I will be graduating soon and really want to work in an ICU. Any advice or wisdom on this? Is it a good idea? Critical care is where my interest lies. Please let me know your opinions/experiences.

Lots of ICUs hire new grads. I started out in the ICU, and I'm very glad that I did. The most important thing is that the facility you're starting with has a nice, long, thorough orientation period. We had 6 months with a preceptor, lots of classes, etc. By the time I was done, I felt very ready to take on my own patients.

There are some who will say that a year of med/surg first is absolutely necessary, and I can't argue with their rationale. In my ICU, our new grads usually do very well, but of course there are some who find out they're not cut out for it. I think it really depends on the person.

It does depend on the person, i started immediately in a sicu but I had a few years experience in the hospital as a cna. That definitely helped but isn't necessary. I have a long orientation period about six months a little less with lots of classes and going through multiple units , all nurses I knew on the floors told me it was impossible and i couldn't do it without a year med surg, that just made it more rewarding for me. Be prepared for people to try to tear you down and tell you that you can't do it but if you stick to your goals and stay strong you can work wherever you want ! [emoji4]

You can definitely start in ICU as a new grad. I did and many of my coworkers did as well. My unit is 50/50 in terms of who started as a new grad in ICU vs people with med surg or intermediate/step down experience. You can't tell the difference in the quality of the nurse based on their path to the ICU. New ICU nurses struggle with the same things, no matter the experience. In some ways, the nurses with previous experience seem to struggle more as they have to learn a completely different form of nursing snd time management compared to working on the floor. It can be hard for floor nurses with years of experience to unlearn how they did things on the floor and how nursing is different in the ICU.

It takes time, passion and dedication to learning to succeed in the ICU, no matter your previous experience. Don't let people try to push you away from ICU. If that's what you want to do, then go for it! My personal recommendation is to look for jobs at a place with a solid orientation and support for new grads. Major academic hospitals and trauma centers tend to hire a lot of new grads and often have good support systems for them. If you live near one, or are willing to relocate, I would look into those type of facilities.

I currently work at a top 10 hospital in the country and when I graduated nursing school I thought I was a hot shot and could hang with the best of them (Cardiac/Transplant) ICU. But I was told to get experience on the CVT stepdown because they didn't hire into that ICU. They did, however, hire new grads into the other ICUs (MICU, SICU, CCU, NICU) but not the CTICU that I wanted to be in.

Starting off in the CVT stepdown was quite possibly the best move I could have made. By having that 1 year on the floor I was able to have extra experience to better prepare me for the intensity that is the CTICU. I was able to work on my time management, understanding of different patient populations, balancing, and prioritization. The stress of 4 semi critical patients is very different from 1-2 critical patients and it is important to experience that IMHO. This was invaluable for my transition down to the unit.

Because I had the experience on the floor and the experience I had in my ICU, I can pick up OT anywhere in the hospital except for L&D, Neonatal ICU, and ED (I help in the trauma bay but don't take patients). Granted a new grad in the ICU would be more capable at the end of 1 year than a new grad who started on the floor; but if that new grad went to the units at the end of that year, by 1 year and 8 months both new grads will be about even, and by 2 years, I feel that the new grad who started on the floor will have had more experience and more knowledge than the new grad who ONLY had unit experience.

I am not saying don't start off in the ICU, but I'm saying the time you get on the floor will only give you more experience and make you more marketable. I will be honest, I would not be as good of a nurse now if I didn't have my 1 year of experience on the CVT stepdown before I transferred to the CTICU. YMMV.

I would say a lot of it depends on your personality. I think for the majority of people, it is a better idea to spend a year on a tele or stepdown floor. That said, I've precepted and worked with several new grads who have done great. I have also worked with nurses with a year + experience that didn't do well at all. There are always exceptions, but only you know you. Without any other hospital experience, I would hope your hospital offers a really good orientation.

Be prepared to have certain ICU nurses eat you alive. But don't focus on them. Focus on you. And your goals. Good luck.