Objective: To review the history and development of critical care nurses, the supply and demand issues related to critical care nursing, critical care nursing's contribution to patient outcomes, and recommendations to ensure a steady and strong workforce. Data Source and Selection: Information presented in this article is based on a review of past and current literature including international and U.S. government reports, professional publications, monographs, newspapers, and journal articles identified by MEDLINE and CINAHL databases. The Internet was used to contact international and national professional organizations and specialists. Data Extraction and Synthesis: Original and selected review articles and guideline documents were reviewed for references to critical care nurses and their role on the multiprofessional critical care team. Conclusions. Critical care nurses are an essential and vital aspect of the critical care team. Nurses contribute to improved patient outcomes, reduced morbidity and mortality, reduced complications and errors, and reduced overall costs. More than 400,000 nurses practice in critical care, and additional opportunities exist and will develop. The challenge is to ensure an adequate supply of appropriately trained staff.