Views on New Grads Entering Critical Care

Good morning Student Nurse!!

Look at the threads that Siri mentioned. Lots of "discussion" there. Please also, look at the references that Timothy provided from the AACN (American Association of Critical-care Nurses)...you'll find it in the thread "eating our young".

Good luck in your last semester!!

I started out in critical care as a new grad, and felt I couldn't have gone anywhere else. I had no problems, finished orientation early; and I have always advocated it, feeling that with good orientation/training it shouldn't be a problem. Keep in mind, I worked my way through school as a CNA and a certain position my hospital has that allowed me to do tasks already learned in school, everything except passing meds (and I do mean everything).

However, I just finished precepting a new grad into CCU, and I must say I had some difficulty. This nurse has an amazing mind and thirst for knowledge, but NO hands on experience! It definitely was an eye-opener. Of course, this nurse is now doing very well. I feel now that,as with any position, applicants should be looked at very carefully, and new grads accepted on a case-by-case basis. I still feel that there are new grads out there who can handle it; I just understand now why some nurses don't want to precept them.

Do New Grads Miss Anything by NOT STARTING in MED/SURG? I have an interview for step-down Cardiac Critical Care, which of course is less intense than Cardiac ICU itself.....BUT: will I be foreclosing certain career options in the future due to having skipped Med/Surg? Will a Visiting Nurse Service or Doctor's Office REFUSE to consider me since I never did the standard first year in Med/Surg where a lot of shots/IVs/manual blood pressures are done??? Thanks everybody. This site is terrific--I'm finally getting around to becoming a dues-paying member---This site has been of immense help BEFORE & DURING Nursing School...and NOW that I'll be studying for the NCLEX and interviewing, I'm sure it'll be just as great! I love being a part of the nurse community--Thanks to the Moderators and all participants on this site!

I started out in critical care as a new grad, and felt I couldn't have gone anywhere else. I had no problems, finished orientation early; and I have always advocated it, feeling that with good orientation/training it shouldn't be a problem. Keep in mind, I worked my way through school as a CNA and a certain position my hospital has that allowed me to do tasks already learned in school, everything except passing meds (and I do mean everything).

However, I just finished precepting a new grad into CCU, and I must say I had some difficulty. This nurse has an amazing mind and thirst for knowledge, but NO hands on experience! It definitely was an eye-opener. Of course, this nurse is now doing very well. I feel now that,as with any position, applicants should be looked at very carefully, and new grads accepted on a case-by-case basis. I still feel that there are new grads out there who can handle it; I just understand now why some nurses don't want to precept them.

Soren Drakes story is great... however this has not been my experience. In our CCU we definetely eat our young. They don't stand a chance. New grads will go to night shift. They never go to days. They work crazy schedules and extra weekends. Their orientation will get cut short because we are " short staffed" and they will be expected to take patients and do so independ. Good luck if this is what you choose. Do so very carefully.

hi all... i am in my final semester on nursing school!! my graduation is august 10th! woohoo ... sorry i am so excited!

i am doing a school project on new grads entering the critical care. i would like your view points good and bad. do you want new grads to enter the critical care so you can mold them or do you think they should have more experience before they attempt the critical care? also what do you think it takes to be a critical care nurse? any input would greatly be appreciated! if you have any stories please send, i would love to hear anything.

thanks in advance,

erika

:monkeydance: hey erika, i don't thing starting out in the icu is a bad thing. although it can be extremely overwhelming. you really would need to get in with a good, young, energetic, knowledgeable nurse who is willing to communicate and tell you why things are happening instead of saying, just do this because that's the way it's done. hate to say it, but the majority of people i have come across with in the icu, even the older ones, don't have any clue as to what the hell is really going on. if you do decide to do cc, you should start with an easy icu patient, and only 1 for at least 4-6 weeks. you really need to learn how to do a physical assessment before you get wrapped up in all of this high-gadgetry stuff. when i used to precept, i'm currently traveling now, we always started out with only 1 patient. my educator on my floor thought that was excessive, but these are people who have gone on to be charge, and precept themselves who are way above average nurses. running into the room after shift change isn't the answer. we always ready through the chart briefly, looked at labs, very important, reading the physican progress notes. then we would go in the room, and before writing anything down, do a completel head to toe assessment.

your experience can be good, but the key is to find an excellent preceptor.

As I just graduated last month and got my license now, yea me, I have an opinion abut this.

I did my preceptorship in a ICU. I was SURE I was going to be an ICU nurse right out of school no matter what. After all I was an honors student, blah blah blah. Who cares if I never did an IV by myself?

I turned down my first offer because it was a surgical floor. I don't need that, I am going to be a critical care nurse.

Well I went on another interview and during this interview I realized that starting out somewhere else has so so so many advantages. Can some new grad go into critical care right off the bat, sure.

I accepted a position on a tele/ transitional care unit. Not quite ICU, not quite med/surg. I still want to be a ICU nurse but not right now. On this floor I can have 3-5 patients depending on acuity and learn how to manage that. I have to learn rhythms, get my ACLS, all that.

If I go straight into ICU I wouldn't know how to care for 5 patient out on the floor. That narrows my ability to take per diem jobs, etc in the future.

But if I learn how to take 5 patients (California max) and then go into ICU, I can do both.

I believe this is a very personal decision coupled with the hospitals ability to train a new grad in critical care. My friend who did go straight into ICU is having a hard time and she is as bright as they come. Sink or swim.

Good luck.

I do not understand what is the big fuss about New Grads in specialty areas. We all started new in life in one thing or another. To some nurses, the idea that there will be someone available and ready to replace them is scarrrrry! or is it?

There are some people who feel proud to think after they are gone, the world will collapse simply because they could not be replaced. It is time that Nurses old and new start working together for the continuum of Nursing. After all (older nurses), it is in your best interest to accept new grads and train them well, for, they will be the ones caring for you soon!

Acceptance makes the world a better place!

The attitude that you seem to convey through your post is exactly what I encountered. Stereotypically, CCU nurses are known as mean ( i can think of another word) and there were days when i wanted to leave this job. But, I have been here under a year and I find this attitude has made me more determined to prove these ahem "mature" nurses wrong- to show them that it didn't take me ten years to get to CCU and I am fantastic at what I do. I go home and read my textbooks, I listen and ask articulate questions on teaching rounds and attend teaching sessions whenever I can. So that one day perhaps the tables will be turned and these young eating nurses will know how it feels to have someone try and take your confidence away

Hi Student Nurse

I am not against it completely, it depends on the type of unit and size of hospital.

I do feel the best solid basis for new nurses is a medical-surgical unit in a small hospital as you learn to take care of all kinds of patients.

Our Crit Care unit was a 3 bed one nurse unit and we put in Swans and patient on respirators............................I went to the ICU coronary class and then into ICU. It was baptism by fire.

But I discovered I loved it. I loved getting to know the patients and the families, working with internal med Docs.

I did get that one year of med-surg first which helped me to make quick assessments and know when to call for assistance.

Good Luck to you.

((((((((((((((((((((((((((HUGS)))))))))))))))))))))))))

Kitt

i hope my coworkers shoot me if i EVER turn into that!