Hi everyone!

So just a little background on me, I'm a senior in nursing school with 2 years of tech experience under my belt. 1 year on a surgical floor and 1 year in the ER at a community hospital. I'm currently in the middle of the senior practicum and was lucky enough to land a spot in the CVICU at the only level 1 trauma center in northern Virginia!

After working in the ER, I have developed a strong passion for pediatrics. I will never forget the first peds code I experienced and how badly I wished that I could follow the patient once we resuscitated him and sent him off to a hospital with a higher level of care and more resources.

Also, after my time in the CVICU, I've realized how much I love critical care. I think it would be a dream come true if I could combine these passions and work in the PICU out of nursing school. How high are my chances of achieving this? Just need some thoughts/opinions/advice!

thanks :)

A lot depends on the culture of the peds hospitals in your area. My quaternary care PICU (in Canada) has hired new grads in significant numbers over the last few years, typically those who had senior practical experience in either emergency, pediatrics or critical care. But there's a mindset that suggests that's a bad idea. We've had some who really weren't on the ball enough to do well, but they're actually in the minority. Most of our new-grad hires have done quite well. Ask around and see if you can get a feel for the potential. It might be that you'd have no problem! Be aware that many facilities will only consider new-grad applicants within the first 3-6 months after graduation.

Since you are located in Virginia, I would suggest looking at Children's National. One of my close friends from nursing school recently got a new grad position in the PICU and they have posted a ton of New Grad PICU openings recently! It is possible. I think your experience and your practicum ICU setting will help, and make sure to include your love for both criticsl care/ ICU setting and peds in your cover letter!

Good luck!

It's been about a dozen year since I was a new grad, but I was hired into the PICU as a new grad in one of the top three pediatric hospitals in the country with very limited experience besides nursing school. It can be done.

That's awesome! Were there any extra steps you took to make this happen? (Volunteer experience, referrals, etc)

That's awesome and so great to hear!! I will definitely be applying.

These jobs are competitive to get but there are definitely programs out there that hire and train new grads. Several of my classmates started out in PICU jobs.

My hospital hires new grads into the PICU, too ... but they are not always successful. Unless you have gotten a lot of ICU experience as a student, I would not recommend that route. Those new grads in the PICU have a high turnover rate -- in my current hospital and in a previous one where I worked. But it can work if you are talented and work hard.

With NICU ... that can work ... but the patient populations, protocols, and culture are often so different that the transition can be difficult. Switching to teenagers from premies is a dramatic change. (I am an old NICU nurse.)

The best route for most people in my children's hospital is through general peds. A couple of years of solid peds experience with all ages of peds patients gives you a strong foundation of peds assessment and disease processes. That gives you the best foundation to build upon.

I would be sure to talk to nurses when you interview about what the new grad support looks like as well as how movement between departments works in the facility. In places that have strong critical care training programs, you don't always have an advantage in starting in med surgery first, and in giving years to a unit you don't plan to stay in you build seniority that you would lose in transferring to a different department. Not to mention you gain comfort in what you do. I know it's not always possible or individually advisable to start in critical care as a new grad, but I do know that nurses at the facility I started with often felt stuck in their unit largely because of the benefits their seniority had in their schedule (many places I work require new nurses on the unit to work every other weekend while nurses with more experience on the unit work every 3rd for example). I started in the emergency department of a children's hospital so began building my now expertise in pediatric emergency nursing from the beginning. I've since spend a few years on a med sure pediatric unit and the skill set was quite different.

I think a key for a new grad is a dedicated preceptor or small team of preceptors. My current hospital, which is fantastic in many ways and hands down the best place I've worked, has a pretty disjointed new grad orientation in my unit- all orienting nurses, new or experienced, are randomly assigned to preceptor trained nurses each shift, sometimes switching preceptors multiple times a shift as they rotate through different zones in one day. There is no consistent mentor, and while we do train successful new grads, that seems entirely dependent on their abilities and not on the support they get. I'd hesitate to recommend a new grad start in my current unit because of that, but I wouldn't discourage a new grad from starting in this type of unit somewhere there's a more consistent new grad orientation.

UVA in Charlottesville has a PICU that is mainly CVICU and does a lot of transplants...they hire new grads.