ICU vs. PCU Units in Hospitals: Exploring the Differences

cardiac monitors in an intensive care unit

PCU and ICU: These acronyms are for two separate and distinct units in healthcare. PCU stands for progressive care unit, while ICU stands for intensive care unit. What's the difference between an intensive care unit and a progressive care unit? If not, then this article is for you! 

We'll explore the differences between the two and how their relationship is intertwined. By the end of this in-depth guide, you'll have a greater understanding of what it means to be a PCU nurse and an ICU nurse, how to find ICU nursing or PCU nursing jobs, and perhaps you'll decide whether one of these two specialties would be a good fit for your nursing career.

Read How to Jumpstart Your Career as a New Nurse

What is the Progressive Care Unit?

It's important to note that the acronym PCU has various meanings in various industries. For our purposes, we're reviewing PCU in the medical setting, specifically the progressive care unit. PCUs are also referred to by some as step-down units or telemetry units. Patients in the PCU require vigilant monitoring due to cardiac problems or other critical conditions such as stroke, severe infections like sepsis, epilepsy, tracheotomies, feeding tubes, and so on.

What is the Intensive Care Unit?

You may have noticed that another term for the PCU is a step-down unit, but knowing the seriousness of patient conditions who are in a PCU, what is a step-up? The ICU provides "care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency." In short, patients in the ICU require the highest acuity of care.

PCU vs. ICU: What are the Differences?

One significant difference between PCU and ICU is the acuity level. Many patients in the PCU arrive directly from the ICU. However, many patients come from other departments, such as the emergency room or a doctor's office, and require an acuity level just less than that of intensive care. While suffering severe conditions and/or illnesses, often, PCU patients have been determined to no longer require the highest level of care, hence the moniker "step-down unit."

Another difference between PCU and ICU is the nurse-to-patient ratio. Understandably, because the ICU has patients with the most critical and complex of conditions, its nurse-to-patient ratio is low, usually 1:1 or at most 1:2.. In contrast, the nurse-to-patient ratio in the PCU is often 1:4 or 1:5. Nurses working in the PCU have to exercise their time-management skills.

The difference in understanding for patients within the PCU does vary. Nevertheless, they typically are more aware than patients in an ICU. What does this mean for PCU nurses? It means rapport, bedside manner, and communication skills are honed and utilized routinely with their patients and their family members. Circumstances for ICU nurses allow less opportunity to establish a rapport with their patients, if at all.

Specialty certifications are a difference that sets PCU and ICU nurses apart as well. The American Association of Critical Care Nurses (AACN) provides different certifications for both specialties. 

  • For nurses providing direct patient care in ICUs, the AACN offers three certifications; CCRN-Adult, CCRN-Pediatric, and CCRN-Neonatal. According to their website, all three certificates are "Eligibility based on verifiable clinical practice hours and current unencumbered U.S. RN or APRN license."
  • For PCU nurses, the AACN offers PCCN-Adult. Per the AACN website, "A current, unencumbered U.S. RN or APRN license is required. Candidates must complete one of the following clinical practice hour requirement options: Practice as an RN or APRN for 1,750 hours in direct care of acutely ill adult patients during the previous two years, with 875 of those hours accrued in the most recent year preceding application, or practice as an RN or APRN during the previous five years with a minimum of 2,000 hours in direct care of acutely ill adult patients, with 144 of those hours accrued in the most recent year preceding application."

How the PCU and ICU are Intertwined

Because of the PCU's role as a step-down or intermediate care unit, it receives patients from the ICU on a routine basis. PCU patients, formerly of the ICU, are monitored and cared for in the PCU with the hopes that their health will continue to improve to be discharged. Unfortunately, PCU patients sometimes take a turn for the worst and require ICU care.

Learn More About PCU Nursing Jobs Here

PCU and ICU Nurse Salary 

PCU and ICU nurses typically earn a higher salary than staff or med-surg RNs, attributed mainly to the critical thinking skills the position requires in an intense environment with complex patient cases and specialty certification(s). ICU nurses earn an average of $57 per hour or $119,473 annually. PCU nurses earn an average of $59 per hour or $122,456 annually. Keep in mind that these figures are a national average, rates will vary by location, and of course, the cost of living should also be considered.

How to Find PCU and ICU Jobs

Are you a certified PCU or ICU nurse looking for a job? Or are you a PCU or ICU nurse working on those practice hours to be eligible for certification? Working per diem (PRN) PCU shifts or PRN ICU shifts is an excellent path to gaining experience and knowledge for your career as a PCU or ICU nurse. You can easily find PCU and ICU jobs by downloading the Nursa healthcare staffing app. Nursa connects specialized nurses to PRN jobs in their area, and the best part? Nursa is accessible for clinicians to use.

How Nursa Works

Download Nursa and register for an account. Next, you'll follow the prompts to complete your personalized professional profile and verify your nursing license. Be sure to follow the steps to set up your wallet, allowing you to receive direct deposit payment for the PRN shifts you work. Browse PRN shifts for PCU or ICU nurses near you. The app will enable you to adjust your geographic settings, which means if you're willing to drive to another town or city near you, you'll see even more opportunities. When you find a shift that fits your criteria and schedule, tap to apply. You'll receive a notification when the hospital or facility selects you for the shift.

Nursa does not impose a quota on the nurses who use the platform. You are responsible for applying for shifts that fit within your schedule, which means if you have another job and can only pick up a few per month, that's no problem. It also means if you're looking to pick up PRN shifts on a full-time basis, there's no problem with that either.

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