How do I become a critical care nurse?

As a new grad starting next month on a critical care floor I can add my two cents on a few of your questions, but obviously defer the floor to the more experienced nurses here.

-Getting a job in critical care.- Oh boy, so many variables! First off, some hospitals WILL NOT HIRE NEW GRADS into the ICU, they will make them work a year or more in another area of the hospital first to make sure they have some basic nursing skills under their belt. Furthermore some hospitals DO NOT HIRE NEW GRADS PERIOD! If this is the case, you will need to get a job in a LTC (long term care) facility (i.e. nursing home) for a number of months before you can even step foot in a hospital... to work for a year before they will let you into their ICU.
This all seemed like a sucky deal to me, so the summer before I started nursing school (2007) I got a job as a CNA (certified nurse assistant) in the only place that would hire me... a nursing home, worked there for about 3 months, got a job as a CNA in a hospital on a med/surg floor and worked there for about 7 months before I found a job in another hospital as a CNA in the ICU. I worked there from 7/5/08 to TODAY and treated every day like it was an interview for a new-grad position. I also treated it as an opportunity to get sweaty and bloody and ask tons of questions to the RNs to make sure I knew as best I could what I was getting into. I also tried to always be on the good side of my nursing instructors (some call it brown noseing, others call it getting the job) and was able to score an internship in the ICU. Anyway, I interviewed last March and got the job in the ICU, while +- half of the rest of my class didn't even get a job offer anywhere.

-Cardiac ICU vs Med/Surg ICU- I originally accepted the job offer to go to a brand new CVICU and asked to be floated down there as a CNA. What I found was that it was going to be at least a year before I was going to take care of the true ICU level patients there. There was a major back log of RNs being trained to recover the fresh open hearts and I was going to be put at the end of that line. I decided to go back with my hat in hand to my manager and ask for a position on the med/surg ICU. There I will still have to wait a while before caring for really sick patients (THIS IS A GOOD THING by the way), it will just not be quite as long as the CVICU.

To sum it up- find out who hires new grads and start now doing everything you can to land the job! Ask lots of questions, get as much experience as you can. For a long time I was that anoying kid who always ran to the front of the line to do CPR, help out with central line insertions, do blood runs, take bodies to the morgue, anything I could to thicken my skin.

I didn't work as a tech during nursing school... but i got my ACLS, PALS, and EMT-Basic done while in nursing school. Volunteered a ton and emphasized my crisis counseling background, humility and the sponge-ness of my brain during the interview. I too am a lucky new grad going into the MICU. I was also lucky because the ICU that I applied at is full of travelers. The manager and the core staff really wanted to get some permanent people in there and thankfully, my manager is open to GNs in the ICU, I am under the impression that many of the staff are not No problem, I will work hard to prove to them that I deserve to be there

Good luck!

I think you would be hard pressed to find any hospital that would hire you out of school into a ICU/CCU position. Most larger hospitals have a critical care internship program, but it requires you to have some general nursing experience.

I am just finishing up a RN refresher course after being out of the field for about 5 years. I expect to be able to get a job in a local hospital ICU/CCU though. The reason being, I have 23.5 years of ICU/CCU experience in high profile full service ICU's.

Not true - many many hospitals hire new grad nurses. I don't necessarily agree with it, although I did it many moons ago (4 months in orthopedic surgical ward then to ICU. It's really sink or swim when you go right into critical care from school. I loved it, several of my contemporaries didn't cope. I did have 3-4yrs experience as an aide at a nursing home by then and strong basic nursing skills. I strongly suggest getting a good background in time management and nursing skills before trying critical care.

I have loved it since i started. Specialized in CTICU after a year and never left the specialty.

I am getting the impression that since many hospitals are not hiring as many numbers of nurses at present, they will give preference to those with a lot of experience since they will not have to train them as much, etc.

What do you mean..."Not true - many many hospitals hire new grad nurses"...... That comment makes no sense.I have worked in Arizona, California, and Washington state....no hospitals there will hire new grads. straight into ICU.

I start at baptist on August 17th. Another GN friend of mine told me about the place. Myself and 2 of my friends were hired on, all with offers for full time critical care. We all just graduated in May and no, there isn't a special internship, there is a 13 week preceptorship and then you gotta start swimming on your own.

Sorry not trying to be critically contradictory, just my experience.

Good for you! If this hospital cares about you and your performance in ICU in this way, I assure you the preceptorship will be done very well or it better. Now is when you really start learning! There is an old saying that when you start a job out of school, you find out how little you know. This is especially true
in critical care. Please don't misunderstand me. I am not trying to scare you. I really hope you love it. :0) It is awesome work!