growth?

The BLS also predicts the demand for RNs, which includes critical care nurses, is expected to  grow by 6%  from 2022 to 2032, faster than the average for all occupations. This growth is fueled by increasing rates of chronic conditions such as diabetes and obesity, the aging population, and an increase in emerging diseases like COVID-19.

What Skills Does a Critical Care Nurse Need?

Being a nurse in an intensive care unit is a demanding position—both physically and mentally. The physical demands might include working on your feet for long shifts, transporting patients by pushing or pulling wheelchairs, and lifting patients as needed. You’ll also be constantly monitoring highly unstable and at-risk patients, so strong analytical skills and the ability to make quick decisions under pressure is a must. 

To be successful working in critical care you’ll need a mix of clinical and non-clinical skills. Some of these include:

• Understanding medical technology and equipment 
• Strong knowledge of anatomy and physiology 
• The ability to create and implement patient care plans
• Understanding how to use various medical devices, such as catheters and feeding tubes
• In-depth knowledge of medications, including side effects and dosing calculations
• Operating life support systems
• Understanding patient safety and privacy rules and regulations 
• Good communication skills and the ability to work well in a team environment 
• Strong organizational skills and the ability to prioritize 
• Comfortably handling end-of-life situations

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No need to wait for spring or fall semester. It's back-to-school time at WGU year-round. Get started by talking to an Enrollment Counselor today, and you'll be on your way to realizing your dream of a bachelor's or master's degree—sooner than you might think!

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ICU Nurse Jobs

Find high-paying ICU nurse jobs nationwide with Aya Healthcare and take your ICU RN career to the next level. Apply now.

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Access ICU Nursing Jobs Nationwide

Aya Healthcare is the largest healthcare staffing agency in the nation. Over the years, we’ve helped tens of thousands of nurses find their ideal ICU nursing jobs, and we’d love to help you, too! Are you looking for ICU travel nurse jobs? Or perhaps permanent or per diem ICU nurse jobs near you? Whatever you’re looking for, Aya Healthcare has ICU nurse job openings for your next career step.

First time searching for ICU nursing jobs with Aya? Don’t sweat it! Our extensive team of recruiting, credentialing, staffing, payroll, clinical and clinician experience experts is the best in the industry. We’re happy to answer your questions and help you as you find the perfect ICU nurse job.

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What ICU travel nurse jobs are available?

Take your skills on the road, develop your talents and gain vital experience while meeting new people, exploring new places and making a positive impact across the nation.

Aya Healthcare offers ICU travel nursing jobs nationwide — including exclusive assignments only available for Aya Healthcare travelers. As an ICU travel nurse, you’ll gain access to the largest job database in the industry, travel resources and your very own team of recruiting, credentialing, payroll and travel experience experts to assist you anytime you need.

Finding ICU travel nursing jobs with Aya Healthcare is super easy, too! Just complete your profile, then search for ICU nurse job openings and express interest with just one click. Plus, you can use filters to set specific parameters, then save your search and receive alerts when matching jobs become available. From there, we’ll help you land a job you’re interested in. Our team can even help expedite the licensing process and streamline all compliance requirements, making sure you’re ready to start on time.

Aya Healthcare also offers an array of benefits for ICU travel nurse jobs, including a 401(k) plan (once eligible), competitive ICU travel nurse salary, insurance options, free CEUs and more. We’ll even send you pizza if you’re working on your birthday. So, what are you waiting for? Sign up with Aya and start searching for ICU travel nursing jobs today!

How can I find permanent ICU jobs?

Settle down without settling with a permanent position at a leading hospital or healthcare organization.

Aya Healthcare is more than an agency for travel nurses. As the largest healthcare staffing agency, we have strong, established relationships with the top hospitals and healthcare organizations nationwide. If you’re ready to put down roots somewhere, our team of industry-leading recruiters can help you find permanent ICU nurse jobs near you and help you secure an offer faster than if you did it yourself.

Finding jobs on intensive care nursing units is as easy as 1, 2, 3. Just complete your profile and application, filter your search for permanent positions and once you click “I’m Interested” a recruiter will contact you to discuss your ideal position. Your recruiter will assist you through the entire recruitment process, from coordinating interviews for permanent ICU nurse jobs near you to helping you prepare for your first day on the job. As your #1 fan, your recruiter will support, advocate and assist you with anything you need.

Aya Healthcare’s recruitment team is the most experienced in the industry. Here are just a few things they can do to help as you search for permanent ICU nursing jobs near you:

• Prepare you for interviews.
• Provide resume advice to perfectly capture your professional experience.
• Work with the facility hiring teams to ensure your application is their #1 priority.
• Gather immediate interview feedback.
• Facilitate salary negotiation.
• Secure offer decisions.

Ready to find your next job as an intensive care nurse? Meet with a recruiter and start your journey today!

What per diem ICU nurse jobs are available?

Take control of your career with per diem opportunities that enable you to work when and where you want, improve your professional skills, supplement your income and more!

Aya empowers ICU nurses to take control of their careers with front-of-the-line access to per diem ICU nurse jobs — including exclusive ICU PRN jobs only available through Aya Healthcare. If flexible work hours and weekly paychecks sound like your cup of tea, then sign up today to find ICU nurse positions near you.

To get started with per diem, complete your profile and search for ICU nurse job openings near you. You can express interest in a job with just one click, and our team will take care of the rest — keeping you updated on any compliance or credentialing requirements. We’ll even schedule mandatory labs or orientation meetings before your first day on the job.

With Aya Healthcare, you can work as many per diem shifts as you want. You can even add extra shifts during a travel assignment and manage your per diem schedule through our mobile app, Shifts. We also offer a variety of perks, including competitive pay, weekly payments every Friday, a 401(k) plan and accrued sick time.

Sign up today to find ICU nurse jobs near you!

What Factors Can Influence A Permanent ICU Nurse Salary?

ICU travel nurse salary, per diem ICU nurse salary and permanent ICU nurse salary all differ and often vary from state to state and even from facility to facility. At Aya Healthcare, we understand you’re a hard-working intensive care nurse who wants to optimize your pay. That’s why we strive to offer ICU nursing jobs with the most competitive rates in the industry.

When looking at ICU nurse job openings, it’s also important to consider the benefits offered in addition to your weekly pay. Aya Healthcare offers myriad benefits for different contracts, and facilities offer their own unique benefits for permanent ICU nursing jobs. Knowing the benefits a position provides can help you make an informed decision as to whether or not you would like to apply for it.

Additionally, top-paying regions frequently change. Because you choose where to work with Aya Healthcare, you can keep yourself updated on the highest paying regions and express interest for positions that offer a competitive ICU nurse salary.

Ready to find ICU nurse jobs that match your personal and professional goals?

Browse ICU nursing jobs, view pay and facility information and express interest with just one click.

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Nursing Jobs at Johns Hopkins Medicine

Found 24 nursing jobs in st. petersburg, fl at johns hopkins medicine.

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Occupational Health RN - PRN

Rn clinical database administrator (cancer and pediatric tumor), rn clinical nurse leader: department of medicine, rn clinical team leader - cvor, rn clinical team leader (or general and trauma surgery), rn - emergency center, rn ii - cvicu (36 hours per week, 12 hour nights), rn ii - ecmo (36 hours per week, 7p to 7a), rn ii- pediatric cvicu january 2025 start date (36 hours per week, 12 hour nights)), rn - nicu (neonatal intensive care), rn nurse educator - periop, rn - operating room, rn - peds med, rn - picu (pediatric intensive care), rn premier per diem - critical care float pool (12 hour nights), rn (registered nurse) ccdh congenital diaphragmatic hernia, 36 hours per week, rn (registered nurse) ccdh congenital diaphragmatic hernia (36 hours per week, 12 hour rotating), rn (registered nurse) cvicu (36 hours per week, 12 hour nights), rn (registered nurse) outpatient cardiology, about nursing jobs at johns hopkins medicine.

Nursing Jobs in St. Petersburg, FL

Apply online today for Nursing Jobs in St. Petersburg, FL at Johns Hopkins Medicine. Become a part of our diverse healthcare team with Nursing Jobs in St. Petersburg, FL and enjoy extensive benefits with a variety of opportunities for personal and professional growth. From academic medical centers to local community hospitals, from downtown to the suburbs, Johns Hopkins Medicine has a work environment that will fit your personality and career goals.

Nursing Jobs in St. Petersburg, FL at Johns Hopkins Medicine can include:

Case Manager – Team members in these nursing jobs are responsible to implement the plan of care for specific patients, beginning on a pre-admission basis and following through placement and into follow-up/after care.

RN I- New Graduate -Med/ Surg- Oncology Unit – Team members in these nursing jobs coordinate care to maximize desirable outcomes, patient satisfaction, and cost-effective utilization of available personnel and resources.

RN II- Endoscopy -PRN – Team members in these nursing jobs lead a team of multi-skilled patient care providers in the delivery of outcome oriented, safe, therapeutic, and cost-effective care.

Apply online now for Nursing Jobs in St. Petersburg, FL. Join Johns Hopkins Medicine in our mission to improve the health of all of our communities by setting the standard of excellence in medical education, research and clinical care. From medical care and social work to finance and IT, Johns Hopkins employees get to make a difference every day. Apply online now.

Featured Jobs

Rn - registered nurse 2 - cvsicu.

Day/Night Rotating Shift with Weekend Rotation You belong here. Elevate your possibilities. The Johns Hopkins Hospital has been at the forefront of discovery, innovation, and medical advances for over 125 years. Our reputation for excellence has earned us a spot on U.S. News & World Report’s Best Hospitals list for …

Registered Nurse ICU Stepdown

Unlock Your Potential at Johns Hopkins! Howard County General Hospital is now “ Johns Hopkins Howard County Medical Center ” and cares for a range of patients with severe health conditions. Our hospital’s highly specialized Intensive Care Unit (ICU) dedicated to adult patients requiring intensive monitoring and care, including after …

NICU RN / Neonatal Intensive Care Registered Nurse Join the Johns Hopkins All Children's Hospital's Team and Elevate your possibilities! The NICU includes 97 beds and cares for Level II-Level IV patients The team in our neonatal intensive care unit (NICU) is dedicated to treating infants who need the highest …

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Critical Care Nurse (CCN)

Critical Care Nurse

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Current issue.

August 2024

Cover Article

CE Article: Intensive Care Unit Sleep Promotion Bundle: Impact on Sleep Quality, Delirium, and Other Patient Outcomes

Reigniting Intensive Care Unit Liberation

CE Article: Reducing Central Line–Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach

Conservative Treatment of Mesenteric and Hepatic Portal Venous Gas Caused by Gut-Derived Infection After Ileostomy: A Case Report

Strategies to Improve Sleep Quality in Intensive Care Unit Patients

CE Article: Cardiac Arrest Due to Capecitabine Toxicosis Treated With ECMO and CRRT: A Case Report

Guest Editorial

The Imperative of Proactivity

Certification Test Prep

Ask the Experts

The Practice of Clamping a Chest Tube Before Removal

Evidence Review Summary

High-Level Burnout in Physicians and Nurses Working in Adult Intensive Care Units

In Our Unit

Device Day: Promoting High-Quality Care With Low-Fidelity Simulation

Education Directory

Practice Pointers

Hit a Handoff Home Run: Cover All the Bases