New grads in critical care?

Nurses General Nursing

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  1. Should new grads be allowed to work in critical care areas?

    • 8
      Absolutely! Give them a chance!
    • 5
      No way, Jose! Get some experience first.

13 members have participated

I'm in my final semester of nursing school, and I've heard multiple opinions at our facility about new grads being hired/allowed in critical care areas. I would like to know your thoughts? Do you think that new grads should be allowed to work in critical care? Or do you think they should start on the floor to gain experience? If so, how long do you think is an acceptable time frame (i.e. 6 months/ 2 years) prior to going to critical care?

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I'm in my final semester of nursing school, and I've heard multiple opinions at our facility about new grads being hired/allowed in critical care areas. I would like to know your thoughts? Do you think that new grads should be allowed to work in critical care? Or do you think they should start on the floor to gain experience? If so, how long do you think is an acceptable time frame (i.e. 6 months/ 2 years) prior to going to critical care?

Most new grads benefit from some time on the floor to learn how to be nurses before transferring into critical care. No one should be transferring after six months -- much of that time you're on orientation and aren't providing any value to the unit. One to two years AFTER you finish orientation is a reasonable length of time. It's pretty unfair to the floor if you don't stay long enough to become competent in your job before requesting a transfer.

I have heard from plenty of nurses who insist that they went to critical care right out of school and they're doing just fine. SOME of them may be right. Most of them, however, would have benefitted from some time on the floor first. (Those who think they're excellent nurses after a year in ICU straight from school might wonder whether their coworkers agree. SOME will, many won't.)

This question has been posed over and over, so I'm assuming you've already read through those threads. What do you think after reading them?

Here you go...from earlier this week...
Specializes in PICU.

I say yes. Wherever you start as a new grad, you will learn those assessment skills. Sometimes it can be much harder to switch later because you will have a steep learning curve regardless. If you start in the ICU, you will learn ICU assessments and prioritizations, if you start somewhere else you will learn those. People have difficulties regaredless of where they start.

Specializes in Trauma ICU.

Highly individual. Some people are ready as new grads and do well in critical care. Some people need a little more time to develop. I went straight to ICU after nursing school, it's a HUGE learning curve with very high stakes.

On the other hand, I've also seen experienced nurses transfer to the ICU and not be successful in that environment. Really it depends on the individual and the support available on the unit.

Specializes in Geriatrics w/rehab, LTC, hospice patient.

Most likely depends on the individual and how confident they are in their own abilities. I think most would transition better after gaining confidence through jobs with lower acuity, but some people are naturally fast learners and cope with stressful situations better than others. Some people are naturally go getters and thrive under pressure and so for them, it would be unfair to deny them the career they have an aptitude for. Others will make good critical care nurses after gaining some other nursing experience. And then there are those new grads who simply will not work those positions their entire career. Some people just do not have the right personality no matter how much prior experience they get. I may be one of those. I highly admire critical care nurses, but I tend to do better with patients that need more patience and routine versus those who constantly require life or death decisions.

Specializes in Critical care.

I started on a tele floor with very high acuity patients. I was there for about 1.5 years then changed health systems and moved up to the ICU. I am personally glad that I started on a tele floor. My current employer will only hire new grads to the ICU in a 2 step program- they start on a floor then move to ICU after a year or so.

I have a friend that started out in the ICU in another state. She did well, but would have done much better if she had been better supported and not thrown right to the wolves. This friend burned out very quickly because of this.

I think most people would benefit from time spent initially not in the ICU. It gives you a chance to become more comfortable with basic nursing skills and really appreciate that you don't know what you don't know. I do think if a unit has the appropriate support and a well planned and balanced orientation process it is possible for a new grad to be successful in the ICU, but I think that such a unit is not very common.

edit: wow, just realized this was my 700th post!

I just finished precepting in the ICU/IMCU. By the end of the 5 weeks, I was able to keep up on assessments, medication, documentation, patient care, etc. However, I realized it's so much responsibility, and anything could go wrong so quickly. I agree that I think working on the floor first could benefit me tremendously. However, one of my charge nurses brought up a good point; we spend significantly more time training and transitioning new graduates compared to nurses who transfer from other floors or facilities. I think that this could be beneficial. I've seen multiple ICU CNA's graduate the RN program, and transition very well in to their roles, and love it there. I think that it is possible, and I think that we have a tremendous team that genuinely cares about seeing each other succeed.

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