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How to Become a Pediatric Intensive Care Nurse

Janice Monti, Ph.D.
Updated January 3, 2023
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Pediatric intensive care nurses care for seriously ill children and adolescents. Find out how to become a PICU nurse and what it's like to work in this challenging field.
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Male nurse holding the hand of a child patient before surgeryCredit: FS Productions / Tetra images / Getty Images

Pediatric intensive care unit (PICU) nurses provide care to seriously ill or injured children and adolescents. They work with a small number of critically ill patients who need constant monitoring, assessment, and interventions. This demanding but rewarding field requires specialized training and skills and the ability to handle the fast-paced and dynamic environment of intensive care units.

Dive into this guide that explains what it takes to become a PICU nurse, licensure and certification requirements, and work settings and responsibilities.

How Long to Become:
2-4 years

Degree Required:

Recommended Certification:
Intensive Care Registered Nurse (Pediatric)

What Is a Pediatric Intensive Care Nurse?

PICU nurses are registered nurses (RNs) who work closely with a team of healthcare professionals to assess, treat, and monitor young patients with serious ailments, including life-threatening conditions. These highly specialized RNs almost always work in intensive care units of hospitals.

Because of the high level of medical care required by their critically ill patients, PICU nurses generally take care of 1-2 patients at a time.

PICU nurses perform many tasks, such as monitoring vital signs and fluid intake/output, administering medications and treatments, and analyzing lab results. They must accurately record and update patient care information in a timely fashion for other nurses and healthcare providers.

An important part of their work is to provide education and reassurance to parents or guardians and other caregivers about the patient’s condition.

Steps to Becoming a Pediatric Intensive Care Nurse

PICU nurses, like all RNs, must complete an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). They must also pass the National Council Licensure Examination (NCLEX). PICU nurses must hold a valid, unencumbered RN license and fulfill specific licensing requirements in the state where they intend to practice.

Employers may require RNs to get certification in basic life support and sometimes advanced cardiac life support.

  1. 1

    Earn an ADN or a BSN degree from an accredited program.

    PICU nurses must earn at least a two-year ADN or four-year BSN degree to qualify for an RN license in their state. Most employers prefer to hire graduates with a BSN degree because it provides more training in healthcare delivery and policy, evidence-based practice, and management.

  2. 2

    Pass the NCLEX exam to receive RN licensure.

    State nursing boards use the NCLEX-RN exam to assess nursing competency and skills. Candidates for state licensure usually take the NCLEX-RN about a month after graduating from their ADN or BSN program.

  3. 3

    Gain relevant experience in pediatric intensive care nursing.

    Because PICU nursing requires specialized skills, RNs do not typically enter the field directly after graduation. Nursing students can boost their chances of employment by completing clinical practicum hours in a PICU or other settings that care for critically ill children.

    RNs who intend to become PICU nurses can gain experience working in pediatrics, the emergency room (ER), or medical-surgical units.

  4. 4

    Consider becoming a certified pediatric intensive care nurse.

    Specialty certifications demonstrate expertise and knowledge to potential employers. Apply for pediatric nurse certifications from either the Pediatric Nursing Certification Board or the American Nurses Credentialing Center (ANCC).

    The American Association of Critical-Care Nurses administers the critical care registered nurse (CCRN) pediatric certification for nurses who provide direct care for acutely/critically ill pediatric patients. The ANCC offers RNs two-year and five-year options for earning the CCRN-pediatric credential.

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Pediatric Intensive Care Nurse Education

Earning an ADN and passing the NCLEX-RN exam provide the quickest educational pathway to a career in PICU nursing, taking two years or less. However, a BSN may lead to more employment opportunities, advancement into leadership positions, and higher salaries.

ADN Degree

A two-year ADN degree enables you to begin your nursing career quickly at a lower cost than a four-year bachelor’s degree. An ADN provides the minimum educational requirement for the NCLEX-RN exam and state licensure.

However, some employers may prefer or even require you to graduate from a BSN program. Nurses with ADN degrees seeking to expand their career options may choose to enroll in RN-to-BSN degree programs which count previously earned credits toward the degree.

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    Admission Requirements

    High school diploma or GED certificate; official transcripts; physical exam; drug screening
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    Program Curriculum

    Nursing across the lifespan; anatomy and physiology; fundamental principles of nursing; patient care management
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    Time to Complete

    Two years
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    Skills Learned

    Patient safety; patient-centered nursing practice; communication and interpersonal competency

BSN Degree

The ADN and BSN degrees both qualify for the NCLEX-RN and state licensure, but the BSN offers other advantages that can enhance career prospects. BSN-holders receive greater employment opportunities, earn higher salaries, and move into leadership positions.

Also, you need a BSN to get into a graduate nursing program that prepares you for advanced practice nursing roles.

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    Admission Requirements

    High school diploma or GED certificate; official transcripts; minimum 2.5 GPA; prerequisites in statistics, microbiology, anatomy and physiology, nutrition, and psychology; letters of reference; essay
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    Program Curriculum

    Pharmacology; pathophysiology; medical terminology; evidence-based nursing practice; and management; community health nursing; mental health; clinical placements
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    Time to Complete

    2-4 years
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    Skills Learned

    Safety and quality care; care plan administration; patient and family education; population health management; organizational skills; critical thinking; communication and interpersonal competency

Pediatric Intensive Care Nurse Licensure and Certification

To become a PICU nurse, you need to earn and maintain an unrestricted RN license in your state. RN licenses are typically valid for two years. However, specific requirements for getting and renewing a state RN license vary by state. Renewing an RN license typically includes completing continuing education units in areas like methods of care, specialized treatment, and medical and technological advancements.

You must also complete a specified number of practice hours and submit the required renewal fee established by your state board of nursing

RNs can expand their career options and marketability by getting specialty board certifications. The CCRN-pediatric certification administered by the American Association of Critical-Care Nurses is strongly recommended for nurses who want to focus on pediatric intensive care nursing.

Nurses interested in applying for CCRN-pediatric certification should have work experience in intensive care units, cardiac care units, medical-surgical ICUs, and trauma units providing direct care to acute and critically ill pediatric patients.

Candidates for the CCRN-pediatric certification must have a valid RN license and 1,750 hours of direct care experience acquired during the previous two years, with 875 of those hours completed in the most recent year preceding their application.

Another pathway is available for RNs who have a minimum of 2,000 hours of direct care experience within the previous five years, including 144 hours attained in the most recent year before applying.

Working as a Pediatric Intensive Care Nurse

You will probably not find employment as a PICU nurse right after completing your degree, but you can begin training for this career before you graduate through clinical placements in pediatrics and critical care. After graduating, prepare by getting work experience caring for critically ill children in ICUs, ERs, trauma units, or medical-surgical departments.

Many hospitals require PICU nurses to have 1-2 years medical-surgical or critical care experience as an RN.

PICU nurses work primarily in specialized PICU units or neonatal intensive care units. Some PICU nurses may also work in critical care transport, helping to move pediatric patients by air or ambulance. Although specific responsibilities vary by setting, these nurses provide round-the-clock care in all aspects of their patients’ treatment, often working nights, weekends, and holidays.

PICU nurses must deliver consistent quality care in volatile and stressful situations. They routinely treat the most seriously ill patients with life-threatening acute and severe chronic conditions. They also treat those recovering from highly complex surgeries.

PICU nurses must monitor their patients closely, particularly when caring for very young children with undeveloped language ability or those who cannot talk because of medical conditions, sedation, or intubation.

According to Payscale data released in December 2022, PICU nurses earn an average annual salary of $81,460, higher than general RNs who make about $11,000 less a year. Because of the expanding demand for PICU nurses, you may receive a higher rate of compensation depending on your job location and type of employer. You can also boost your salary with PICU certifications and specialized training in areas like pediatric oncology, cardiac care, and burn care.

Frequently Asked Questions About Becoming a Pediatric Intensive Care Nurse

What are the challenges of being a pediatric nurse?

RNs, even those with several years of experience, may find working in a fast-paced pediatric intensive care unit stressful and challenging. PICU nurses must balance their compassion for the most vulnerable patients with the emotional strength to handle rapidly deteriorating conditions, suffering, and the possibility of death.

How long does it take to be a pediatric intensive care nurse?

The minimum educational requirement for a PICU nurse is a two-year ADN degree, but a four-year BSN will lead to greater career opportunities. PICU nurses need a bachelor’s degree for professional certifications and about two years of clinical experience as an RN.

What does a typical day look like for a PICU nurse?

During the course of an 8-12 hour shift, the work of a PICU nurse depends on the caseload and patient care needs. They perform assessments, record updates, and administer the daily care plan, which includes feeding and bathing the patient.

PICU nurses spend part of their shift collaborating with physicians, therapists, and other specialists. They also must quickly respond to bedside monitors that signal patient discomfort or changes in their condition. Sometimes, they must provide end of life care for the patient and family.

Is it hard to be a PICU nurse?

Caring for critically ill young patients can be particularly difficult. PICU nurses work in intense and stressful environments requiring emotional stability. They must also have advanced specialized training and experience to handle rapidly changing conditions and high-tech medical equipment. They should also have the ability to coordinate with specialized healthcare teams.

Related Pages

Page last reviewed December 15, 2022

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