How do I become a critical care nurse? - page 5

by mark1973

102,873 Views | 52 Comments

I would appreciate feedback from anybody working in critical care. My questions are: -What does a critical care nurse do? -Can you get a job working as a critical care nurse right out of nursing school? -If you... Read More


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    Quote from fmf corpsman
    i know this is going to sound offensive to many of you new grads and there's really no way around it, but i've never been a strong believer in political correctness. i say what i have to say and let the chips fall where they may, but at least hear me out. the only reason any of you new grads are even being considered for specialty units directly out of school, is because of the nursing shortage.
    *** first there is no nursing shortage and there has never been one in the 18 years or so i have been a nurse. the "nursing shortage" is only self serving propaganda put out by those who stand to gain financialy from a glut of nurses. second that's actually not the case, well maybe for some hospitals. other hospitals have discovered they prefer to have properly trained new grads in icus. one hospital i work for actually prefers new grads and continues to hire them into it's icus even though there is no nursing shortage and many experienced med-surg nurses (from other hospitals) apply. they have a 7 month nurse residency program followed by a mentorship program for new grads. we get nurses who are trained the way we want them trained and with fewer bad habbits. applications from experienced med-surg nurses are not considered. only applications form new grads and experienced icu nurses are considered for hiring.
    Last edit by PMFB-RN on Jul 28, '12 : Reason: wanted to add
    kpmiller likes this.
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    Quote from missalfie1
    "Quote from ghillbert .

    *** I work in a large 26 bed SICU and we pretty much only hire new grads. Of course we will hire experienced ICU nurses but almost never do they hire med-surg nurses. We have a 7 month nurse residency program for new grads going into the SICU. In my opinion med-surg experience is not very helpful for ICU nurses. "


    what hospital do you work at. i am in nyc
    *** I work in two hospitals. One in Minnesota full time and another in Wisconsin part time. Also work per-diem in several other hospitals.
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    Quote from pmfb-rn
    *** first there is no nursing shortage and there has never been one in the 18 years or so i have been a nurse. the "nursing shortage" is only self serving propaganda put out by those who stand to gain financialy from a glut of nurses. second that's actually not the case, well maybe for some hospitals. other hospitals have discovered they prefer to have properly trained new grads in icus. one hospital i work for actually prefers new grads and continues to hire them into it's icus even though there is no nursing shortage and many experienced med-surg nurses (from other hospitals) apply. they have a 7 month nurse residency program followed by a mentorship program for new grads. we get nurses who are trained the way we want them trained and with fewer bad habbits. applications from experienced med-surg nurses are not considered. only applications form new grads and experienced icu nurses are considered for hiring.

    thanks for your reply. first, i'm not certain what area of the country you work in and that is an important consideration, and secondly, i admit i have been retired for a few years so my information could be a little bit rusty. there is still a nursing shortage in certain parts of the country and it isn't just self-serving propaganda for financial gain. i also couldn't know what nurses in your area are paid and that too is a fairly wide variable across the country. when i made my statement about new grads and specialty units, i was referring to them coming out one door and marching right in the other, as some blogger made it sound and as i have seen practiced in some areas and it was an utter failure, dangerous and deadly for the patients and completely unfair to the nurses. all it did was set them up to fail, as they were unprepared for the challenges. it also obviously opened the facility to litigation and cost several people their jobs. (i wasn't one of them) it also made the hospital terribly gun-shy about who they hired for there specialty units for quite some time, but eventually they too went to hiring new rn's and even lpn's with a years experience, but only after a 10 month critical care program, acls certification. they had to prove they were proficient on 12-lead ekgs, all of the hemodynamic drugs etc, run a mock code, standing on their head, lol. it was pretty grueling. then after that, they had a preceptor for 2 months. my hospital didn't restrict med-surg nurses from applying for the units, but they had to have a 2 sponsors from the unit they were applying to, but they had to be vetted of sorts, references, old nursing evals reviewed, supv, interviewed etc., and then go through the same the same 10/2 month course everyone else went through. all in all, a much better program than we used to have in place, and much better nurses as well.
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    thanks for your reply. first, i'm not certain what area of the country you work in and that is an important consideration,

    *** currently i work in the upper midwest. wisconsin and minnesota. i live and practice in a very rural area of wisconsin and also super commute to minneapolis for my other job as rapid response nurse for a large hospital. i have worked as a staff rn in 4 states, wi, mn, ca, & or. i have worked as a travel nurse in a half dozen other states, including some very rural areas. being an avid hunter and fisherman i have alwasy looked for rural areas to work. at the same time i really thrive on trauma, er, cvicu, etc so have worked in some large medical centers.

    and secondly, i admit i have been retired for a few years so my information could be a little bit rusty. there is still a nursing shortage in certain parts of the country and it isn't just self-serving propaganda for financial gain.

    *** we are inundated with false and self serving "nursing shortage" propaganda. this false propaganda is put out by those who stand to gain financialy from a glut of nurses. while it may be true that there are areas of the county where there are a variety of nursing jobs open, like for example in the very rural critical access hospitals near where i live, this is not evidence of a nursing shortage. when one looks at the number of lisenced rns in my state there are more than enough to fill every rn position several times over, obviously some of those are travelers, or retired, but still there are plenty. rather i think those open positions are evidence of the poor pay and working conditions being offered. the local economy hasn't been as hard hit as other areas of trhe county and people here may have more non nursing oppertinities available.

    i also couldn't know what nurses in your area are paid and that too is a fairly wide variable across the country. when i made my statement about new grads and specialty units, i was referring to them coming out one door and marching right in the other, as some blogger made it sound and as i have seen practiced in some areas and it was an utter failure, dangerous and deadly for the patients and completely unfair to the nurses.


    *** yes of course. that is a very different situation than what i was talking about. throwing new grads to the wolves of icu without great training and preperation is almost criminal imo. i was refering to those hospitals who, after careful consideration, have implamented real training programs developed to take nurses from grads to competent entry level icu rns. this involves not only structured training but follow on support of the new nurse through a mentorship program. i am a graduate of and now instructor in just such a program and it works very well. not everybody makes it, but those that do are well prepared.

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    believe it or not, here in florida we still suffer from a lack of qualified nurses. for awhile it looked as if there was going to be a glut of nurses, but then it just sort of petered out, and the economy seemed to drive people to other parts of the country. we have been hit very hard in the housing market and many, many people lost their homes to foreclosure. those who had no other reason to stay, moved away. florida and the other southern states have never been known to pay very well to begin with and with the economy in the toilet, you can imagine where we've gone. hopefully things will begin improve shortly and maybe wages will start to go up. all of this has done terrible things to all aspects of healthcare from the floor nurses to home health. medicare reimbursement has been cut and the number of allowable visits is dwindling. the face of health care is changing, as we know it. if obamacare survives, things will be different than they have ever been before. that should make for an interesting conversation or two.

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    Quote from fmf corpsman
    believe it or not, here in florida we still suffer from a lack of qualified nurses.
    *** oh i have no trouble at all beliveing that. florida has such a terrable reputation as a place for nurses to work. it's widely known (or people think they know) that nurses in florida are over worked, underpaid, and disrespected.
    i can name 5 nurses off the top of my head who were either trained in florida, or for one reason or another ended up working there who fled the moment it was possible for them. an aquantence of mine who owns and runs a small travel nurse agency tells me he has such a hard time filling florida positions he's cut back on his contracts there. i ask why "nobody wants to work there and the pay isn't there".
    nope i don't have any trouble believing it.
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    As a critical care nurse for a few years now, even I have a hard time answering this question because we do it all. Post-ops, dealing with doctors, questioning labs, assisting in inserting emergency lines such as CVPs, hemodynamic monitoring, ventilators, drips (the most dangerous of our jobs is making sure all the drips are right) You really cant screw up or a patient's life is in your hands. As a critical care nurse, you deal with very sick, dying patients and with families also. Your compassion is very much needed in this field.

    yes you can but I personally would not recommend it. As a new graduate, you do not posess the necessary critical thinking to achieve this role this fast.

    Start in a medical surgical floor, gather your clinical experience, critical thinking skills, give yourself a year to learn about the drugs, learn your passion.
    A typical day is never the same. You come in, get your assignment, get report, choose who is more critical and start your assessments. you must check your medications against the orders to make sure you dont mess up..especially drips. some doctors order multiple drugs in one drip and you must be able to make sure they are in the right dosages in a bag. you dont just hang whatever. ORRRR..you come in, two patients are crashing and you dont even have time to check your assignment, you just get the crash cart and spend an hour trying to save one or the other while the dr is yelling. ORRR..you come in, see you only have ONE patient and you smile, then as you sit down to get report, a call comes through that a trauma is coming in 5 minutes and its yours. the room is not ready and you have no time to get report!!!

    In more ways than not, it is rewarding when you see a patient at death's door actually start to get better, and then? you get family who do not appreciate your hard work, co workers who refuse to help, get overwhelmed with so much to do all at once, ect. even as a 6 year critical care nurse, I still get overwhelmed. This is why I strongly suggest giving yourself ONE hear in a med surg floor just gathering your wits, thoughts and skills. Thank you for asking. its important to learn these things.
    FMF Corpsman likes this.
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    I think that is why big teaching hospitals have CC Fellowships or Residencies for new grad nurses. They are selecting the best among candidates that they can train and mold into excellent CC nurses. In the long run, the hospital will save a lot of money. Studies have shown that a quality residency program can reduce turnover rate and increase job satisfaction in general. Retaining these nurses can save the hospital a lot of money.

    I like the fact that they are hiring new grad nurses into CC fellowships/residencies. But then again I'm biased because I am a new grad. But I also understand why some nurses feel like a year or two under your belt is highly encouraged.

    Btw, the CC residency I am hoping to get is a 1 yr program. (which means its a VERY expensive program and they are really investing heavily in these new grads).
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    I graduated, realized the hospitals in my area didn't pay nearly as much as the long term care facilities, and took a charge nurse position at a SNF. I was quickly promoted into management. Then I tried to leave, and they promoted me to director. All of this occurred over the course of 1 year! I have learned all that I feel I can in long term. I interviewed yesterday for both a CVICU and an ICU position. I have ZERO critical care experience. I received formal offers of employment for both positions within an hour of my leaving this hospital. It is a large level 2 trauma center. Go in believing you can do it, don't ******** about your abilities. Know your weaknesses, know your strengths. Be honest about them. Most hospitals are willing to take the time to train a good fit. And don't ever NOT APPLY because you don't think you're qualified. Do it anyway. Can't hurt, and you never know what opportunities may be out there.
    pdlafitz, kpmiller, and FMF Corpsman like this.
  10. 0
    Quote from mark1973
    I would appreciate feedback from anybody working in critical care.

    My questions are:

    -What does a critical care nurse do?

    -Can you get a job working as a critical care nurse right out of nursing school?

    -If you can't become a critical care nursing right out of school, how do you go about getting into critical care?

    -If you are a critical care nurse, how do you like your job?

    -What are your duties? What is a typical day like?

    I'd like to hear from people in different specialties, such as surgical ICU, cardiac critical care, etc.

    Thanks to all the hard-working, underappreciated nurses out there! You rock!

    Mark
    I graduated with a BSN in 1996. Never worked a day of my life as a nurse and have been teaching high school biology for the last 9 years. Took a nurse refresher course two years ago. Passed NCLEX on August 7 of this year and had an ICU job at a 200 bed hospital in Oklahoma within a week. It CAN be done. If this is what you really want, don't give up! =)


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