The Critical Care Nurse Certification, CCRN®, is a national certification a critical care nurse can obtain. Once you pass this test, you get to add CCRN® to your credentials! It’s a pretty awesome thing to have, and many health care organizations support nurses in getting this certification as well as look highly upon job applicants who have it as well. However, to get the certification you must pass the exam. So let’s chat about how to pass the CCRN®.
To outline the best way to go about conquering the exam, I decided to interview someone who teaches CCRN and PCCN review courses!
Nicole Kupchik MN, RN, CCNS, CCRN-K, PCCN-K has practiced as a Critical Care nurse for over 25 years and has her MN with a specialty as a Clinical Nurse Specialist. Nicole is a well-recognized national and international speaker on several emergency and critical care topics. She has taught CCRN® and PCCN Certification review courses for over 12 years. Nicole has had a very productive career which has included numerous publications, launching a Sepsis & Post Cardiac Arrest Hypothermia (TTM) program, as well as Quality Improvement in Resuscitation and has been the host of a Resuscitation podcast and YouTube show. Nicole has published six books and won numerous national awards. To learn more about Nicole, click here.
Critical Care Nursing Certification
Now, this is a pretty comprehensive post. If you want to jump to a section, use one of the links below:
Requirements for the CCRN® exam
“First, you have to factor in the basic requirement of having at least 1,750 practice hours first. If you’re working full time as a nurse, you’ll get that within your first year. However, what I’ve noticed is that a really great time to start thinking about it would be 1-2 years after starting in critical care. If you try to do it before the first year, you’re still in that steep learning curve and it’d be pretty tough.
“Once you begin connecting the human beings you’ve cared for to the didactic knowledge needed to pass the exam, that’s a great time to take the certification step. For example, if you’ve had a patient who had pancreatitis and you go back and read up more on it, you’re connecting your experience with your knowledge, and that really takes your practice to the next level.
“They did add a new clause that states if you’ve been a nurse for at least 5 years and have at least 2,000 practice hours, you only need to have 144 hours in the most recent year.
“Another sign that you’re ready is if you’re feeling stagnant and like you need something more from your profession. So if you start to feel like you’re just showing up for work to get your 12 hours in, it may be a good time to take on a new challenge.
“If you’re in a leadership position on the unit, having that certification really solidifies your position as well. I believe every charge nurse should be certified, as it is a leadership position and shows that you desire to take your position to the next level.
“It’s important to realize that people who pass the test and obtain the certification are board-certified. That’s a really big deal to have a board certification in your specialty.”
Critical Care Nursing Certification: CCRN exam handbook
The CCRN exam handbook is a critical tool in preparing for the CCRN exam. It details information you will need to before you take the CCRN test including:
The CCRN exam handbook, provided by AACN.org, is a resource you should review thoroughly and keep handy as you prepare. When you prepare to renew your CCRN, you’ll want to check for the most up to date version of the guide and review the CCRN requirements for renewal at that time.
Barriers to taking the CCRN® exam
Nicole notes that “Some of the biggest barriers I’ve seen are summoning the courage to take the exam and conquering the fear associated with it. I personally didn’t have the courage to test – I waited seven years! I took three certification review classes. I honestly probably over-studied. When I got the paper that said I passed, my first reaction was that I couldn’t believe I waited so long!”
“The hospital I worked at provided a higher hourly rate for nurses who had their certification. I did the math and I would have made about $2,000 more a year multiplied times 5-6 years! That’s a lot of shoes!”
“Money can also be a major barrier as well because there is a cost associated with the exam and any review materials,” said Kupchik.
Check and see if your health care organization has a professional development fund for their staff. They may cover the cost of the exam and review materials! I know both health care organizations I’ve worked for cover certification exams and memberships for professional organizations. I paid up front and was reimbursed.
Nicole adds, “The busyness of life also gets in the way of getting certified as well. It’s really tough to work nights and think about studying for something like this.”
Speaking as someone who took and passed the CCRN® in 2015, you definitely need to be intentional about studying. It’s more in-depth than just reviewing a few concepts for sure, but nothing like the NCLEX®. Differentiating the CCRN® exam from the NCLEX®
So many of us have had terrible experiences with the NCLEX®. It was a major source of stress and even years later I shuddered at the thought of another exam (probably still dealing with my NCLEX® hangover, honestly). This is why I felt it so important to ask Nicole about how the CCRN® differs from the NCLEX®.
Critical Care Nursing Certification: How the CCRN® exam differs from the NCLEX®
Nicole notes that “It is so important for nurses to realize that the CCRN® is not the NCLEX®. First of all, you’re not going to lose your job if you don’t pass”.
Let’s hit pause for a second and rewind. You won’t lose your job if you don’t pass. I know, I know. It seems obvious to point out, but I think this is important.
Something I’ve seen over the years with nurses considering certification exams is that even years later, they are still traumatized by their NCLEX® experience and never want to have to go through anything like that again… signing up, taking a review course, sitting for the exam, and possibly failing. I get it.
While a certification exam is important, it’s nowhere near NCLEX®-level. It’s not a computer adaptive test (CAT), so it doesn’t shut off at different points.
Nicole adds that “The CCRN® has 150 questions and the PCCN has 125. You will always get that many questions. And they’re not trying to trick you in any questions. So for example, we all hate those questions worded like, ‘All of the following are true EXCEPT’ because they’re very confusing even when you know the right answer. They’ve removed all of those questions.”
She elaborated to say that because they are not trying to trick you, it’s really important to follow your gut response for answers. Nicole likened it to when you walk into a patient’s room and you just know something isn’t right. She even makes her students in her review courses pinky-swear that they don’t change any answers!
When you get a question, use the piece of paper they give you and cover up all of the answers. Answer it in your head first, then uncover the answers and see if it’s listed.
“Honestly,” Nicole adds, “You have to remember that your motivation with the NCLEX® was so different. You to do it to become a nurse. There was no option.
“Motivation for the CCRN® is different. Arguably most are doing this because they want to further their professional development. The worst thing that can happen is you don’t pass and you simply take it again. Your job isn’t on the line here.”
Important considerations for the Critical Care Nursing Certification
Before going through a solid study plan, Nicole had a few really important things to consider in your approach.
First, like the nursing process, assess your life first. If you’ve got other stressors going on in your world, now might not be the best time to study for a board exam. Nicole mentioned that the holidays simply are not a great time to try to fit this in, nor is trying to study for it on vacation.
Many of us equate studying with nursing school, a season of life that required us to cram it in whenever we could. We don’t have to do that for this. You have options when you can decide to prioritize this. Kupchik emphasized how important it is to enjoy your vacation, time off, holidays, or other major life events without having to add studying and an exam on top of it.
Speaking as a parent, if you’re expecting a child, I highly recommend not trying to study or take the exam during maternity leave. Trust me, it’s not a vacation and there isn’t enough time to devote to this. You’re barely getting sleep and surviving, let alone adding studying into the mix, which should be done when you’re rested and can focus. Even if you did get some time, your mental and emotional energy would be much better spent resting or doing something you enjoy so you’re fresher for yourself and your baby.
Therefore, since you can take this exam whenever you want, try to schedule it during a period of your life in which you are not experiencing major life changes (getting married, moving, having a child, and so forth).
Set yourself up for success. Assess your life commitments. Plan accordingly.
Critical Care Nursing Certification: A typical CCRN® study plan
Nicole highly recommends a review course. These can be online or live, and she advocates for scheduling this review approximate two months before your desired test date. Mentally plan on studying about 3-4 days/week for about 15-30 minutes for a total of 6-8 weeks.
Keep in mind, there isn’t a hard and fast rule about the two-month timeline. She makes a point of asking students who passed the CCRN® after her course (which is most of them!) about their keys for success, and most say that it’s important not to wait too long to sit for the exam. Many say no more than two months is best.
When I sat for mine back in 2015, I spread my study plan out over three months and definitely would have tested earlier if I could do it all over again.
A marathon versus a sprint
Two months doesn’t sound like a ton of time, but it really is when you’re dedicating 3-4 days a week of studying that is highly focused for 15-30 minutes.
Once you decide on your timeline and review course, Nicole highly recommends not looking at a textbook from that point forward. She advises nurses to soak up the course, get clarification on topics that are unclear, and then stick to practice questions during study time from that point forward.
Use your focused study time of 15-30 to be 100% productive and distraction-free. Thirty minutes of focused time going over practice questions, reading rationales, and taking notes is significantly more valuable and productive than three hours with Netflix streaming in the background and refreshing your Instagram stories every 10 minutes.
Think of it like you’re training for a marathon; you don’t cram or try to do everything for extended periods of time the week before. Putting in consistent focused time beginning two months before your test date is a wise training schedule.
Two weeks before test day
Nicole advises ramping up your studying two weeks before your test date. She recommends doing a minimum of 50 practice questions in a row about 2-3 times. The reason for this recommendation is that we’re not used to sitting for long periods of time, and rapid-fire answering question after question. Nicole says, “We run around a shift for 12-hours, so the mental aerobics really help train you to sit and repeatedly answer questions without losing focus and getting antsy”.
The week prior to the exam, Nicole advises sitting for two full practice tests (she includes 100 practice questions in her live course and three full practice tests with rationales in both of her books). This again gets your brain and body trained for the long haul of sitting and focused for an extended period of time. Plan for these practice tests to take around 90 minutes.
Don’t study or cram the day of the test. It really just makes anxiety worse.
Think of it again like a marathon. On race day or the night before, you don’t try to get 10-20 miles in at the last minute. You rest, relax, and give your brain and body a break.
Sample CCRN® exam study plan download
If all of that was a lot to keep straight in your brain, no worries – I’ve got your back. I created a free sample study plan that takes the above information and plugs it into a calendar so you can see how to plan your time appropriately.
You can easily move days of the week around to accommodate your work schedule. Work three days, study three days, and have a day off!
When to consider moving your test date
Nicole noted that if you’re not scoring at least 60-65% consistently on practice exams, you might not be ready to test. Additionally, if you’re missing a lot on cardiac or respiratory, you may need to push the test back. Those two areas make up a huge aspect of the exam, you want to know you’ve got those down.
Also, Nicole wisely advises that if your life outside of work is chaotic, it may not be the best time to sit for the exam. Life happens, so if some unplanned event occurs (death in the family, sudden illness, a major financial issue, or whatever it may be) and you now don’t have the time to study, do what you need to do. However, don’t push it back lightly – especially if you’ve invested in a review course. If you’re going to push it back, you should have a really good reason.
Conquering test anxiety
Yea, we’ve all got that! Now, how do we conquer it?
One of the most powerful things you can do when dealing with test anxiety is accepting it. Don’t do that thing we tend to do as humans and pretend like something isn’t a big deal when it actually is.
Even though it’d be nice to walk into an exam and destroy it, it’s okay that something that you’ve invested time and money into makes you nervous. We don’t need to pretend that it doesn’t or try to save face. When we deny our natural human emotional response and attempt to fight the battle silently, we are facilitating our own demise. We isolate ourselves from the very support we need from those around us as we pretend to be
Give yourself permission to fully experience the emotions and vulnerability that comes along with setting a goal and working towards it.
Our knee-jerk reaction to feeling inadequate, scared, intimidated, or vulnerable can be to deny it, buck up, and put on a brave face and pretend everything is fine.
Don’t do it! Acknowledge and embrace the insecurities. Objectively observe them, and allow the feelings to pass as you dig into the study.
Remember, just because you feel inadequate doesn’t mean you are.
Just because you feel anxious doesn’t mean you can’t pass the test.
Our thoughts and feelings are not who we are. Emotional objectivity is a powerful tool, especially when we take on new challenges.
And remember, this isn’t the NCLEX®. Your job doesn’t depend on it. The worst-case scenario is re-taking the exam. While you might be out some cash, it’s nothing like what you spent on NCLEX® and NCLEX® reviews most likely. You’re guaranteed to get 150 questions and it’s not a computer adaptive exam.
When and if those fears and doubts begin to creep up as you prepare, actively respond to them with intention and remind yourself of the truth: You can do this. You are becoming a better nurse simply by studying for this. It means nothing about you who you are as a person if you need to retake the exam.
Practical ways to reduce anxiety
Fear of the unknown is also a major factor and doing what you can to reduce that will also make a considerable difference. Familiarize yourself with the testing site and how to get there.
Nicole recommends showing up thirty minutes early to the exam and said that they lock the doors after ten minutes. If you’re late, you’re out of luck and must reschedule. You can always arrive early and hang out in your car until the appropriate time to come in. (That’d be a great time for some breathing exercises and calming music, like this song which has been shown to significantly reduce anxiety.)
Nicole added, “Also make sure you know the dos/don’t of the testing site. A major mistake I made was showing up in a cami and a hoodie because I wanted to be comfortable. I didn’t realize I couldn’t wear a hoodie in the testing area. My option was to either forfeit the exam or sit in a tiny tank top and freeze for 90 minutes.”
You also can’t take anything with you into the testing room except for your car keys and identification. They give you a bag to lock your things in, including your phone which must be off. If your phone goes off at all during the testing time, you fail.
The clock to take the exam does not begin until you start it. You can sit there at the desk for 10 minutes beforehand if you want to. If you’re nervous, Nicole recommends a brain dump on the piece of paper supplied by the testing site.
Every person gets one scratch piece of paper to use when they sit the exam supplied by the testing site. If there are lab values you are stressing on remembering, or some other important pieces of information you don’t want to forget, write them all down on the piece of paper (a brain dump) as soon as you sit down. Then, you can refer to it if/when you need it and aren’t trying to keep that information fresh in your head as you navigate questions on various unrelated topics.
How many people have to take the test again?
Now, for those reading this that want to know how many people really do pass this exam, I’ve got some stats for you.
According to the American Association of Critical-Care Nurses (the people who write the exam), in 2018 77.3% pass the adult CCRN® on the first time. Essentially, 3 out of every 4 who sit for the exam pass. And if you’re taking a review course and have an active study plan you are setting yourself up for success.
The people who don’t pass
Rarely does Nicole encounter nurses who take her review course and don’t pass. However, if that happens she always follows up to learn more. She said, “Whenever someone comes to me and says they didn’t pass my first question isn’t ‘Did you change any answers?’ It’s, ‘How many answers did you change?’ Our nurse gut-instinct is powerful, and most often the first answer we go with is the right one. When you start second-guessing yourself and changing your answers, that’s when you can get yourself into trouble.”
Another reason people may not pass the first time is life happens and prevents the study plan from being executed. I get it… kids get sick, jobs change, furnaces break and OT shifts get picked up, etc. Or maybe something happened shortly before the exam that pulled you into a really tough headspace. If my long-term boyfriend and I broke up, my mom got a cancer diagnosis, or a friend was in a horrific car accident the night before the exam, I think it’d be tough for me to focus.
Life happens, and if you need to adjust to set yourself up for success – do what’s truly best for you and don’t try to tough it out against your better judgment.
Nicole notes that those who don’t pass almost always re-registered and pass the second time.
Nicole’s review course
I asked Nicole specifically about the course she created to help nurses pass the CCRN® (she has other courses for different certifications as well) and what makes hers different.
Nicole says, “I was very deliberate. I’m a CNS and teaching a review course is not something a CNS generally does. However, several years ago I was an assistant manager and we were going for Beacon and we needed to get people certified, and decided to create an internal course. I taught a few sections of it and realized that I got so much joy out of seeing light bulbs go off in nurse’s heads. It brought me so much joy to see that. I started speaking on cardiac arrest and sepsis, and I was asked to teach half a course and kept getting review course requests and ultimately decided to make my own. One of the reasons this does bring me so much joy is that this is different from the NCLEX®, which is something we all have to do. Nurses who sign up for certification review courses want to be there and it is so enjoyable teaching them.
As a certified nurse, I personally checked out her course and books and was really impressed. It’s concise yet impactful (which is right up my FreshRN alley!).
The American Association of Critical Care Nurses has a test blueprint for the exam (which can be found on pages 15-18 of this document). Nicole’s review course follows it precisely so you know you’re getting the information you need and not being bogged down learning information that won’t be on the exam.
I appreciate Nicole’s devotion to brevity because we tend to think more is always better… but when you’re talking about learning information to pass an exam, it’s not helpful to learn and study things that you won’t be tested on. Why waste your cognitive space on learning incredibly complex things that are not going to be on the exam?
If there are disease states you can’t pronounce or never heard of, it’s not on the exam.
I had that problem when I reviewed back in 2015 for the CCRN®. I bought a textbook that way WAY too detailed, high-level, and technical. It was so difficult to engage in meaningful learning and really comprehend the topics because there was an exorbitant amount of unnecessary and irrelevant details.
One thing to keep in mind about this review course (and all certification review courses) is that that they truly are reviews. They are not a “learning it for the first time” kind of situation. If you need help with basics, never fear. I’ve got your back with my and my .
The bottom (isoelectric) line
If you are considering sitting for the CCRN®, you may hear some discouraging comments from colleagues who say things like, “I don’t get why you’re doing that. It won’t help you at all.”
At the end of the day, when you decide to do this, Nicole closes by saying, “You will go on a journey of studying and educating yourself. Your knowledge is going to increase. A knowledgeable nurse can simply better advocate for their patient. I’ve been on the family side and the nurse side, and to be honest I want to have a nurse who demonstrates their knowledge. I want a nurse who understands and get things and shows a desire to further their professional development by dedicating time and effort towards achieving certification.”
Remember, the worst thing that can happen is you have to re-sit. You won’t lose your job. You will still have gained knowledge in the process.
Learn more about Nicole’s certification resources
Nicole has a plethora of online CCRN® review material, as well as resources for the CMC, CSC, and PCCN. To check out all of Nicole’s products, click here.
As far as CCRN® prep, you can purchase individual books, the online course, or bundle and save. If you just want the books, you can get a bundle of both and save $10. You can purchase the standalone online course, or bundle it with both books and save $20!
If you’d like to check out Nicole’s list of latest in-person reviews that are a fast-paced 2-day course, click here.
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More resources for the Critical Care Nursing Certification