When children and adolescents become critically ill or injured, they’re admitted into the highly experienced hands of a hospital’s Level I or Level II pediatric intensive care unit (PICU). These units have a low patient-to-professional ratio due to the severity of the conditions being treated, including seizures, renal failure, pancreatitis, traumatic shock, and meningitis. PICU nurses are among the licensed providers caring for children during this frightening time. As registered nurses, PICU nursing staff constantly monitor young patients’ vital signs to alert clinicians to complications that must be addressed immediately. PICU nurses are child care specialists who provide emotional support to parents and families while keeping the patient calm. Pediatric intensive care nurses help doctors determine the best course of treatment to promote children’s full recovery.


Statistics on Salary.com report that the median yearly salary for pediatric intensive care RNs in the United States is $68,462. This is equivalent to a median hourly wage of $33, or $1,317 weekly. With benefits like social security, 401(k) plans, disability, healthcare, and vacation time included, the total annual average compensation for PICU nurses is $96,110.

Beginning Salary

When just starting in the PICU unit, registered nurses can expect landing in the bottom quarter percentile of earnings with yearly income around $55,531. Pediatric intensive care nurses with years of experience and supervisory roles can eventually earn base salaries beyond $79,791 each year. Those who advance as PICU nurse practitioners bring home $101,260 on average.

Key Responsibilities

PICU nurses have the primary responsibility of assessing, treating, and monitoring young patients under 18 years old who are presenting acute, serious ailments. Pediatric ICU nurses coordinate age-appropriate care with other healthcare members. Typical nursing duties include measuring blood pressure, following oxygen levels, tracking urine output, inserting IVs, changing wound dressings, administering antibiotics, adjusting ventilators, and analyzing lab results. PICU nurses must record patient information concisely and accurately because every symptom matters. Pediatric intensive care nurses also answer questions and provide education for caregivers about managing their child’s health condition. Conforming to all HIPAA regulations and safety standards is essential.

Necessary Skills

Successfully working in the PICU unit requires nurses possess excellent communication skills to effectively relay messages to clinicians and parents. Interpersonal skills help PICU nurses clearly inform parents about their youngsters’ condition with sensitivity and compassion. Clinical skills must be sharp because PICU nurses are often placed in life-and-death situations where resuscitation may be needed. Pediatrics jobs mandate sympathy, kindness, patience, and emotional stability to handle intense realities like death. Technical skills are important for PICU nurses to accurately operated the latest medical equipment. Pediatric intensive care nurses need organizational skills to maintain flawless patient records. Fast critical thinking skills are also essential for PICU nurses to make good, split-second care decisions.

Degree and Education Requirements

Becoming a PICU nurse will require that you fulfill your state board of nursing’s requirements for registered nursing licensure. Most states mandate that RNs complete an Associate of Science in Nursing (ASN) or Bachelor of Science in Nursing (BSN) from an accredited nursing school. If you’ve already completed a nursing diploma or two-year associate degree, RN to BSN and LPN to BSN bridge programs are suggested. The AACN recommends that today’s young nurses complete a four-year bachelor’s degree for well-rounded clinical training. Venturing further into graduate school for a Master of Science in Nursing (MSN) can unlock advanced practice roles, including pediatric nurse practitioner or pediatric critical care specialist.

Pros and Cons of the Position

Pediatric ICU nursing can be difficult mentally, physically, and spiritually for RNs to cope with. On a daily basis, PICU nurses treat young patients facing serious diagnoses that could be life-threatening. Finding the emotional stability to deliver devastating news to parents is challenging. PICU nurses have to administer treatments that are painful and frightening to children, which can cause guilt. Pediatric intensive care nurses deal with above-average stress and frequently suffer burnout. PICU nursing also requires lengthy time spent standing or walking during sometimes fluctuating work shifts. However, the rewards of becoming a PICU nurse outweigh the difficulties for certain RNs. Pediatric ICU nurses are given the unparalleled ability to assist in children’s recovery from health crisis. They’re able to use fun, silly practices to make young patients as comfortable as possible. PICU nurses enjoy decent salaries with excellent health and retirement benefits. Higher education is minimal to only the associate-level in many states.

Getting Started

While attaining your nursing degree, being to tailor your career for pediatric intensive care positions by gaining acute treatment experience. Specialize your program’s field practicum in intensive care units, emergency rooms, and other critical care settings. Finding internships in PICU units helps get your foot in the door. Upon graduation, test your skills by taking the National Council for Licensure Exam (NCLEX-RN). Other RN requirements may include getting fingerprinted and submitting to a background check. Becoming licensed will open staff RN positions in hospitals and urgent care centers. Completing at least 1,750 hours in direct care of critically ill patients is required for the next voluntary step. The AACN Certification Corporation offers the Critical Care Registered Nurse (CCRN) designation in Pediatrics. You’ll have to pass a three-hour test with 150 multiple-choice questions.

Future Outlook

According to the AHRQ, there are nearly 6.4 million hospital stays for children 17 years or younger in the United States each year. That’s approximately 16 percent of hospitalizations. Advancements in medicine have made the in-hospital death rate for children very low at 0.4 percent. Demand for qualified PICU nurses to deliver the high-tech children’s services that save lives is growing. What’s worrisome is the RN workforce supply is expected to be 20 percent below the HRSA’s projected need by 2020. Critical nursing shortages will be particularly large because pediatric intensive care units are filled with baby boomers reaching retirement age. The Bureau of Labor Statistics predicts that the 16 percent RN job growth will require 439,300 more nurses nationwide. PICU nurses find abundant jobs in general hospitals, children’s hospitals, regional medical centers, and surgical hospitals.

Overall, PICU nurses are RNs equipped with the specialized knowledge to quickly evaluate children and relieve their suffering for the best health outcomes possible. Pediatric intensive care nurses implement evidence-based practices to facilitate healing for acutely ill youth in a soothing, caring environment. Taking the steps to become a PICU nurse can be a rewarding option for professionals with the emotional strength to treat children when they’re most in need.


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