I started as a new grad RN in the CV-ICU in a large university hospital. At the time it was a little easier for new grads to get hired in the ICU, but now with economy market and all, I'm hearing it's difficult for a new grad to get hired on any unit. I know that for new grads to get hired straight to the ICU it looks good if you have some kind of nursing exposure to the ICU- whether it was a clinical rotation, extern, nurse aid, or tech. You definately want to mention that in your resume & cover letter. Also, whoever writes your recommendation letters can mention why they think you would be great candidate for the ICU. Larger university hospitals are more likely to higher new grads into the ICU than smaller community ones. So if there's none around your area, maybe think about if your willing to relocate to work in a CV-ICU. Search multiple hospitals and apply everywhere, but just make sure it specifically says "open to new grads" (a lot of openings say "experience required"- don't bother with those) If you find an opening, make sure you keep following up with the recruiter- this can sound annoying, but trust me persistance is key! If you can't find any openings, maybe consider working in the stepdown CV floor/intermediate care unit. This is where the CV-ICU patients are transferred after, and you will get good experience. You are more likely to get hired there and can transfer to the CV-ICU after 6 months to a year if there's a position available. Well I hope this information is helpful, feel free to message me if you have any other questions, I am glad to help. Best of luck in your search!