RN-MSN Programs as a Path to Becoming a Critical Care Nurse

Critical care nursing, interchanged with acute care nursing, is focused specifically on patients with life-threatening problems. Acutely and critically ill patients are defined by the American Association of Critical-Care Nurses (AACN) as those at a high risk for actual or potential life-threatening health problems and those who require complex care due to their highly vulnerable and unstable conditions.

It is the responsibility of critical care nurses to ensure the delivery of intense, vigilant nursing care to these patients.

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Careers for the MSN Critical Care Nurse

Critical care nurses fulfill a number of roles, including clinicians, educators, nurse leaders, and researchers. At the graduate level, critical care nurses who possess a Master of Science in Nursing (MSN) and national advanced practice nursing certification through a recognized accrediting body serve as either nurse practitioners or clinical nurse specialists. Both of these advanced practice nursing professions require a core set of competencies, which is achieved through theoretical and clinical study:

Clinical Nurse Specialist (CNS) Critical Care Nurse

Clinical nurse specialists are expert clinicians who are responsible for identifying, intervening, and managing clinical problems as to improve care for patients in critical or acute conditions.

CNSs in critical care settings must make clinical decisions related to complex patient care; therefore, their work may include interpreting diagnostic tests, risk appraisal, and treatment. All CNSs are educated and certified from wellness through acute care; as such, there is no reference to critical care in any CNS role designation. In other words, all CNSs must possess the ability to care for complex, high acuity patients.

Certified nurse specialists, through education and certification, are qualified to:

  • Function as expert clinicians and patient advocates
  • Lead the advancement of the nursing practice
  • Identify opportunities for organizational and system leadership

CNSs in acute/critical care settings work in any number of populations, including neonatal, pediatric, and adult-gerontology. The population focus includes patients with acute, critical, and/or complex chronic illnesses who may be:

  • Vulnerable to complications
  • Technologically dependent
  • Physiologically unstable

Patients of critical care CNSs are also likely to experience:

  • Episodic critical illness
  • Chronic critical illness
  • Acute exacerbation of chronic illness
  • Terminal illness

Nurse Practitioner (NP) Critical Care Nurse

The critical/acute care nurse practitioner is skilled to:

  • Perform comprehensive health assessments
  • Order and interpret all diagnostic teste and procedures
  • Use a differential diagnosis to reach a medical diagnosis
  • Order, provide, and evaluate the outcomes of interventions

Critical care nurse practitioners are educated and certified to provide advanced nursing care across the continuum of healthcare services as to meet the needs of patients with acute, critical, and/or complex, often chronic, health conditions. NPs provide this care in any setting where a patient may receive critical or acute care.

NPs in critical care are educated and skilled to provide care for either pediatric or adult-gerontology patients along the wellness-to-illness continuum. Their work is accomplished through physical and mental status examinations and health risk appraisals.

How to Become a Critical Care Nurse: Critical Care MSN Degrees

Critical care nurses are registered nurses (RNs) who have completed a pre-licensure nursing program and have passed a national licensing examination. Pre-licensure nursing programs, although they offer students some exposure to critical care, do not provide comprehensive study in critical care nursing. Instead, graduate degrees, like the Master of Science in Nursing (MSN), are designed specifically for students interested in working in critical care settings.

As such, advanced practice registered nurses (APRNs) who possess an education at the master’s or doctoral level and the appropriate national certification generally serve as critical care nurses.

RNs without APRN certification may also serve as critical care nurses; however, many employers require their critical care nurses to possess APRN certification.

To achieve an APRN designation as a critical/acute care nurse practitioner or a critical/acute care clinical nurse specialist, RNs must successfully complete both a Bachelor of Science in Nursing (BSN) and a Master of Science in Nursing (MSN).

A popular program choice for today’s licensed RN who wants to become an APRN in critical care is the RN to MSN program, which combines the coursework and clinical practicum requirements of both the BSN and an MSN.

These programs, which are designed specifically for the practicing RN, are generous in terms of transferred credits from a student’s pre-licensure program. As such, RN to MSN programs are often completed in as little as two to three years. Many RN to MSN programs are offered online, thereby allowing students to complete their BSN and MSN curriculum at their own pace and on their own time.

While the undergraduate portion of an RN to MSN program and the graduate core coursework provide a solid nursing foundation, the graduate curriculum requirements of an MSN program in critical care nursing are aimed specifically at providing evidence-based practice in critical care settings as to stabilize patients, prevent complications, and maximize their overall health:

RN to MSN Curriculum Requirements for Nurse Practitioners in Critical Care

RN to MSN acute/critical care nurse practitioner programs feature the following graduate curriculum for the study of acute/critical care:

  • Advanced health assessment applications
  • Advanced health assessment and clinical reasoning
  • Advanced physiologic and pathophysiologic foundations of acute care
  • Advanced pharmacotherapeutics for acute care nurse practitioners
  • Pathophysiology and collaborative management in acute care
  • Critical care nurse practitioner practicum

RN to MSN Curriculum Requirements for Clinical Nurse Specialists in Critical Care

RN to MSN acute/critical care clinical nurse specialist programs feature the following graduate curriculum for the study of acute/critical care:

  • Advanced pathophysiology
  • Clinical decision making in acute care
  • Clinical decision making in acute care
  • Advanced pharmacology
  • Advanced health assessment

Clinical Requirements for Critical Care RN to MSN Programs

RN to MSN programs in critical care include specific clinical requirements that provide students with the opportunity to specialize their focus on a specific area of critical care, such as:

  • Cardiology
  • ER/trauma
  • Digestive health
  • Nephrology
  • General surgery
  • Transplant
  • Oncology
  • Neurology/neuro-surgery
  • Wound/ostomy/continence
  • Pulmonary

Clinical/practicum activities in RN to MSN programs in critical care allow students to apply the knowledge they gained through their MSN curriculum to a real-world setting.

APRN Certification for MSN Critical Care Nurses

Upon graduating from an MSN program in advanced practice nursing, with a focus on nurse practitioner or clinical nurse specialist critical care, individuals must achieve national certification through a national certifying body that is recognized by their state board of nursing.

Once national certification is achieved, RNs must apply for APRN certification through their state board of nursing.

Jobs and Salary Statistics for Critical Care Nurses

Critical care nurses nurse practitioners and clinical nurse specialists can be found working in a number of settings, such as:

  • Cardiac catheter labs
  • Emergency departments
  • Intensive care units
  • Neonatal intensive care units
  • Outpatient surgery centers
  • Pediatric intensive care units
  • Progressive care units
  • Recovery room
  • Telemetry units

Salaries for these MSN critical care nurse professionals may range from $80,000 to well over $100,000. The National Association of Clinical Nurse Specialists, for example, reports that annual salaries for clinical nurse specialists can reach $110,000 and above, while the American Academy of Nurse Practitioners reported an average, annual salary of $94,050 for nurse practitioners in 2011.

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