[isis73]

First of all I just want to say hi! This is my first post here(*I was wrong--according to allnurses, this is my 7th post!* :Snow: ) , though I have been reading posts for advice and encouragement for the past year and a half of nursing school--I love allnurses.com and really appreciate being able to come here.

My question involves where to start as a new grad when I graduate in May. I spent all day yesterday shadowing on four different units at a big hospital within an hour of home. It is a small commute (35 miles) but well worth it for the great experience. The hospital is a heart hospital and is a faith-based hospital. I loved the hospital and would gladly work there--the problem is deciding where to start?

I am deeply interested in critical care and have worked as a tech in the local ED. The hospital I shadowed at let me spend time on IICU, Telemetry, MCCU and Surgical. Everyone working there seemed to really enjoy their job and take pride in their work, and all the unit managers knew each other well and had an obvious respect for each other. All four units are hiring new grads and the critical care units have a very intensive and thorough six month orientation (part of the attraction).

Here's the pros and cons in a nutshell:

IICU (ICU step-down unit)--small, 3:1 ratio, great learning environment, the nurse I shadowed was extremely friendly and described their unit as being "very laid back" with a certain level of indepedence and a great starting point before going to a more specialized unit like ICU or MCCU. This was the first unit I shadowed on and I left there very encouraged and sold on the idea that it was a great place to start.

Telemetry--I'll be honest, I did a rotation on Telemetry in clinicals and it wasn't my favorite. Though the unit manager was very nice, she and the preceptor/nurse educator (esp. the nurse educator) did a hard sell, and I don't like being pressured. I also tend to be suspicious of someone who is too eager to hire you and wants an immediate verbalization of interest or commitment...

MCCU--This one is complicated--I LOVED the unit manager (who did not try to sell me on the unit at all) and I loved the obvious intensity of the floor. She made it clear that the last thing they want is someone who doesn't want to be there and that in terms of critical care, especially coming in as a new grad, you have to WANT it. Seeing her in action was inspiring and the depth and breadth of her knowledge and experience was obvious. I want it, I do, but it is also a terrifying prospect! I will only be a new grad--can I learn enough in six months of orientation to deliver safe care? She emphasized that I will never feel truly ready or that I have mastered everything (and that no one there does), but that they will know when you are ready, even if you don't realize it yet.

Surgical (5:1 ratio--which is really good compared to the local hospital) You know what I'm going to say...everyone says do your time in Med/Surg first. The unit manager is obviously skilled, and expressed interest in hiring me, and a willingness to prolong the 12-week orientation if I felt I needed more time. Concerns: According to the nurse recruiter, when she came to the unit two years ago there was only one staff nurse and all the rest were travel nurses--even so she cleaned house and rebuilt the unit from the ground up. That is a major accomplishment, but the day I was there they were short-staffed one nurse and they have one nurse that is moving to another state. Other concerns: My heart isn't in it. I know I would learn excellent skills, time management and organization, but would I dread going to work? My coworkers will all have been there for less than two years (with one exception) and the one I spoke with was only there for the extra paycheck (PRN--works FT at a diffferent hospital). They are short-staffed.

What to do? I love the hospital and everyone I met, but I want to have a great first year learning. School has been rough and stressful, and some of my instructors have been cold and unsupportive, making it hard to have self-confidence in myself. I know the first year is bound to come with it's share of stress, but I could really use a supportive learning environment.

All that being said, I am not afraid of hard work. I am dedicated, concientious, detail-oriented and eager to learn. I WANT to be a great nurse, I do. Any help in making the right decision in where to start would be greatly appreciated (and thanks for reading the small novel!).

[love-d-OR]

You are officially Welcome to allnurses!
From reading your post I can tell you really liked the step don and MICCU unit. Go for what you like! You are going to feel intimidated anywhere you go as a new grad. You will have no experience. Thats why you are called a new grad.! Plus, if you dont find the ICU to be a good match, for whatever reason, you can always step down. Good luck.

PS: I graduate in June, and I am applying for MICU!

[Tweety]

Nix the med-surg. As a med-surg charge nurse, I feel the same as the manager who only wants employees who want to be there.

You're never going to learn all you need to know. I've been in it for 16 years and don't know all I need to know. Every day is a learning experience. Six months is an awesome orientation for critical care and I think that's plenty of time to get a new grad started in critical care.

So my advice is to not let the critical care environment intimidate you if that's what you want. The IICU sounds like a good starting point as well. But definately nix the med-surg idea, it's not necessary to "do your time".

Good luck!

[isis73]

Yay! I'm so glad to hear that it's okay to not start in Med-Surg, especially if my heart isn't in it. I really liked and respected the Surgical unit manager, but I felt it would be unfair to her as well to take a job I felt no enthusiasm for.

Thanks so much for the advice--I'm going to try for MCCU first, ICU second (it may be available before May), and IICU third. I'll let you know what happens!

[mt4now]

Go by your feelings..........if it doesn't feel right then it's never right.

[isis73]

I just wanted to post an update...I'm going to the MCCU!

I just graduated, and now it's off to kill the NCLEX dragon...Thanks for the advice and encouragement!

[Tweety]

Nice to hear the update. Congratulations and good luck!!!