What Is a Pediatric Intensive Care Nurse?

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Published December 23, 2022

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Pediatric intensive care (PICU) nurses work with the most vulnerable children in the hospital. Learn how to become a PICU nurse and what the work is like.
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Pediatric intensive care unit (PICU) nurses care for children in ICUs, meaning they nurse some of the most vulnerable children in the hospital. This work can come with emotional rewards, but it can be one of the most stressful nursing roles too.

To excel in this role, you must provide empathetic care for children and their families without becoming emotionally overwhelmed yourself. If this unique challenge sounds right for you, this guide can help you explore this fulfilling career. Discover more about PICU nurse jobs, responsibilities, and rewards.

How Long to Become:
2-4 years

Job Outlook:
6% increase from 2021-2031

Average Annual Salary:
$82,750

What Does a Pediatric Intensive Care Nurse Do?

ADN or BSN Required
Certification Recommended

PICU nurses care for children under the age of 18 in intensive care units. They also provide information, education, and support for family members. Many but not all hospitals have separate neonatal intensive care units for newborn infants, so some PICU nurses also care for newborns.

PICU patients may be admitted to the PICU after treatment in the emergency department, so PICU nurses can expect to partner with critical care nurses during handoff. They may also discharge patients to pediatric nurses or neonatal nurses once patients no longer need intensive care. They may also receive the handoff from pediatric or neonatal nurses.

PICU nurses treat a range of serious conditions caused by illnesses or injuries. Because young children, especially, can have trouble communicating when they are sick or in pain, PICU nurses must have excellent communication and observational skills.

male nurse checking child patient with stethoscope

Ridofranz / iStock / Getty Images Plus

Key Responsibilities

  • Monitoring patients using advanced equipment and alerting nurse practitioners or physicians about serious changes
  • Administering specialized medication and treatments
  • Using medical equipment such as feeding tubes and catheters
  • Keeping medical records complete and updated

Career Traits

  • Extremely detail-oriented
  • Able to analyze, decide, and act quickly
  • Strong collaboration skills with colleagues at all levels
  • Able to manage stress under emotionally and physically demanding conditions
  • Can communicate effectively with worried parents or guardians and family members

Where Do Pediatric Intensive Care Nurses Work?

Most PICU nurses work in general hospitals, specialty hospitals like pediatric specialty hospitals, or specialty departments. They also work in different levels of PICUs, such as community-based (broadest level of services), tertiary (more complex cases), and quaternary (highest complexity and specialization).

General Hospitals

PICU nurses typically work in dedicated units. The equipment is designed for children, both for their smaller size and to be as comfortable and reassuring as possible. However, some work in general ICU units, so they must be able to adapt.

They can expect to work with a variety of other nurses, as well as other PICU and pediatric nurses.

Pediatric Hospitals

In a pediatric hospital, PICU nurses are somewhat more likely to care for pediatric patients with chronic conditions, though they also care for acute conditions and emergencies. The entire setting is dedicated to pediatric care.

Pediatric Specialty Hospitals or Departments

Some PICU nurses work in specialty functions or hospitals, such as cardiovascular, neurocritical, or organ transplant facilities. These dedicated facilities may treat families from across an entire geographic region, across the country, or even international patients.

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Why Become a Pediatric Intensive Care Nurse

PICU nurses have the double intensity of working with children and working with patients who are most at risk. This makes their work uniquely stressful, but also uniquely rewarding.

Advantages to Becoming a Pediatric Intensive Care Nurse

  • There is typically a low patient-staff ratio.
  • Saving young lives or improving quality of life is particularly rewarding.
  • PICU nurses work as part of a team dedicated to children.
  • Often, children recover more quickly than adults, so the emotional rewards might come faster.
  • Family members are typically grateful and express their thanks.

Disadvantages to Becoming a Pediatric Intensive Care Nurse

  • PICU nurses can experience the emotional strain of caring for children with serious health conditions or injuries.
  • There is a high likelihood of caring for survivors of child abuse.
  • PICU nurses might encounter difficulty communicating with children who are preverbal or cannot express themselves fluently.
  • Family members may take out feelings of frustration, helplessness, and fear on staff.

How to Become a Pediatric Intensive Care Nurse

You can work as an entry-level PICU nurse with just two years of college by earning an associate degree in nursing (ADN). However, because of the high level of responsibility, many employers prefer a bachelor of science (BSN) degree, which takes four years. Whichever degree you earn, you must pass the National Council Licensure Examination for Registered Nurses (RNs) and earn an RN license.

You can also start your nursing career in another critical care or pediatric setting and then transition to become a PICU nurse. Once you have experience as a PICU nurse, you may want to earn certification.

One of the most popular is the critical care registered nurse pediatric credential from the American Association of Critical-Care Nurses. You must have a current and unencumbered nursing license and at least 1,040 hours of critical care pediatric nursing experience during the previous two years. At least 260 of those hours must have been completed within the year before you apply.

How Much Do Pediatric Intensive Care Nurses Make?

Because pediatric ICU nursing is a relatively narrow specialty, the existing data on PICU nurse salaries is limited. However, Pasycale reports an average annual salary of $81,460 and hourly salary of $32.60 as of December 2022. Geographic location, experience, and certifications all affect PICU nurse salaries.

In general, critical care nurse salaries are somewhat higher than other specialties and pediatric nurse salaries are near the average salaries. The U.S. Bureau of Labor Statistics (BLS) projects 6% job growth for all nurses across all RN specialties.

Frequently Asked Questions About Pediatric Intensive Care Nurses

What does a PICU nurse do?

PICU nurses care for children in intensive care units. They generally work in either community hospitals or specialty hospitals.

They monitor patients, administer medication and treatments, and use equipment such as catheters, intravenous lines, and feeding tubes. They also communicate with and educate parents or guardians and other family members.

What's the difference between a pediatric intensive care nurse and a neonatal nurse?

Neonatal nurses specialize in treating newborns, while PICU nurses treat children of all ages, up through adolescence. Neonatal nurses and PICU nurses may work together, especially on patient handoffs from one level of care to another.

What makes a good PICU nurse?

A PICU nurse must be able to maintain emotional balance and manage stress effectively. At the same time, they need to be able to treat patients and family members with empathy. Like all nurses, they must have exceptional attention to detail and be able to respond rapidly to changes.

What are the levels of PICU?

The American Academy of Pediatrics updated its guidance in 2019, so you may see some older terminology. The broadest level is community-based PICU, previously known as level II units. The next level of complexity and care is a tertiary PICU, previously called a level I unit.

Quaternary/specialized PICUs are the highest level of complexity and treat the most challenging cases.


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Page last reviewed December 15, 2022

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