“A good critical care nurse is comfortable with living in the ‘grey space,’ as patients are unique in their situations. You may handle routine cases, but since every person responds differently, we must be able to pivot at a moment’s notice.”
Sara Grieshop, MHI, Practice Excellence Supervisor, American Association of Critical-Care Nurses (AACN)
In the early 1900s, Lillian Wald, a nurse, organized some of the nation’s first emergency care services through the Henry Street Settlement in New York City. Today, that spirit of rapid response lives on in two specialized nursing roles: emergency room (ER) nurses and critical care nurses.
Though often grouped together, these roles serve distinct purposes, and both are indispensable. ER nurses are frontline responders who triage and stabilize patients arriving with undifferentiated injuries or acute illnesses. Their practice is fast-paced, unpredictable, and focused on immediate intervention. Critical care nurses, by contrast, care for patients whose conditions are already known to be life-threatening — typically in intensive care units (ICUs) — where continuous care is required.
Demand for these nurses remains strong. According to the U.S. Bureau of Labor Statistics (BLS), overall employment of registered nurses is projected to grow 5 percent from 2024 to 2034, adding about 166,100 new jobs across the profession (BLS 2025). ER and critical care nurses, because of their highly specialized skills, are expected to remain in particularly high demand.
Success in these roles requires not only clinical expertise but also resilience in high-pressure settings, acute attention to detail, and strong organizational skills. Most begin with a bachelor of science in nursing (BSN) and registered nurse (RN) licensure, with many later pursuing graduate education such as a master of science in nursing (MSN) or doctor of nursing practice (DNP).
The following guide explores the career pathways into ER and critical care nursing, including degree options, licensing, and advanced training.
Meet the Expert: Sara R. Grieshop, MHI, BSN, RN
Sara Grieshop is the practice excellence supervisor at the American Association of Critical-Care Nurses (AACN)—the largest specialty nursing association in the world, with about 130,000 members. She is a leading healthcare expert, recognized for her extensive experience as a former clinical nurse educator in progressive care and critical care units, as well as a surgical ICU nurse at an academic level 1 trauma center.
In her current role, Grieshop delivers support and resources to the acute, progressive, and critical care community to drive nursing excellence and create a better future for nurses, patients, and families. She is one of the primary clinical experts for AACN’s knowledge assessment tools and a contributor to its competency framework that sets the standard for assessing new nurses in progressive and critical care.
HealthcareDegree.com: What are some qualities of a good critical care nurse?
Grieshop: A good critical care nurse is comfortable with living in the “grey space,” as patients are unique in their situations. You may handle routine cases, but since every person responds differently, we must be able to pivot at a moment’s notice.
Critical care nurses must possess clinical expertise and critical thinking. These may sound like a “given,” but you need to have them ready to use at any instant. Nursing school gives us knowledge, but authentic learning happens every day, every shift. I get super calm and focused in chaos, which is a vital trait for a critical care nurse. If we stay calm, it will help patients, families, and other staff stay relaxed.
HealthcareDegree.com: Do you have any advice for someone interested in becoming a critical care nurse?
Grieshop: If you have that spark in your heart, embrace it and go for it. I started in the ICU as a brand new grad after earning my degree and license, and many people told me I needed to first gain a foundation in med/surg or progressive care…But I knew those settings weren’t where I would thrive.
If you’re drawn to critical care, spend time with a nurse on an ICU unit if you know one or if you are working as a tech. Seek out opportunities to truly learn what a “day in the life” looks like, because it is very different from what you see on TV! Know that you are committing yourself to life-long learning, both individually and as part of a team.
HealthcareDegree.com: How does critical care differ from ER nursing (or other specialties)?
Grieshop: Critical care is different from the ER and other care environments in several ways, including focus, rhythm, and approach, but a patient can be critical, no matter what unit they reside in. Regardless of the location, the care of a patient is similar.
The ER aims to stabilize patients so they can be discharged or transferred to another unit for ongoing care. ER nurses are constantly in high-stakes situations, so they triage, stabilize, and move to the next patient. ICU nurses like to fine-tune and provide continuity of care. We aim to understand the factors that have led to the patient’s need for high-level care and assist them in returning to their baseline.
Honestly, it takes all of us to help the patient return to their previous life, working together toward a common goal. I recently saw the best analogy: ER nurses are sprinters, and ICU nurses are marathoners. Similar, but we all have our lanes!
HealthcareDegree.com: What does the future of this role look like to you?
Grieshop: We’re already seeing the need to embrace technology and a continuing evolution of our scope of practice. The future of bedside nursing will not mean “just a bedside nurse.” It’s moving toward a specialized, tech-enabled, team-integrated role with expanded clinical authority, stronger support systems, and pathways for career growth, while keeping direct patient care and advocacy at the heart.
We take our own set of boards, make an oath to always care, and are true partners to every clinician in care settings.
ER and Critical Care Nurse Specializations & Degree Types
ER and critical care nurses must have at least an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN).
ER and critical care is a specialization within the nursing field with unique licensing and certification requirements, detailed below.
Admissions Requirements for ER and Critical Care Nurse Programs
Aspiring ER and critical care nurses must pursue an associate or bachelor’s degree to be eligible to complete the NCLEX-RN exam to become registered nurses (RNs). Typical admissions requirements to undergraduate nursing programs include a completed application, official transcripts, a competitive GPA, SAT or ACT scores, and a personal statement.
Some nurses in this field choose to complete graduate education. Admission to an MSN or DNP degree program typically requires an application, a GRE score, letters of reference, a statement of purpose unique to the candidate, and a resume citing the preparation made for the program.
ER and Critical Care Nurse Program Accreditation
The two leading accreditation organizations for nursing programs in the U.S. are the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). These organizations oversee bachelor’s and master’s programs for nursing. They are both recognized by the US Department of Education, which assures prospective candidates that programs of their choice accredited by either organization can rest assured that the education will meet excellent standards.
On-Campus ER and Critical Care Nurse Degree Programs
Here is a variety of campus-based programs that can benefit aspiring ER and critical care nurses.
Oregon Health and Science University (OHSU)
The OHSU program is ranked in the top ten best undergraduate programs in the nation The BSN program focuses on four public health and communications areas: hospital critical care work, outpatient and traditional care clinics, research labs, and communities. Students enrolled in the BSN program can complete their degree within three years or nine terms of work.
OHSU has five regional campuses throughout Oregon, which include Monmouth, Portland, Ashland, La Grande, and Klamath Falls.
- Location: Portland, Oregon
- Duration: Three to four years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
University of Michigan School of Nursing
The University of Michigan offers an MSN and DNP degree in adult-gerontology acute care—an advanced study option for those interested in critical care settings. The school emphasizes diagnostic reasoning, advanced assessment, decision making, consultation, referral skills, and therapeutic interventions.
- Location: Ann Arbor, Michigan
- Duration: MSN (two years); DNP (three to four years)
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The Marcella Niehoff School of Nursing at Loyola University Chicago runs its adult-gerontology acute care clinical nurse specialist (CNS) program, focusing on improving nursing personnel, healthcare systems, and patient care.
Graduates are trained to provide in-depth practice in system leadership, advocacy, acute and critically ill patient care within a variety of inpatient settings, research, consultation, and ethical decision-making.
- Location: Chicago, Illinois
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education
Duke University prepares nurses to educate themselves within a diverse community of clinicians, researchers, and colleagues. This highly-rated program focuses on the core values of research, community health, engaged alumni, global impact, educational excellence, and clinical practice.
The program boasts state-of-the-art simulation techniques, hands-on clinical rotations, and intensive courses that maximize student engagement. It comprises 48 credits and 728 clinical hours. The application process requires proof of one year of full-time acute care experience and a valid advanced cardiac life support certificate.
- Location: Durham, North Carolina
- Duration: 16 months
- Accreditation: Commission on Collegiate Nursing Education
Emory University – Nell Hodgson Woodruff School of Nursing
The Emory University Nell Hodgson Woodruff School of Nursing has been educating nurses since 1905. It has grown into an internationally recognized program that has over 1,000 BSN, MSN, and DNP students annually.
The adult-gerontology acute care program incorporates advanced pharmacology, the management of acutely ill adult patients, clinical decision-making, and diagnosis. One component of the program that sets it apart is its seminars on the physiological and psychosocial impact on patients (and their families) facing chronic and acute illness.
- Location: Atlanta, Georgia
- Duration: One year
- Accreditation: Southern Association of Colleges and Schools Commission on Colleges
Online or ER and Critical Care Nurse Degree Programs
Purdue University Global is ideal for working professionals seeking flexible online options for higher education. This university offers an RN-to-BSN program and the chance to transfer 135 credits. Candidates can complete the flexibility of online courses based on their schedules and availability.
Purdue’s online MSN offers multiple focus areas, including an adult-gerontology acute care nurse practitioner option. The school provides one-on-one support, hands-on learning, preparation for career readiness, and the flexibility needed when working as an RN.
- Location: Lafayette, Indiana
- Duration: Two years (MSN)
- Accreditation: Commission on Collegiate Nursing Education
The University of Connecticut offers an online adult-gerontology acute care nurse practitioner program to fit the needs of the working professional. The program was initially designed for RNs who hold a BSN with two years of critical care experience, and UConn provides paths for MSN or DNP degrees.
The master’s program comprises 45 credits taught by professionals in the field. The program courses last five to seven weeks, and require 700 to 800 clinical hours.
- Location: Online/Storrs, Connecticut
- Duration: Two or Three year MSN program
- Accreditation: Commission on Collegiate Nursing Education
Grand Canyon University provides prospective BSN and MSN candidates with CCNE-accredited programs. The university aims to graduate experts in quality care for individuals and communities, promoting health and fostering wellness.
GCU offers pre-licensure and post-licensure BSN options, as well as MSN and DNP programs. The tuition is competitive within the field of nursing programs, and the online program provides a special rate for active duty and active reserve students pursuing their education.
- Location: Phoenix, Arizona
- Duration: 30 months (MSN)
- Accreditation: Commission on Collegiate Nursing Education
Walden University offers multiple tracks for higher education degrees in nursing. The online BSN-to-DNP or MSN-to-DNP are available with a personalized practicum support option to prepare nurses to positively impact their communities. The adult-gerontology acute care NP program is ideal for those looking to work in critical care. They allow a transfer of up to 40 credits and begin course-based learning at the end of each August.
Admissions requirements include a current RN license, a completed BSN, online application, and general admission requirements. These degrees prepare nurses for advanced work in trauma centers, specialty care centers, intensive care units, and emergency departments.
- Location: Minneapolis, Minnesota
- Duration: 27 months (BSN-to-MSN)
- Accreditation: Commission on Collegiate Nursing Education
How Long Does it Take to Become an ER and Critical Care Nurse?
When considering how long it takes to become an ER and critical care nurse, it is important to factor in high school, college, and requisite career experience. At a minimum, it takes two years after graduating from high school to earn an associate degree—one possible starting point for a career in this field.
How To Become an ER and Critical Care Nurse – Step-by-Step Guide
Step 1: Graduate from High School or Complete a GED (Four Years)
The first step to becoming an ER and critical care nurse is completing a high school diploma or GED program. While enrolled in high school, it would be helpful to complete courses in STEM fields.
Step 2: Complete an Associate or Bachelor of Science in Nursing (Two to Four Years)
Completing an associate degree takes two years, and a bachelor of science in nursing (BSN) takes roughly four years.
If the interested party chooses to complete an associate’s degree, degree completion programs are available to help fulfill the requirements for a BSN. Clinical practicum work is provided for hands-on work in all undergraduate programs.
Step 3: Become a Registered Nurse (Timelines Vary)
Becoming a registered nurse (RN) is a fundamental requirement for ER and critical care nurse careers. The timeline for RN licensure varies on the interested party and the educational background choice of an ADN or a BSN completion. After one of those critical educational steps is completed, an application for an RN licensure must be completed. Then, the person may take the NCLEX-RN exam.
Step 4: Gain Work Experience (Two Years Minimum)
There is no substitute for work experience in the field of medicine. Critical lessons are learned through hands-on practice, collaboration, observation, and practice. Studying the topic of medicine, nursing, and science is the basis from which experience draws.
A minimum of two to three years of experience in critical care or emergency settings is required before a candidate is eligible for the certified emergency nursing (CEN) exam and job application process for hospitals across the country.
Step 5: Complete a Graduate Degree in Nursing (Two to Four Years, Optional)
Completing a graduate degree in nursing can take anywhere from two to four years, depending on the program (MSN, post-master’s certificate, or DNP) and student enrollment status (part-time or full-time).
Step 6: Obtain National Certification for Specializations (Timelines Vary)
National certification in ER and critical care nursing work is provided by three main organizations:
- AACN: American Association of Critical Care Nurses
- BCEN: Board of Certification For Emergency Nursing
- NCC: National Certification Corporation
AACN Certification Corporation, the credentialing arm of AACN, develops and administers more than 15 certification programs, offering exams for advanced practice nurses and nurses who seek to validate their knowledge in specialty and subspecialty practice areas.
Step 7: Obtain State Licensure (Timelines Varies)
State licensure, procedure, and practice laws vary across the country. There are similarities in obtaining state licensures across the country, including completing a degree program and the NCLEX exam.
Step 8: Maintain All Certifications and Local Licensure (Every One to Five Years)
Maintaining all certifications and local licensure for ER and critical care nurse positions may include continuing education credits, proof of work in the field, and fulfilling other unique local licensure requirements.
What Do ER and Critical Care Nurses Do?
Emergency Room (ER) Nurses
ER nurses specialize in rapid assessment and immediate intervention for patients arriving with urgent or undifferentiated conditions. Their responsibilities may include:
- Performing triage to prioritize care based on severity
- Stabilizing patients in life-threatening situations
- Initiating diagnostic testing such as blood work, EKGs, or imaging orders
- Administering medications and emergency treatments
- Providing wound care, sutures, and splinting for fractures
- Assisting with intubation, airway management, and cardiopulmonary resuscitation (CPR)
- Preparing patients for admission or safe transfer to other hospital units
Critical Care Nurses
Critical care nurses provide continuous, highly specialized care for patients with complex, life-threatening conditions in intensive care settings. Their responsibilities may include:
- Monitoring vital signs and invasive lines
- Managing patients on mechanical ventilation and advanced life-support technologies
- Administering and titrating intravenous medications such as vasopressors, sedatives, or pain control
- Interpreting hemodynamic data to guide treatment decisions
- Collaborating in multidisciplinary rounds to coordinate care plans
- Supporting patients and families through complex medical decisions and critical illness
ER and Critical Care Nurse Certifications & Licensure
Certification and license requirements for RNs in the ER and critical care nurse specialization can vary from state to state. National certification boards for this specialization are included in the following list below:
- American Association of Critical-Care Nurses (AACN)
- American Nurses Credentialing Center (ANCC)
- National Certification Corporation (NCC)
Board-certified licensure for this specialty could include the following certifications:
- Adult Acute Critical Care Nursing (CCRN)
- Pediatric Acute Critical Care Nursing (CCRN)
- Adult Cardiac Medicine (CMC)
- Adult Cardiac Surgery (CSC)
How Much Do ER and Critical Care Nurses Make?
The Bureau of Labor Statistics does not differentiate nurse salaries based on specialization. The 3,282,010 registered nurses in the US earn $98,430 per year on average (BLS May 2024). The percentiles for wages are:
- 10th percentile: $66,030
- 25th percentile: $78,610
- 50th percentile (median): $93,600
- 75th percentile: $107,960
- 90th percentile: $135,320
ER and Critical Care Nurse Career Alternatives
Check out three career alternatives to becoming an ER or critical care nurse.
Become a Nurse Educator
A nurse educator provides curriculum and education for the profession. The focus of the career is to give skills, knowledge, and training to the next generation of nurses in the field. This career requires at least an MSN degree from an accredited program.
- Typical Education: Master’s of nursing education or DNP in nurse education
- Licensing or Certifying Organization: Certified Nurse Educator (CNE) and Certified Clinical Academic Nurse Educator (CNE) through the National League for Nursing (NLN)
Become a Nurse Anesthetist
Nurse anesthetists provide care and compassion for patients during stressful surgery situations. These nurses work for precision, medication disbursement, and collaboration with anesthesiologists and surgeons to provide continued care in surgery.
- Typical Education: MSN or DNP
- Licensing or Certifying Organization: National board of certification and recertification for Nurse Anesthetists (NBCRNA)
Become a Nurse Administrator
Nurse administrators supervise, recruit, and hire nurses and care team members. The job details may also include giving performance reviews and building work schedules for the team members they oversee. Professional nurse administrators earn a master’s degree for their positions.
- Typical Education: MSN or DNP
- Licensing or Certifying Organization: Completing an American Nurses Credential Center (ANCC); American Organization for Nursing Leadership (AONL)
Matt Zbrog
WriterMatt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about trends within the healthcare workforce, with a particular focus on the power of interdisciplinary teams. He’s also covered the crises faced by healthcare professionals working at assisted living and long-term care facilities, both in light of the Covid-19 pandemic and the demographic shift brought on by the aging of the Baby Boomers. His work has included detailed interviews and consultations with leaders and subject matter experts from the American Nurses Association (ASCA), the American College of Health Care Administrators (ACHCA), and the American Speech-Language Hearing Association (ASHA).
Rachel Becker
WriterRachel Becker is a freelance writer who enjoys life in the PNW. She holds a master’s degree in education and taught in elementary classrooms for twelve years. When she is not running around after two toddlers, she makes time for daily movement, running two blogs, and reading.