New Grad Career Advice

[nyemt2005]

I'm currently in my last semester of my RN program and in the process of interviewing for jobs when I graduate. I was just offered a position in the ICU of a small community hospital. My goal is to be in a critical care area with the hope of some day working as a flight nurse. I also have interest from a large hospital to work on one of their telemetry floors. I'm trying to decide if I would learn more working on a large busy cardiac telemetry floor or working in a 12 bed ICU at a small community hospital. Is the ICU experience less valued at a small hospital, or is the ICU experience valued no matter how big the facility.

[nurseprnRN, BSN, RN]

take the telemetry floor. you'll be exposed to far, far more situations than you will in the smaller hospital. heck, some of those smaller hospital's icu patients will show up as transfers in your telemetry unit.

and as to the icu/flight nurse thing, it's sort of like how all the high school and college basketball players want to play in the nba. good goal, reach high for your dream, and all that stuff ... but check the numbers. most of those kids are doing something else, and happy with it.

[Perpetual Student]

Look into the acuity of the patients and frequent diagnoses of the smaller ICU. Is there a mix of medical and surgical patients? What types of surgical patients are seen? Is there a cath lab or are STEMI patients shipped out immediately? Is it a somewhat isolated hospital or is it 10 minutes down the road from the large referral center? Look carefully into the orientation offered for both places.

I wager that when it comes to applying for a flight job or whatever other position that requires critical care experience they would consider any ICU experience preferable to tele experience. If you decide you need to work in a larger hospital, you could always get a job in one in a few years already having some critical care experience.

My preference would be for the ICU job based upon the provided information and my personal desires and experience. Also consider how long they would expect you to stay on the tele floor before transferring to an ICU. Some hospitals in my area won't consider putting new grads who're hired onto a floor through their critical care orientation programs for 2 years.

[ckh23, BSN, RN]

Take the ICU experience. Even though it is a smaller hospital it will expose you to a lot of critical care meds and is a great stepping stone for transfer to an ICU at a larger hospital. The smaller hospital is also a great way to fine tune your critical thinking skills because you do not have the resources as you do at a larger hospital. You also don't have the doctor to rely on as much, especially at night. In the smaller hospitals there is usually a night house doctor that knows nothing about the patient so they rely on you for your recommendation. I think this will help you in the future as a flight nurse since it will be you making the decisions.

[MJB2010]

The ICU job is an actual offer and the tele job is a "maybe" with no offer, right? I would take the icu job. You can always go from icu to tele later on, but it would be harder to get an icu job later. Tele experience will help you and you will learn a great deal, but an icu job is hard to get as a new grad.