[Aaron Catmull]

Should new graduates be able to work in the ICU? Do they have the experience to make critical decisions? How long should they have to work on a general med-surg floor before being allowed to work ICU?

[pink.edwina]

Originally Posted by Aaron Catmull

Should new graduates be able to work in the ICU? Do they have the experience to make critical decisions? How long should they have to work on a general med-surg floor before being allowed to work ICU?

In the UK Yes, An RN here is expected to qualify here competent to practice at point of registration....with appropriate preceptorship package and suprenumery period they can fly if motivated and supported.

[bcjams]

I think you need to be a great ICU nurse before you can be a great med surg nurse. You still need all the critcal thinking skills and nursing knowledge in either area and med surg doesnt have all the infomation readily available..you have to just be able to look at the patient and know when something is going bad....I am going ICU first...then Med surg...it safer for everyone.

[witnurse]

Originally Posted by bcjams

I think you need to be a great ICU nurse before you can be a great med surg nurse. You still need all the critcal thinking skills and nursing knowledge in either area and med surg doesnt have all the infomation readily available..you have to just be able to look at the patient and know when something is going bad....I am going ICU first...then Med surg...it safer for everyone.

I am not sure I understand your post. Our nursing leadership team has decided to require one year of med/surg before any cross-training. I feel strongly about this in our facility because our ICU nurses are responsible for their own vents, we don't have Resp Therapy. Also, the care of med/surg patients really does build experience and confidence. I wish you the best though. Critical care nurse for 25 years.

[suzanne4]

Originally Posted by Aaron Catmull

Should new graduates be able to work in the ICU? Do they have the experience to make critical decisions? How long should they have to work on a general med-surg floor before being allowed to work ICU?

It all comes down to the type of orientation and how long your preceptorship will be for. No facility is going to put a new grad out to the wolves the first week that they are out of school. Critical thinking needs to be learned and practiced, it is not something that can be done overnight.

If the nurse wants to work in the ICUS, then there is no reason that they need to put in a year in med-surg. Each is their own specialty. Each has its own nuances that can only be learned while doing.

[bcjams]

Originally Posted by witnurse

I am not sure I understand your post. Our nursing leadership team has decided to require one year of med/surg before any cross-training. I feel strongly about this in our facility because our ICU nurses are responsible for their own vents, we don't have Resp Therapy. Also, the care of med/surg patients really does build experience and confidence. I wish you the best though. Critical care nurse for 25 years.

I can see why an absolute newbie should work med surg for a year. However I have been an LVN for 7 years and feel more than ready to go to ICU....i hope that clears it up.

[janfrn]

Our experience with new grads in our PICU (mostly CV and trauma) has been mixed. Some have been pretty on-the-ball, and some have been downright dangerous: they don't know enough to know when they're in over their heads and don't ask for help. The way our unit's census changes, it's not always possible to find an assignment that is appropriate for a lot of these new grads once they're off orientation, so they are assigned patients they shouldn't be. We're seeing this a lot lately because in the last year we've hired a more than a dozen of them (>10% of our total staffing). We may only have one or two stable single-system patients in the unit, and four new grads to find spots for. So the more senior nurses are left responsible for watching over these nurses and their patients to ensure nothing goes wrong, plus their own assignments. I seem to find myself riding herd on a group of new-grad or very junior nurses whenever I work nights. I really think that a stint on a med-surg floor would help them prioritize and organize their work, offer them practice in assessment and hands-on nursing skills and prepare them better for the pace of the ICU. My

[Eric1233]

I was upset when I heard my ICU was going to required me to go to med-surg for 6 months. Now, that it is all over and I'm in ICU, I can see how valuable it was. You get the basics down in med-surg, that way when you go to ICU it is not totally overwhelming. If you have been a LVN in a hospital for 7 years you will have no problem. For me a brand new nurse with not much prior experience med-surg was a good thing.

[CHATSDALE]

with prior experience as you would probably qualify as icu material
depending on your facility requirements.
however if my loved one was in icu i would prefer an experienced nurse..i probably wouldn't be told one way or theother

[RRT/RN]

Originally Posted by Eric1233

I was upset when I heard my ICU was going to required me to go to med-surg for 6 months. Now, that it is all over and I'm in ICU, I can see how valuable it was. You get the basics down in med-surg, that way when you go to ICU it is not totally overwhelming. If you have been a LVN in a hospital for 7 years you will have no problem. For me a brand new nurse with not much prior experience med-surg was a good thing.

I am a resp therapist with over 12 years experience and have been working as a med surg RN since January. I voluntarily decided to work med/surg for a while before going to ICU, and boy am I glad I did. I miss working with vents and critical patients, but the skills that are learned on med/surg--basic nursing--are building blocks for critical care IMHO. I've seen (and spoken with) many nurses who have done it both ways, and most say that their time spent on med surg helped them imensely. Don't know how long I will stay med surg, but I think I made the right decision.