Precision and purpose: refine your proficiency with a career in critical care nursing

Critical care nursing is a diverse and rewarding field, with opportunities to make a genuine difference in the lives of patients needing urgent care for life-threatening conditions. As Australia’s population ages and the rates of complex health conditions continue to rise, so does the demand for skilled critical care nurses.

As a critical care nurse, your role is indispensable. You’ll work in environments where you can hone your problem-solving skills and your clinical proficiency, where every decision matters.

This article explores the typical roles and healthcare settings that critical care nurses work in, the related benefits and challenges as well as how to determine whether this nursing career path is right for you.

Critical care nurses in Australia: industry snapshot

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In Australia, there are 345,000 employed registered nurses and 42,100 working in critical care nursing. The Nursing Supply and Demand Study 2023-2035 projects a shortfall of nurses across healthcare settings over the coming decade, which includes critical care and intensive care environments. This shortfall is problematic as statistics from the Australian and New Zealand Intensive Care Foundation show that Australians have a 1 in 2 chance of requiring intensive or critical care at some point over their lifetime.

To help tackle this imminent nursing workforce need, the government has implemented the National Nursing Workforce Strategy, which aims to attract and retain talented nurses and address the many challenges related to the Australian nursing sector. Target areas include supporting the specific workforce needs of nurses in urban, rural and remote areas. It also involves empowering nurses to practice to the full extent of their professional scope and endorsing pathways for nurses to develop their expertise or pursue specialisations.

What is critical care nursing?

Critical care nursing is a specialised field of the profession where registered nurses care for seriously ill or injured patients who require close monitoring and treatment. Patients under their care may be in a critical condition due to the acute phases of a disease or may need support following an injury or surgery. Critical care nurses can be found in various critical care settings, using specialised skills and equipment to promote patient recovery.

This unique sector of nursing provides an opportunity to develop yourself as a nurse. You’ll be exposed to challenging cases, provide care with precision and collaborate closely with medical teams to become an expert in managing critically ill patients. You’ll also be immersed in environments that are conducive to constant learning, making critical care nursing an excellent career path and a strong foundation to move into senior or advanced practice roles.

What does a critical care nurse do?

The roles and responsibilities of critical care nurses can differ based on their workplace and the specific needs of their patients.

Here is an overview of the typical responsibilities of critical care nurses:

• Plans, delivers and evaluates nursing care for patients in alignment with established standards and best practices
• Collaborates with other healthcare professionals and multidisciplinary teams to ensure comprehensive, patient-centred care
• Delivers interventions and appropriate treatments including medications, while monitoring patient responses to ensure effective care
• Advocates for patient health by engaging in educational initiatives and community awareness programs
• Provides clear and compassionate communication to patients and their families, addressing questions and offering guidance on treatments and care
• Oversees the work of enrolled nurses and other healthcare staff to maintain high standards of care delivery

Where do critical care nurses work?

Critical care nurses have the opportunity to work across a diverse range of settings, including public and private hospitals, intensive care units, special care nurseries, emergency departments and retrieval services to name a few.

Depending on the specific healthcare environment, critical care nurses can support patients from various demographics and with diverse health conditions. These may range from paediatrics to geriatrics and may include patients presenting with specific critical conditions, such as cardiovascular, neurological, renal or respiratory illnesses.

Here are some of the common settings where critical care nurses can work:

Intensive care units (ICUs)

Critical care nurses often work in ICUs in hospitals, delivering high-level nursing care to patients in critical and life-threatening conditions. Patients in ICUs require continuous monitoring and treatment by nurses, doctors, specialists and other medical professionals.

Nurses in ICUs are trained to use specialised medical equipment to support the wellbeing and recovery of patients. Some of the equipment ICU nurses may commonly use includes ventilators, incubators, enteral tube feeding devices and intravenous medications. They are also responsible for various monitoring devices, such as cardiorespiratory, apnoea, heart rate, oxygen saturation, temperature and pulse oximeters. ICU nurses also manage drainage tubes and perform complex wound care dressing changes.

ICUs are either general units or specialised units, such as burns or trauma units, cardiac ICU, neonatal ICU, paediatric ICU, perioperative ICU or renal ICU. The nurse to patient ratio in ICUs is typically 1:1, which allows critical care nurses to closely monitor and respond promptly to the complex needs of critically ill patients.

High dependency units (HDUs)

Nurses in critical care can also work in HDUs, which is known as an intermediate care unit, progressive care or step-down unit. Critical care nurses in HDUs provide care for patients who are less critical than ICU patients, yet still require a greater level of monitoring and treatment than patients in a general ward. In some hospitals, these units are within an ICU itself or may exist as a stand-alone unit.

Nurses in HDUs may use similar equipment to ICUs, such as ECG machines, oximetry and non-invasive ventilators. As patients are generally more stable in HDU compared to ICU, the nurse to patient ratio is typically 1:2. This allows nurses to continue to provide close and specialised care while managing a slightly increased patient load.

Recovery and post-anaesthesia care units (PACUs)

Depending on the specific hospital or healthcare setting, critical care nurses may assist with the anaesthesia recovery process of patients following surgery. This will be case-dependent, particularly in the instance of high-risk surgical patients who need more advanced care. However, in many cases, these wards are staffed by PACU nurses who have received specialised training to qualify as perianaesthetic or perioperative nurses.

Emergency departments

Critical care nurses can also work in emergency departments within hospitals to deliver urgent care to patients who’ve been admitted due to acute trauma or illness. They are skilled in triaging, determining the urgency and complexity of care required and administering critical interventions such as intubators as well as supporting patient transfer to ICU if required. They may work alongside other registered nurses in these settings, including acute care nurses.

Flight nursing and retrieval services

Another dynamic role for critical care nurses is working as a flight nurse or in retrieval services. Nurses in these roles are involved in aeromedical evacuations or road transportation to ensure patients are safely transferred between locations. This may be from a remote location in Australia to a hospital or between medical facilities.

Critical care nurse salary

According to Talent.com data, the average annual salary for critical care nurses is $91,000, with salaries for entry-level positions and experienced critical care nurses ranging between $80,000 and $133,000 annually.

Salaries may vary depending on experience, location and specific work environment. Pursuing postgraduate study and completing a critical care nursing course may also lead to higher salary positions due to the advanced skills, responsibilities and expertise involved in critical care nursing roles.

Average annual salaries of critical care nurses in each Australian state and territory:

• Western Australia: $113,000
• Northern Territory: $103,000
• Queensland: $95,000
• Tasmania: $93,000
• South Australia: $92,000
• Australian Capital Territory: $85,000
• New South Wales: $85,000
• Victoria: $78,000

Common benefits and challenges faced in critical care nursing roles

Essential critical care nursing skills

Madeline Kessler, an experienced nurse and educator, reflects on her early nursing experience as a student in critical care in a hospital high dependency unit. She explains that there is a great deal of skillfulness required in these roles. “The room for error is very negligible to non-existent. When you’re in a specialist role, it requires great diligence, precision and extra care.”

There are many important skills that critical care nurses should cultivate to be successful in their roles, including:

Attention to detail: Your clinical decisions have a direct impact on patients and their health recovery, which means precision nursing and fine attention to detail are important skills in critical care unit nursing.

Technical proficiency: Staying up to date with current and emerging technology, equipment, best practices and ensuring your technical proficiency in this field will ensure you carry out your role efficiently and with a high level of care.

Adaptability: Critical care can involve high-pressure and unpredictability, with patients requiring close monitoring and rapid intervention. You should demonstrate the ability to adjust quickly to handle evolving circumstances with patients.

Collaborative skills: Nurses in critical care work closely with doctors, intensivists, allied health and other healthcare professionals. As such, effective communication and teamwork are essential for coordinated and comprehensive patient care.

Accountability: Critical care nurses work with one or two patients and make important, life-saving and difficult clinical decisions. It’s crucial to take responsibility in these roles, while practicing ethically, morally and adhering to your professional and workplace standards.

Self-sufficiency: While collaboration is vital to the success of critical care roles, you should also be comfortable working independently as you may need to make crucial decisions and problem-solve when necessary.

Resilience: The demands of these roles can be emotionally challenging so building resilience is therefore essential. Working with critically ill and sometimes terminally ill patients often means facing difficult situations, including the loss of patients despite your best efforts to care for them.

Emotionally intelligent: Nurses in this field should cultivate a strong sense of self-awareness, while monitoring for compassion fatigue or burnout. Checking in with yourself, debriefing with your team leader or even making the call to care for a different patient are all important for your own self-preservation and longevity as a critical care nurse.

Who should consider becoming a critical care nurse?

When it comes to determining whether you should pursue a role as a critical care nurse, it helps to understand your own inherent qualities, strengths and interests.

As Madeline shares, these roles may suit nurses who love a challenge and enjoy learning. “You have to absorb a lot of information from the team, the specialist, the doctors from when you get a handover.” She also says that it would suit nurses who love the ‘detective’ side of this specialised role who are detail-oriented and methodical with a massive capacity for data. She also mentions the rewarding aspects of critical care roles. “When it goes well and people get better and they come back and visit you in five years’ time, it’s massive.”

Nursing career specialist Michelle Deroubaix shares insights from her decade of experience in critical care nursing on who should consider these roles. “We like variety. We like the adrenaline rush,” she explains as she describes the dispositions of critical care nurses in her view. Michelle adds that these roles are “pretty full on but very exciting”, saying you need to be able to “spring into action quickly and know what you’re doing”. Michelle also emphasises the importance of being a good communicator, practicing kindness and having the capacity to control your emotional state. Her advice to nurses considering these roles is for them to understand that the theoretical knowledge of nursing in critical care underpins your practical experience in the field. She also highlights the added value of postgraduate education in relation to increased salary potential and greater confidence and authority in your role. “It helps with talking to the medical staff if they’ve got a concern about a patient and gives [nurses] that little bit more authority to speak up.”

Is an ICU nurse the same as a critical care nurse?

The terms ICU nurse and critical care nurse are often used interchangeably, however, they are not strictly the same thing. Importantly, all ICU nurses are critical care nurses, however, not all critical care nurses are ICU nurses.

An ICU nurse specifically works in an intensive care unit, while a critical care nurse is a role that applies to different settings and sectors within healthcare, which may include ICUs among other environments as mentioned above.

Both roles offer specialised and advanced care to critically ill patients, ensuring they receive the attention and interventions they need. The level of care is carefully determined depending on the unique presentations and complexity of each patient. ICU and critical care nurses work to ensure they deliver high-quality nursing care for the best possible patient outcomes.

How to become a critical care nurse

There are a few steps to follow if you want to become a critical care nurse.

1. Consider if this nursing role is right for you
   Now that you have an idea of what critical care nursing entails, you can begin to think about whether this role is right for you. Take into consideration the time investment required to become qualified, the benefits and challenges of these roles as well as your own career goals to determine whether critical care nursing is something you want to pursue.

   As Michelle and Madeline have mentioned, this career path suits people who enjoy variety, love a challenge and excel in environments that demand a high degree of proficiency. While there are intrinsic emotional challenges involved, as you cultivate resilience in the role, the rewards are also immense and can help you enjoy longevity in this dynamic field.

2. Complete a nursing degree
   The most common pathway to becoming a critical care nurse is to complete a bachelor’s degree in nursing, which provides a pathway to becoming a qualified registered nurse. Most undergraduate nursing degrees take around three years to complete in a full-time capacity.

   If you have a prior degree in another field, many universities provide fast-track pathways into nursing with a graduate entry Master of Nursing program. This option usually takes around two years to complete full-time.

3. Obtain your nursing registration
   Once you’ve completed your studies to become a registered nurse, you’ll need to apply for registration with the Nursing and Midwifery Board of Australia (NMBA), which you’ll need to renew each year.

   If you have a nursing degree from overseas, the NMBA may recognise your qualification and provide pathways to become a registered nurse in Australia. Importantly, the NMBA can provide alternative pathways to you if your qualification doesn’t automatically meet the accreditation standards.

4. Gain critical care nursing experience
   Gaining a minimum of one year of experience in critical care nursing is the next step toward a career as a critical care nurse. This is important to develop hands-on clinical experience in this specialised field, where you can gain a foundational understanding of the demands of critical care nursing environments.

   It also enhances your career prospects for future critical care roles as employers highly value nurses with direct experience in this sector. Working in a range of critical care roles across different healthcare settings can also help you identify hidden strengths, develop your expertise and help determine whether continuing to pursue a path of critical care nursing is right for you.

   Building your experience in critical care settings is usually also a prerequisite for postgraduate study in this field. Many graduate certificate courses in critical care nursing require one year’s experience and current employment, while master’s degrees usually require between two to three years of minimum experience.

5. Pursue postgraduate study in critical care nursing
   While postgraduate study in critical care nursing is not compulsory in order to be a critical care nurse, it is immensely beneficial if you’re looking to excel in this demanding field. For instance, a graduate certificate course, such as the University of Technology Sydney (UTS) Online’s Graduate Certificate in Critical Care, is an ideal launchpad into critical care nursing. This course is delivered online with multiple yearly intakes and is suitable if you want to further your knowledge of core critical care concepts and develop the skills to provide care for patients with serious and critical conditions.

   Many universities in Australia offer a range of postgraduate courses tailored to nurses seeking to advance their knowledge of critical and intensive care nursing. For example, if your focus is on adapting to and working in broad critical care settings, you could consider the Graduate Certificate of Critical Care Nursing from the Australian College of Nursing, the Graduate Certificate in Critical Care Nursing from Curtin University or the Graduate Certificate of Critical Care Nursing from Deakin University.

   You may also wish to consider a comprehensive master’s degree in critical care nursing. Edith Cowan University’s Master of Clinical Nursing (Critical Care Nursing - Intensive Care), Deakin University’s Master of Advanced Clinical Nursing (Critical Care) and Curtin University’s Master of Advanced Practice (Critical Care Nursing) provide a comprehensive pathway to strengthen your clinical decision-making skills, technical proficiency and management expertise to seek out leadership or senior critical care nursing roles.

   If you want to pursue a role as an intensive care nurse, consider the Graduate Certificate in Clinical Nursing (Intensive Care Nursing) from the Australian Catholic University or Deakin University's Graduate Certificate of Intensive Care Nursing. These courses are ideal if you’re interested in a fundamental understanding of intensive care principles, equipping you with the skills to provide specialised nursing care to critically ill patients. Deakin University also offers a Master of Advanced Clinical Nursing (Intensive Care), which would be ideal to support you in pursuing leadership or advanced clinical intensive care nursing roles.

   Are you a registered nurse or midwife interested in developing additional theoretical skills in obstetrical and gynaecological critical care? Charles Darwin University’s Graduate Certificate of Maternal Critical Care helps build your knowledge of acute and chronic maternal conditions while equipping you with advanced nursing skills in maternal critical care.

   Many nurses pursuing studies in critical care decide to join the Australian College of Critical Care Nurses (ACCCN), which is a non-profit organisation representing the critical care clinical sector in Australia. The ACCN supports nurses working in critical care settings with resources, publications and research grants and advocates for the critical care nursing profession.

6. Apply for critical care nursing roles
   You may already be working in a critical care setting following on from your nursing degree. However, if you’ve completed postgraduate study, you may be able to pursue a diverse range of roles with some additional expertise and confidence. A good place to start may be with your current employer. Explore whether there are advanced roles or positions available in a niche or general area that may be of interest to you. You can also make the most of your professional network, mentors and peers to find opportunities in your local area.

   Browsing job boards such as SEEK or Indeed is another way to find critical care nursing jobs. You can explore jobs via a nursing agency, government departments or your professional association to see what may be suitable. Take the time to look at the potential salaries, different sectors or explore critical care nursing jobs in rural or remote locations. Considering all your options can help you make the best decision that suits your career and professional aspirations.

Start your critical care nursing career today

A career as a critical care nurse is rewarding, challenging and purposeful. You’ll work in a field with opportunities to solve unique problems, practice precision nursing, build resilience and provide life-saving care that makes a meaningful difference in patient health outcomes.

Advancing your knowledge in critical care provides you with specialised skills and gives you the confidence to manage complex presentations in high-acuity environments. If you’re interested in pursuing a postgraduate critical care nursing course, browse the critical care nursing and intensive care nursing courses, select a course and enquire to speak with a Student Enrolment Advisor.

At GlobalHealth Education, we partner with respected universities to offer healthcare courses in a range of fields. These include nursing, health leadership and management, counselling, psychology, public health, social work and mental health. Transform your career in healthcare and enquire today.