Discover everything you need to know to become an Intensive Care (ICU), nurse. From the interview to the job, this is your complete guide.
What is an ICU Nurse?
Before you apply to work as an ICU nurse, it’s important to understand what they do. In my post, “What do ICU Nurses Do?” I explained their responsibilities and duties. It’s worth a look. You’ll be able to see what a normal shift is like from beginning to end.
A critical care nurse works in the Intensive Care Unit (also referred to as like the Critical Care Unit). This person will provide nursing care to critically ill patients. You are responsible for the direct bedside care, monitoring, and responding to changes in condition.
You are also communicating with providers and other healthcare team members, as well as families about their loved one and the patient themselves. This can become quite tricky, as you are trying to explain complex medical conditions to laypeople, many of whom have little experience or previous understanding of healthcare.
ICU Nurse Responsibilities
ICU nurses normally only care for one or two patients since they require almost constant care. The responsibilities of an ICU nurse include:
- Monitor the patient’s condition, which becomes very complex as patients become more unstable
- Oversee and provide care to the patient
- Communicate with the patient and family and provide support them
- Assess the patient’s and their response to treatment, suggesting changes as necessary
- Use high-tech equipment to provide quality care for the patient
- Stay educated on the latest evidence
- Document appropriately
How To Become an ICU Nurse When You are a New Nurse
Let’s look at some tips that will help you become an ICU Nurse. It’s one of the most difficult jobs to obtain and even more difficult for new nurses.
Becoming an ICU Nurse Right Out of School is Tough
Please understand, becoming an ICU nurse is a very selective process. This job requires so much mentally from nurses that the entire hiring process is rigid and difficult to pass, especially for new grads. In fact, to get a job in the ICU right after graduating from nursing school is the exception and not the rule.
If you want to get a job in the ICU as a new nurse, there are a few things you can do to prepare and give you a competitive edge. But the best thing you can do is give yourself time to grow professionally and personally.
Becoming a Nurse is Like Learning to Swim
I like to compare learning how to become a nurse to learning how to swim.
Nursing school is like learning how to swim in the kiddie pool. Jumping into the 3-foot area is like jumping into med-surg. Patients are typically stable, and while it still is very challenging, you can still put your feet on the floor and touch the ground.
Starting in critical care right out of school is like jumping from the kiddie pool into the deep end. You’re learning how to swim while trying not to drown. For some, they can pull it together and learn how to tread and keep their head above water. But for most (myself included), they need some time in the shallow end before heading out into deeper water.
How to Land a Job as an ICU Nurse
Now that you understand how difficult it is, if you are still wanting to apply, here are some tips that will help you nail the interview. While these tips won’t necessarily get you the job, they will set you apart from the rest of the applicants and make you that much more hirable.
1. Show Your Experience – Even as a New Nurse
The very first step is to graduate from an accredited nursing school, pass the NCLEX®, and get your nursing license from the state board of nursing you wish to practice in . This is the minimum expectation and you must be a registered nurse to work as a nurse in ICU.
Experience always speaks volumes on a resume and in the interview. But how do you show experience when you are a new graduate?
While you are in school, try to get as much critical care experience as possible . This can look like ensuring you get into critical care units during clinical rotations or selecting this environment for a senior year internship. t’s also a good idea to network during clinicals by building rapport with the nurses on the unit and any leaders you work with . The more you can get people to vouch for you and say, “Oh, I remember Sarah – she was a great student to have. I’d definitely love to work with her!” – those are the kind of references you want!
You can also gain experience by becoming a CNA and working in an ICU during school . This shows that you want to get some good experience in the environment and also demonstrates that you’ve seen how difficult working in critical care is, yet you still desire to work in that unit. It is very helpful to the hiring team if they know that you’re aware of what it’s really like.
If you can’t be a CNA in ICU, try to volunteer at a hospital and get into the ICU . If you can show any kind of familiarity with the environment, it will help you stand out.
Keep in mind that nothing can replace floor experience as a nurse. You can figure out how to be a nurse first without being responsible for patients who are unstable and need constant interventions.
If you do decide to work on a nursing floor first, make sure to keep track of your accomplishments on the floor. You’ll want to highlight any times that you worked in stressful situations and how you handled yourself.
Success and professional development while in the med-surg environment is looked at positively. Your experience is a vital component that could help you become hired.
2. ACLS Training
You will also need Advanced Cardiac Life Support, ACLS certification as a critical care nurse. If you are thinking about applying to work in the ICU, be proactive and obtain this certification. When you include this on your resume, you will stand out from the rest of the competition.
This is not required to land the ICU job. But if you already have it on your resume, you will be even more hirable.
3. American Association Of Critical Care Nurses
Finally, if you are serious about becoming a critical care nurse, join the American Association of Critical-Care Nurses (AACN).
This organization will provide you with exceptional support and education. Plus, it will make you stand out among the other applicants and show your dedication to the field. They publish journals regularly, and if you mention a recent interesting article or finding published by the AACN in the interview, that looks really awesome and like you’re in the know.
After two years of working at the bedside in critical care, you can obtain your CCRN certification. You can mention that this would be a professional goal of yours as you grow in your role as a critical care nurse.
4. Take the FreshRN® Cardiac Nurse Crash Course
Before the interview, demonstrate your willingness to learn and your proactivity by completing the FreshRN® Cardiac Nurse Crash Course.
My online course will teach you:
- Cardiac assessment keys
- Giving a cardiac nursing report in the ED, ICU, and floor
- Diagnostics – cardiac catheterization, labs, ultrasounds, stress tests
- Cardiac-specific conditions, surgeries, and patient priorities – CEA, CABG, AVR/MVR, lobectomy, dysrhythmias, pleural effusions, HIT, STEMI & NSTEMI, PE, CHF, and more!
- Equipment – chest tubes, pacemakers, pericardial tubes
- Interventions – thoracentesis, paracentesis, pleurodesis
- Medications – anticoagulants, antiplatelets, dysrhythmics, vasoactive medications, and more!
- ACLS tidbits
- Specifics for the emergency department, ICU, and cardiac nursing floor
If you’re able to include professional development activities on your resume and speak to them in the interview, it looks awesome and like you care about becoming the best nurse you can be. It shows that they don’t have to motivate you to grow in your profession; that you already care enough about improving that you’ll seek out opportunities independently.
ICU Nurse Interview Tips
Now that you know what an ICU Nurse does and how to become one, let’s talk about the interview. This is probably one of the most important pieces of the puzzle. If you want to become a critical care nurse, you’ll have to ace the interview, and this is how you do it.
The most important thing is to realize the challenge that’s ahead of you. Do not take it lightly. You must be willing to do what’s necessary to be successful in the role. Once you understand this, you just have to express it in the interview.
1. Highlight Your Experience
Working in the Intensive Care Unit is a huge learning curve. You’ll have to provide concrete examples of how you grasp new concepts quickly. Are you able to pick up on new charting systems fast? Or learning pharmacology, pathophysiology, or even picking up on personalities and reading the emotional climate of a situation well?
It’s also helpful to reference any experiences with death and dying, navigating tough situations with families, and various intensive care equipment like arterial lines, central venous catheters, continuous renal replacement therapy, ventilators, extraventricular drains, and so forth.
The more you can speak to specific examples of your experience in critical care, the better.
2. Express How You React Under Pressure
Next, the ICU is a very difficult and fast-paced place to work. Discuss with your interviewer other times that you thrived under pressure and kept up with a nonstop shift.
This is a fantastic time to bring up any praise you’ve received from management about your ability to keep up with a busy, nonstop floor.
You’ll need to prove that you can keep your cool and maintain emotional composure during times of stress.
3. Highlight Your Experience with Technology
Finally, express your comfort levels with new machines and equipment. Someday you could be working with very high-tech and sensitive equipment. You’ll need to communicate your desire to stay educated about new pieces of equipment, which means you’re aware that you’ll be coming in for training on your days off to stay up to speed.
Critical care nurses must use high-tech equipment that evolves rapidly. There are updates to new IV pumps, new charting requirements, new devices to monitor various patient data, and more. Expressing your willingness to learn as well as your awareness of this aspect of the job will look great.
If you have praise from a nurse you worked with or clinical instructor about your ability to master equipment without issues, bring it to the interview. That will make a huge difference.
4. Highlight Your Experiences in the ICU
Express to the interviewers that you understand the reality of the ICU. It will help if you can describe your experiences working it – whether that was as a volunteer, CNA, or a student.
Hiring managers need to know you understand the seriousness of the job and how challenging it is – that you’re not romanticizing the role and will have reality shock and bail once you see what it’s really like.
5. Do Practice Interviews
Finally, interviews can be nerve-wracking for anyone, especially if you are fresh out of school and don’t have much experience with them.
Ask a seasoned nurse or a hiring manager that you know if they can sit down with you and do a mock interview. Glean as many tips and suggestions from them that you can. You’ll be able to learn how to present yourself confidently and with poise.
Another super beneficial course is my FreshRN ® Resumes and Interviews online course. It’s affordable and will show you common habits people have in interviews and how to overcome them so you stand out. A Director of Clinical Education and I discuss top tips for interviews, what to say and what not to say, as well as do mock interviews highlighting a good, bad, and mediocre interview. Click here to learn more.
Remember Why You Want to Be a Critical Care Nurse
This is a very difficult job to attain. Don’t let a “we chose someone else” response keep you from trying again. Use it as motivation to keep training, keep learning, and become a stronger candidate next time.
I know many who tried ICU right away and it was too much, so they did med surg for a bit and then tried again and were successful. So if you are hoping to get this job, it might be wise to ease into it by working on the med surg floor first.
Any job you obtain as a new nurse can prepare you for a future job in the ICU. Get as much out of any other job you do land as possible. Network. Build connections.
You can be successful in ICU out of school, it just takes a lot of work. You have to be at the top of your game while at work, and doing homework to better understand the patient population and pathophysiology at home. Use the FreshRN Cardiac Nurse Crash Course or Neuro Crash Course to expedite this learning.
Cardiac Nurse Crash CourseNeuro Nurse Crash CourseResumes and Interviews CourseMarino’s The Little ICU BookAACN Essentials of Critical Care Nursing, Fourth EditionThe First Year: Conversations with a New ICU Nurse