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  • 14 September 2020
  • 16 min read

How To Become An ICU Deputy Sister

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    • Richard Gill
    • Aubrey Hollebon
    • Mat Martin
    • Kim Carr
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  • 5511
"I found myself looking for a little bit more from my work, I wanted a change and a new challenge."

ICU Deputy Sister, Suzanne, describes her career journey as an ICU Nurse, what it takes to work in Critical Care, as well as some tips on how to carve out your own career in an Intensive Care Unit.

Topics covered in this article

What Inspired Me To Become An ICU Nurse

What Is An ICU Deputy Sister?

Training To Be An ICU Deputy Sister

What Type Of Setting Does An ICU Deputy Sister Work In?

What Are The Key Skills Needed?

How Long Does It Take To Become An ICU Deputy Sister?

What I Love About Being An ICU Nurse

Challenges You Face As An ICU Nurse

What Salary Can You Earn As An ICU Deputy Sister

The Difference Between Working In Private And State Sector

Career Prospects And Opportunities

Further Studies You Can Do To Advance Your Career As An ICU Nurse

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What Inspired Me To Become An ICU Nurse

I knew I wanted to be a Nurse since being a little girl.

While I was completing my nursing degree, I did a three month placement in Blackpool Victoria’s ICU department.

It was the longest placement I did during my studies and I loved every minute of it, those three months in ICU stayed with me long after I finished my nursing degree.

After qualifying I returned to A&E but didn’t stay long.

I had already worked in the department for over a decade, it was where I started and where I felt comfortable.

But I found myself looking for a little bit more from my work, I wanted a change and a new challenge.

Based on my placement experience in ICU, I set my sights in that direction and haven’t looked back.

One of the things that really drew me from A&E to critical care is the difference in attitudes and care between the two departments.

By the end of my time in A&E, I wanted to give more patient focused care and spend more time with my individual patients.

Critical care offered me both those things while still posing something new and further learning opportunities.

I successfully applied to the general critical care unit at Blackpool Victoria.

In the following years in critical care, I was regularly a shift leader on the high dependency unit and attained a number of advanced certificates in ICU care.

Later, I accepted a band 6 Sister’s post.

Around this time, I met My husband-to-be and moved down to London.

I took a position at North Middlesex Hospital, during this time I took on an acting band 7 position to manage and develop a level 1 area for intensive care step down and postoperative admissions.

My current post at Guys and St. Thomas’ Hospitals is a band 6 Shift Leader / Deputy Sister in general critical care.

What Is An ICU Deputy Sister?

A Deputy Sister in critical care is a multidisciplinary role.

You work closely with and support all ICU nursing staff on shift while also providing a high standard of care for your allotted patient.

You will oversee all members of the multi-disciplined teams to ensure safe and effective care for patients and work closely with consultants to ensure:

● Global awareness of all patients

● Effective discharge planning and bed management

● Supporting and teaching junior staff

● Assisting during invasive procedures including tracheostomy and bronchoscopy

Care for patients receiving:

● Artificial ventilation

● Continuous venous-venous haemofiltration therapy

● Invasive cardiac output monitoring

The role is varied from day to day as you support each patient’s specific needs and condition.

No two shifts will be exactly the same, each day brings a new challenge.

Situations can change rapidly in intensive care, coping with and reacting to these changes is a big part of the role.

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Training To Be An ICU Deputy Sister

I completed my nursing degree then some time later entered an ICU department as a band 5 staff Nurse, then climbed to Senior Staff Nurse position, and later achieved a shift leader / deputy sister role.

I’ve completed a number of advanced learning certificates including:

● Managing Care Delivery in the Intensive Care Patient

● Assessment and Monitoring in the Intensive Care Patient

● Supporting and Assessing Learners in Practice

My current ICU position has given me experience and relevant skills in new fields including:

● Post Op complex cardiac surgery

● Patients undergoing extracorporeal membrane oxygenation treatment

● Continuous haemodialysis

● Renal transplant recipients

● Simultaneous pancreas and renal transplant

● Complex thoracic surgery

● Removal of cancer tumours with reconstructive surgery

I feel that my training and personal development as a Nurse never really stops. It’s an ongoing process that needs a regular investment of time.

A Nurse is only as good as their training.


Any nursing placement can be daunting; intensive care is no different.

As daunting as it may be, the ICU is generally a very popular placement choice for Student Nurses.

It offers them a real wealth of knowledge and learning opportunities.

The nature of ICU makes it multi-organ focused, this gives students a chance to see a wide variety of conditions and treatments within one environment.

There is always something to learn in an ICU and lots of skilled Nurses to teach you.

Placements are so important to trainee Nurses, getting in there and actually doing the role is the best way to get an idea if it is right for you.

It will give you a chance to meet staff that already work in that department, it could even help your future application to a similar role.

You may find a placement is not for you, it might not be what you were expecting or just not a good fit for you.

That is absolutely fine, that is the whole point of a placement.

I found the right department for me through doing a placement, you can too.


Mentoring is incredibly important, it is one of the best ways to pass on knowledge and experience.

I have my mentorship certificate, I chose to do it because I strongly believe in its value in nursing.

In my current role, I support both Student and Junior Nurses.

It can be challenging at times but is ultimately extremely rewarding.

As a Nurse, I challenge myself with providing the highest possible standard of care for my patients at all times.

It makes me very proud to see student and Junior Nurses adopting this same professional challenge while under my mentorship.

Mentoring also does a great deal of good for me as a Nurse, working closely with less experienced staff really puts the focus on me and my knowledge.

It helps keep my professional skills and knowledge sharp, it's a great way of being regularly tested.

Sometimes being a good mentor is just being an open, friendly and non-judgemental face.

People need to be able to feel confident and comfortable coming to you for help or advice.

I have had some great mentors over the years and I try and pass on that experience to others, together we can all learn.


As a Registered Nurse we must register every year and complete a professional development review, we must also revalidate every three years.

CPD forms a large part of this process, some is mandatory and some is optional.

I try to take on as much as I can and anything that is specifically relevant to my role.

Some of the CPD I have completed in recent years include:

● Leadership and Empowerment Courses

● End of Life Care Conferences

● Advanced Life Support

● Fire Warden Training

● Safe transport of Patients Training

● New Equipment Training

CPD is a great way of staying up to date, there is always something new to learn or an area to explore in more depth.

You can bring all this knowledge and new skills back to your unit and peers, spread it around and everyone can benefit.

What Type Of Setting Does An ICU Deputy Sister Work In?

My particular role is largely found within an ICU department.

Similar roles are found in Intensive Overnight Recovery for example and ICU’s can be broken down into specialist ICU units and teams.

I work in General Critical Care because I like to deal with a bit of everything and have the skill set and experience to do so.

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What Are The Key Skills Needed?

The key skills I rely upon the most day after day in my role are communication skills.

As a shift leader it is essential that I am able to effectively communicate between the staff and patients I support at all times.

Communication within a critical care department is much more complex and challenging than you may first think.

Imagine trying to have a simple conversation with someone who has a tube down their throat and cannot speak.

Dealing with and overcoming barriers in communication is a big part of my role as a Critical Care Nurse and Deputy Sister.

A shift leader needs to be able to support and motivate the teams they oversee.

This can be as simple as being a friendly and supportive face during a difficult shift or as complicated as defusing a tense atmosphere between co-workers.

There is not always a right answer and you sometimes feel like you are trying to juggle and someone just keeps adding an extra ball.

Some other key skills that are particularly important in critical care are: exceptional observation skills, the ability to work autonomously, quick response/problem solving, and self confidence.

When you are supporting someone at such a critical point of care; you need to be able to recognise problems quickly, act quickly, and have confidence in what you are doing for them.

A huge part of what we do is providing end of life support for our patients and their families.

The skills you need for this can be researched and learned but dealing with it in real life is very different.

With time and experience it gets easier and dealing with this aspect of the job becomes more natural, but even after years it can still hit you hard out of nowhere.

How Long Does It Take To Become An ICU Deputy Sister?

There isn’t really a clear-cut answer here.

Everybody is different and progresses at varied speeds with varied personal priorities.

It can depend greatly on your starting level and the specific career route you take to get to your goal.

For a start you will need a nursing degree, let's say three years minimum for that.

Then you would need to spend some time on the job as a qualified Nurse, give it two years as base experience.

Then you would need to start working your way up the chain, maybe another two years in further training and progression.

During this progression period you will be working closely with senior staff that will be assessing and monitoring your suitability for increased responsibility and promotion.

They will know when you are ready for that next step up.

It may take time, but if you have the drive and the ability, you will get there.

What I Love About Being An ICU Nurse

What I really love about my job is the level of care it allows me to give my patients.

In an ICU, we give the highest possible level of support at the most critical time in a patient’s care.

We are there for them around the clock, by their bedside, doing what we can for them.

It’s why I became a Nurse, why I love it, and what keeps me going.

I’m a very “hands on” Deputy Sister, I always have been, It’s just the way I like to work.

I find it is the best way to really know what is happening with all the patients on your unit.

I really enjoy the close quarters care as it is the time I get the best insight into my patient’s condition and gives me the chance to really do something to help them.

Helping people is what it is all about for me, I'm very proud of it and will continue for as long as I can.

It’s what I do, who I am, and I wouldn’t change it for anything.

Challenges You Face As An ICU Nurse

One of the biggest challenges I face in my role is simply time management, this applies both directly and indirectly to my work.

Finding the right work and home life balance is extremely important and can be a real challenge to maintain long term.

Critical care can be highly demanding and emotionally draining, it can be hard to leave work at work and find the space to clear your head.

When you work in a high pressure environment, you need to find ways of breaking that pressure and effectively relaxing, It can be harder than you would imagine.

Patient’s relatives can be very challenging at times.

It must be horrible to be in that position, helplessly watching a loved one suffer, they all have my sympathy.

But they can sometimes fail to understand what we are doing for their relatives, how important what we do is, and make our jobs harder than they have to be:

We care about our patients and our work, let us get on with it and do what we can for the people you love.

A very difficult challenge I regularly face is helping patients start to come to terms with changes to their health or bodies.

Many patients I care for have undergone life changing surgery or injury, they may have lost limbs, internal organs, or have severe surgical scarring.

Changes such as these can be extremely hard for patients to accept and adjust to.

What Salary Can You Earn As An ICU Deputy Sister

In this role you are likely to earn either a Band 6 or Band 7 salary.

Broadly, that means you'll earn somewhere between around £35,000 and £45,000 a year. But for an exact figure at different bandings or years of experience, use’s handy nursing salary pay guide and calculator.

The Difference Between Working In Private And State Sector

The differences between private and state sector ICU care can be few and far between.

Private critical care does exist but due to the nature of ICU support, its cost, and the sheer number of specialised care teams needed, it is not that common for extended periods of time.

Quite often, if a private patient’s ICU stay exceeds a certain duration they are transferred out to a state run unit.

The level of care, available resources, and staff are largely the same across both settings.

As ICU care teams are so specialised, they often work between both the private nursing and state sector / NHS nursing, there simply aren't enough medical professionals to cover both sectors at once, cross-over is necessary and inevitable.

A Nurse, Surgeon, or Doctor will give the same level of care no matter what building they happen to be working inside that day.

Career Prospects And Opportunities

Nursing really is a wonderfully open profession with an abundance of possible career paths and specialities.

From a Deputy Sister role you could move up to a Sister role, then possibly a Matron or Nurse Consultant.

Progression and opportunity is here, you just have to work for it.

Nursing allows you to specialise or to move around and experience varied roles, It’s up to you where you take your career or what band you progress to.

You could ultimately end up in hospital or care home management if that is the route you want to take.

For now I am happy where I am, but that doesn’t mean I’m not building up the skills and experience I need to progress when I am ready.

It all adds up.

Further Studies You Can Do To Advance Your Career As An ICU Nurse

There is a wealth of further study, CPD, and advancement opportunities within the nursing profession.

There are always new courses to complete and further qualifications to gain no matter what role or department you work in.

For me personally, completing both ‘Managing Care Delivery in the Intensive Care Patient’ and ‘Assessment and Monitoring in the Intensive Care Patient’ certificates were essential studies in the advancement of my career.

Let me know in the comments your thoughts on becoming an ICU Nurse and what I've said about my journey - let's chat there!

Oh, and please Like this article to let me know you enjoyed it - thank you!

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About the author

I am a lifelong nurse with a real passion for care. I started my career in a busy seaside A&E department and am now an intensive care deputy sister at a large city hospital. My work is and always has been a big part of my life, I fill the rest with my fantastic family, loving husband James, two beautiful little girls and cheeky cockapoo called Charlie.

    • Richard Gill
    • Aubrey Hollebon
    • Mat Martin
    • Kim Carr
  • 0
  • 5511

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