ICU Straight outta school?

mrsboots87 · Jul 8, 2014

Make connections now during clinical. It is hard enough for a new grad to get ajob right out of school, let akone a hospital job. Soecialties within the hospital are even harder to get. Dont give up, and definitely try to get an ICU new grad job because they are available. Just don't get your hopes up and make a backup plan. You may need to get a year or 2 under your belt before you get into ICU. You may get lucky and it take less time. But the best thing you can do now is use every clinical day like its a job interview and oerform your best. Try to network. Maybe get a CNA or tech job in a hospital so they can see how you work. GL

tmac19 · Jul 8, 2014

I would say that it is possible to get an ICU job right out of nursing school, simply because I have seen it done in the hospital I used to work at. However, I would say that most hospitals would not hire new grads for ICU simply because the learning curve is incredibly steep.

I think that many need that time in some sort of med/surg environment first, to solidify skills in an environment with more support and somewhat less stress. I don't know your particular level of experience as an EMT, but for example, being confidant with inserting NG tubes, managing PICC lines, inserting IVs, inserting foleys, dealing with a CODE situation, etc... are all things that will be so helpful to be experienced with before also learning the additional the skills that go along with ICU nursing. There is so much experiential knowledge that you can gain in med/surg units that is so foundational for anything you go on to pursue later on.

Having said that, every nurse is different. You know what you want, and you need to follow your heart and put in the work to get where you want to go. I'm sure you will get there!

DisneyNurseGal, BSN, RN · Jul 8, 2014

At my hospital, without prior nursing experience, we had to get hired on through the residency program. In my program, one girl was hired direct to the ICU (she too had EMT experience). I won't say whether this was a good idea or bad idea, but I will say that she was floated to my floor the other night, she could not handle 6 patients on a med surg floor. Four of us ended up taking a 7th patient because she could not handle more than her usual two.

Now, not saying that you would do the same thing, but here is my my thought. Working non-ICU unit would give you a great foundation to transition to ICU. My life long dream is not to work on the Med-Surg/Oncology Floor that I am working on now, but I am getting invaluable experience that I believe will help me in my future goals. Not saying that you can't get this experience on the ICU; however, the more narrow your [early] experiences are, the less exposed you are to what else is out there. You think it is easier to start with 6 patients and then move to do 2 patients in the ICU or the other way around?

That being said, you have to follow your dreams. No one can decide your path. Take the advice that people are giving you and only you can chart your course; but, one of the best parts of nursing is that if you don't like something you can always move on to another experience.

Good luck to you!

Hobberdog · Jul 9, 2014

It is possible, but difficult. You may have to travel to get the experience needed to go to CRNA school. Your grades matter. Keep them high. The hardest part for me was finding an "in". I graduated in May and was just hired at a Trauma 1 center into the trauma/surgical ICU. This is my first nursing job. I got the interview because I was shameless about telling everyone I knew about where I wanted to work and how it is so hard to find an ICU job as a new grad. I found a friend who knew someone at the hospital who was pretty high up on the food chain. I was asked to interview for an ICU position because of that connection. Keep your head up and work hard. Also, don't mention to anyone that your goal is CRNA school. They won't hire you if you are already planning on leaving.

applesxoranges, BSN, RN · Jul 9, 2014

See if it has to be a trauma center for your grad school. I was hired right into an ICU but I hated it so I switched over to an ER at a different hospital. I'm loving it on a different level than when I was in an ICU.

ChristineN, BSN, RN · Jul 9, 2014

At my hospital, without prior nursing experience, we had to get hired on through the residency program. In my program, one girl was hired direct to the ICU (she too had EMT experience). I won't say whether this was a good idea or bad idea, but I will say that she was floated to my floor the other night, she could not handle 6 patients on a med surg floor. Four of us ended up taking a 7th patient because she could not handle more than her usual two.
Now, not saying that you would do the same thing, but here is my my thought. Working non-ICU unit would give you a great foundation to transition to ICU. My life long dream is not to work on the Med-Surg/Oncology Floor that I am working on now, but I am getting invaluable experience that I believe will help me in my future goals. Not saying that you can't get this experience on the ICU; however, the more narrow your [early] experiences are, the less exposed you are to what else is out there. You think it is easier to start with 6 patients and then move to do 2 patients in the ICU or the other way around?
That being said, you have to follow your dreams. No one can decide your path. Take the advice that people are giving you and only you can chart your course; but, one of the best parts of nursing is that if you don't like something you can always move on to another experience.
Good luck to you!

Most ICU nurses, even the most experienced would struggle with a Med-Surg assignment. It is not what they are used to. My hospital has a policy that ICU nurses that float to Med-Surg can only have a max of 3 pts. This is much safer for them since they are not used to juggling 4+ pts a shift

HouTx, BSN, MSN, EdD · Jul 9, 2014

It is certainly possible to begin your nursing career in a specialty unit - many of us have done this. My first job was in a neuro-trauma unit. Chances are, that any type of specialty department that hires new grads already has an established process for handling them. There are a couple of key factors. First of all, the new grad needs to have the right type of personality for that environment; e.g., a shy, timid person is probably not ever going to feel comfortable in a typical ICU or high level ED... s/he would just be trampled underfoot. The other critical factor - is the level of support available. There needs to be a qualified preceptor who is competent to deal with the new grad transition process. There needs to be sufficient infrastructure (including adequate permanent staff) to prevent the new grad from being forced into functioning independently due to insufficient staff.

The length of the transition program (orientation, residency, etc) is not as important because 'completion' should be measured by outcomes, not by hours. The time needed to accomplish the pre-determined development goals can vary a lot.

Also wanted to clarify.. EMTs are trained as first responders... very different scope of practice than nursing. Some technical skills such as IV starts or airway placement are the same, but many EMT skills are just not relevant, even in an ED environment. In my state, licensed first-responders are classified as "Unlicensed Assistive Personnel" in a hospital setting.

PMFB-RN, RN · Jul 10, 2014

Where I work pretty much only new grads are hired into the ICU. They are hired into a 9 months critical care nurse residency program designed for new grads. Its very intense.

Mostly likely if you find an ICU willing to train a new grad they are going to ask for a contract for 2 or 3 years after they train you.

I warn you though, you will be pretty much useless to the ICU for the first year. Nurse managers are on the look out for people like you who want to accept a lot of valuable and expensive training just to dump the unit as soon as you are eligible for CRNA school. Being honest about your intensions will make it nearly impossible to get hired into an ICU, and lying about your intentions makes you, well, a liar.

PMFB-RN, RN · Jul 10, 2014

Also, don't mention to anyone that your goal is CRNA school. They won't hire you if you are already planning on leaving.

This is very good advice. I have known SICU managers to go so far as to contact nursing school instructors and ask them if the candidate has ever expressed an interest in CRNA school, and even trolling your facebook and AN profiles so see if you ever mention it.

PMFB-RN, RN · Jul 10, 2014

In my program, one girl was hired direct to the ICU (she too had EMT experience). I won't say whether this was a good idea or bad idea, but I will say that she was floated to my floor the other night, she could not handle 6 patients on a med surg floor. Four of us ended up taking a 7th patient because she could not handle more than her usual two.

Of course she couldn't! That was totally unreasonable to expect her to be able to handle that kind of patient load. Just as unreasonable as expecting a med-surg nurse to float to ICU and be assigned the two sickest patients on the floor.

Lucky for me I have never worked in a hospital that had so little regard for their nurses as to float them to a totally different specialty unit and expect them to preform like a nurse who is trained and experienced in that unit.

Do you have to float to L&D or NICU and take a full assignment? How would you feel if you were expected to do so?

WalterWho · Jul 12, 2014

Thanks everyone for all the great replies! I am aware that EMTs and RNs have very different scopes of practice, I was simply hoping that my experience as one would illustrate my ability to handle high stress situations. My wife is a nurse, and she has worked at the hospital that I am hoping to be hired on at. I'm hoping my connections through her and my clinical experience with these same connections will allow me get into the ICU relatively painlessly. She seems to think that I wouldn't have any problem with getting directly on a specialty unit, but I was and am still somewhat dubious. The over all reason I am asking this is because I'd like to get at least a slight idea of how much money I should be putting away each month to help pay for living expenses if I become a full time student... once again.... Again, thank you so much for responding! All of your responses were very helpful and enlightening.