How to become a critical care nurse

Critical care nurses look after the sickest patients in a hospital: people on ventilators, those needing support for several failing organs, and patients recovering from major surgery or trauma. You need to be a registered nurse first, usually in adult nursing, and most people join an intensive care unit at band 5 and then complete a critical care course funded by the employer. In England from 1 April 2026, band 5 pays £32,073 to £39,043, band 6 £39,959 to £48,117 and band 7 £49,387 to £56,515.

The units and the patients

Critical care covers intensive care units (ICU, sometimes called ITU) and high dependency units (HDU). Some hospitals combine them in one department, and larger hospitals have specialist units for cardiac, neurological, burns or liver patients. Patients are often grouped by the level of care they need. Level 3 patients, such as those on a ventilator, are the most dependent. Level 2 patients need close monitoring or support for a single organ.

Staffing reflects that. Under the professional standards most units work to, a ventilated level 3 patient usually has a registered nurse to themselves for the whole shift, while a nurse in HDU commonly cares for two level 2 patients. Senior nurses without their own patients coordinate the shift. When units are under pressure these standards are stretched, and that is one of the main sources of stress in the specialty.

A shift involves continuous assessment and documentation, managing infusions of drugs that act within minutes, caring for patients on ventilators and kidney replacement therapy, preventing complications such as pressure damage and infection, and talking with families at very difficult moments. End of life care, including organ donation conversations, is a regular part of the work.

Getting in

To start you need NMC registration. Adult nurses are the majority, but some units take nurses from other fields, and children’s nurses work in paediatric intensive care. The route to registration is covered in how to become an adult nurse.

Many units advertise band 5 posts for newly qualified nurses, with a structured preceptorship that includes several weeks working alongside an experienced nurse before taking your own patients. Others prefer applicants with some ward experience, often in acute medicine, surgery or a respiratory unit. Experience with deteriorating patients helps your application either way.

At interview, expect scenario questions about a deteriorating patient, prioritising care, and escalating concerns. Our guide to nursing interview questions covers the common formats.

Training once you are in

Many units use a national competency framework for adult critical care nurses, worked through in steps over the first year or two. You are assessed on each competency by senior colleagues, and the early steps focus on caring safely for a level 3 patient with support.

After that, most nurses take a post-registration critical care course at a university, usually part-time while working and often funded by the trust. Completing it is commonly expected for band 6 posts. Life support courses, transfer training for moving critically ill patients between hospitals, and specialist skills such as managing tracheostomies or kidney replacement therapy are added along the way.

Bands and pay

Role	Typical band	England, from 1 April 2026
Critical care staff nurse	5	£32,073 to £39,043
Senior staff nurse or junior sister/charge nurse	6	£39,959 to £48,117
Sister/charge nurse, practice educator, outreach lead	7	£49,387 to £56,515

In Scotland, the 2026/27 rates are £34,494 to £42,977 at band 5, £43,169 to £52,603 at band 6 and £52,769 to £61,377 at band 7. Wales is reported to have followed the 3.3% England award, and Northern Ireland’s 2026/27 award had not been confirmed by 16 October 2026. In London a high cost area supplement is added; at band 5 entry that takes pay to £38,488 in inner London. See band 5 pay and band 6 pay for the detail.

Critical care runs around the clock, so most nurses work a mix of days, nights and weekends and receive unsocial hours payments on top of basic pay. Rates depend on when the hours fall. Beyond band 7, nurses move into matron, consultant nurse or advanced critical care practitioner roles, which are usually band 8a or above.

Shifts and the toll of the work

Most units run 12-hour shifts, typically about three a week for full-time staff. The length makes for fewer days at work but long, demanding shifts; working 12-hour shifts looks at the trade-off. Night workers are entitled to a free health assessment, and you must get at least 11 hours’ rest between working days.

The job is mentally heavy. You see patients die, sometimes young and sometimes suddenly, and support families through it. Units usually run debriefs and have access to staff psychological support, and many nurses value the depth of care and the teamwork. Others find the intensity hard to sustain and move to outreach, education or ward roles after a few years.

NHS Pension Scheme contributions are tiered by pay. At band 5 entry you pay 8.3% (on pay from £28,855 to £35,155), and at band 6 9.8%. Use the take-home pay calculator to see what a band 5 or band 6 salary leaves after deductions, and browse nursing and midwifery jobs for current ICU posts.