new grads in icu

  1. Hi everybody,
    I graduate from an ADN program in December. My goal is to be a CRNA. Logically, my next step would be to obtain my BSN while working in ICU. The thing is, I have heard some negative things about new grads starting in ICU (including form some of my instructors). How does everyone feel about this? I know it will be tough and I will need to study and work very hard to learn everything I need to know to be a excellent ICU nurse. I am a good student, I have a 3.9 GPA. My biggest problem is that I tend to doubt myself/low self confidence To be honest ICU scares me. Do you think I should start in Med-surg or a stepdown unit like some people suggest, or would it be a waste of time, since I ultimitly need/want to work in ICU. What have some of your experiences been as new grads in ICU? Any advise would be totally appreciated.
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  2. 14 Comments

  3. by   WntrMute2
    So I'll shut up for a while after this. I and some friends went directly to the ICU and loved it. Go directly to the ICU do not stop at the floor. No, run to the ICU. The floor and ICU require vastly different skills and unfortunatly it is difficult to change gears as my orientees have told me. The floor forces you to do the minimum due to the pt load while the ICU forces the opposite. ICU nurses "tend' to be more aggresive about seeking out orders, interventions, things like that, while the floor's workload means that the less needs to be done the better. I am NOT denegrating floor nurses, I never could manage/balance that number of patients but there is a difference in what you need to know/do. Yes there are some skills to learn on the floor but you'll get those skills in the ICU. There is nothing you'll need in anesthesia school that can only be gotten on the floor. The only one lacking may be IV starts if you come from a place where most pts are so sick central access was the rule. There is no good reason to do floor nursing first, I believe that instructors and other nurses tell us new grads that is to perpetuate the "work up from the bottom" mentality. Most nurses did it that way so they believe that's what you should do. DO NOT BELIEVE IT!!!
  4. by   Qwiigley
    I have to agree Dave. Iris Mae you don't have your locator filled in. Where are you? In the Los Angeles area you can apply to critical care depts as a new grad, and most teaching institutions have a new grad program. I would suggest to try for high acuity. Good Luck!
  5. by   alansmith52
    I agree. also. go strait to the ICU., I did not I worked on the floor. but that was a diffrent time. If you don't work in the ICU some UAP will
    matt
  6. by   kmchugh
    I went straight to the ICU on graduation. As I've said before, the skills you learn in patient assessment, time management, etc are completely different from those required on the floor. I really believe going to "the floor" first is a waste of time. Besides, the longer you are in the ICU, the more you will learn.

    Kevin McHugh, CRNA
  7. by   rebelwaclause
    Normally, Id maintain for a new grad to go to med-surg to develop skills and connect the theory that is in your brain to the actual everyday nursing. But in reading the above posts, maybe it is better to roll up your sleeves and get to learning.

    Apply for a new grad orientation at the facility you hope to work at. The longer the training weeks they afford you, the better. Pick your preceptor's brain and ask questions galore.

    ....And good luck! They need you in ICU/CCU/NICU!
  8. by   Brenna's Dad
    I also agree with everyone else on this topic. You do not need to go to the floor. The reason your instructors tell you this to to perpetuate the histroical nursing heirarchy. In today's work climate, you should have NO trouble finding an ICU job as a new grad, especially with a 3.9.
  9. by   smogmatt
    As a new ADN grad as of May 02 and having moved right in to ICU I agree with the above. I worked as a LPN as I was finishing my RN I worked on the Medical floor. I believe as the others IT IS TOTALLY DIFFERENT TYPES OF NURSING!!! get into the icu

    I would say go for it!! if you don't have committement to stay in one place there are tons of jobs out there for new grads in the ICU. I interviewed 6 places, and was offered 6 postions. its not an issue of if you can get into an icu its which one to go to!!

    good luck you'll do great

    Matt
  10. by   irismae
    Thanks for your support, you guys are awesome. I hoped you would say go right to ICU, based on what I have seen from school clinicals, I do not think I would like med/surg nursing- I always feel like I am forgetting or neglecting someone. I just want to get the best experience so I can be an awesome nurse and if that means soing med/surg first then I will. but, since you say it is not neccessary Yay for me!

    Qwiigley, As a matter of fact I am located about 30 minutes from Los Angeles. Do you recommend any hospitals with good orientation programs or just good teaching hospitals in general. I want to learn, learn, learn. I was kind of thinking of USC university hosp, UCLA, or UCI.

    Iris
    :roll
  11. by   traumarns
    if icu is where you want to practice. GO FOR IT.

    I worked neurosurge, then er as an lpn.
    went straight to icu as a new grad rn. let me tell you, no matter how many years of med surge you have prior to going to icu, you have to relearn just about everything, including how you think, and organize and prioritize your time.

    there is very little difference in the training new grad rns get, and transfering med surge rns received with their icu training, in the hospital i work. new grads get a bit more time with a preceptor.
    everybody has to go to the critical care class, and basic ekg/rhythm class. we are supposed to go to a cardiac pharma class, but that has not been offered since i started.

    good luck to you!!!!
  12. by   whipping girl in 07
    I started in ICU straight out of nursing school nearly a year ago, and I don't regret it a bit. In fact, due to some "creative recruiting" on the part of the nurse mgr of our ICU and cardiac step-down unit, several nurses that I graduated with were told that they'd get into ICU within a year if they started on stepdown. Guess what happened? Many, many nurses on step-down quit, and the mgr decided she wasn't going to use stepdown as a training ground for ICU. So my classmates who expected to be in ICU within a year won't be getting there unless they quit and go to a different hospital. Pitiful, isn't it?

    When I was interviewing I did not make the mistake of expressing any interest in stepdown, and I was offered a position in ICU. I was initially nervous, but I got a great orientation and the nurses I work with are always willing to teach if you want to learn.

    Also, if you start as a grad nurse, you get a longer orientation, 12 weeks vs. 4-6 for an experienced nurse (no matter how pertinent the experience is). And I never got pulled out of orientation for the day because we were short (something that happened to nearly all the experienced nurses who were in orientation).

    I personally don't think doing floor work first will make you any better in ICU. They are just not the same. And as for time management?! That can be learned anywhere. I learned excellent time management skills waiting tables and raising a child while attending nursing school!
  13. by   RENAISSANCE RN
    Hi,

    I was wondering what qualities make a good ICU nurse? I find this work facinating and I think it would be for me. I have felt this way since my grandmother was hit by a car and placed into the icu. The icu nurses are unbelievable...
  14. by   AL bug
    IMHO... a good ICU nurse is able to manage crisis without freaking out, organize and prioritize tasks, think critically and seek information to the rationale of treatments (this makes you smarter), communicate intelligently with physicians but still be able to communicate with families of all educational backgrounds, show compassion to the patients and do for them what makes them more comfortable even when they are out of it and won't remember that you did it sometimes (drugs), and still have a sense of humor to not go crazy actually caring about all these strangers you have poured your life into for the last 12 hrs.

    Hope all that made sense. I loved the atmosphere of the ICU, but got dissatisfied with the grunt work. You can never imagine how much you can learn from it until you go there. I felt I am capable of making a bigger contribution to healthcare and to the patients through anesthsia and so far I am enjoying it.

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