Looking for a good MI hospital for ICU

*nrsang97* · Apr 26, 2008, 06:00 AM

Re: Looking for a good MI hospital for ICU

I also do not suggest that a new grad start in ICU either. I suggest 1 year of med surg first to sharpen skills. Then you can go anywhere.

thyme39 · Apr 26, 2008, 11:34 AM

Re: Looking for a good MI hospital for ICU

Originally Posted by Kati2005

Well some might not agree with me, but I wouldn't suggest starting out in ICU. In fact, my manager won't hire new grads. Work a year on step-down, get your skills down then go to ICU. ICU can be extremely overwhelming. Even I am overwhelmed and I've been a nurse for over two years. I strongly suggest a year of step-down/progressive care because you'll see everything that an ICU sees but on a less critical level. Just my opinion. Not all would agree with me.

I just graduated and am starting in a progressive/step down unit. I found it pretty hard to get a job in an ICU unit right out of school if you don't have experience such as doing your preceptorship on an ICU floor or working as a tech on an ICU floor. Even though several hospitals said they hire new grads into an ICU (and a lot more flat out said they won't hire new grads into an ICU) when I interviewed most of those wanted you to have done an internship or tech on an ICU floor. And then they only hired you if you had done it on their floor. I am very interested in critical care so I started out with my heart set on working in the ICU. What I ended up doing was starting on a progressive/stepdown unit. I think it is the best place for me. This unit gets almost everything an ICU gets but not as critical. I did not tech or preceptor on this unit but did shadow. I feel I will learn a tremendous amount here and in a year I will probably then look at going to an ICU. I know people who have gone to an ICU unit directly out of school but most has some tech experience. I think it can be done but you have to have a VERY good orientation/preceptorship when you start and a LOT of helpful experienced nurses. And be able to handle a lot of stress. I know this is off the topic but had to put in my 2

.

*TurnLeftSide* · Apr 26, 2008, 01:46 PM

Re: Looking for a good MI hospital for ICU

Originally Posted by thyme39

I just graduated and am starting in a progressive/step down unit. I found it pretty hard to get a job in an ICU unit right out of school if you don't have experience such as doing your preceptorship on an ICU floor or working as a tech on an ICU floor. Even though several hospitals said they hire new grads into an ICU (and a lot more flat out said they won't hire new grads into an ICU) when I interviewed most of those wanted you to have done an internship or tech on an ICU floor. And then they only hired you if you had done it on their floor. I am very interested in critical care so I started out with my heart set on working in the ICU. What I ended up doing was starting on a progressive/stepdown unit. I think it is the best place for me. This unit gets almost everything an ICU gets but not as critical. I did not tech or preceptor on this unit but did shadow. I feel I will learn a tremendous amount here and in a year I will probably then look at going to an ICU. I know people who have gone to an ICU unit directly out of school but most has some tech experience. I think it can be done but you have to have a VERY good orientation/preceptorship when you start and a LOT of helpful experienced nurses. And be able to handle a lot of stress. I know this is off the topic but had to put in my 2 .

No matter what, at any new job there will be stress. I worked on progressive care/stepdown for over two years before going to SICU. Both are very stressful. I was lucky that when they asked about my experience, I told them that if they offered a critical care course, I wanted it. So I took the critical care course and I had class twice a week and then worked on the unit twice a week for 9 weeks. It was very helpful. Many ICUs make you take a test in order to be able to stay on ICU. I think they are called the BKATs. It has meds, rhythms, and ICU stuff on it. We were only allowed to take it three times. If you didn't pass after the three times, you had to transfer to another unit. Thank goodness I passed the first time.

What hospital do you work at now?

poppy07 · Apr 27, 2008, 07:31 PM

Re: Looking for a good MI hospital for ICU

Katie,
Could you tell me about this test? Is it about different pressors, what rates you would expect them to run at and when their maxed out, etc.? Also, mcg/kg/min vs. mcg/min, etc? Could you also tell about the kind of patient problems the step-down handled. Being at the hospital I am, I was very surprised to see what patients they let stay in the unit vs. shipping them to a floor or step-down relative to the last hospital I worked at, when I was on a really busy med-surg floor.

*TurnLeftSide* · Apr 27, 2008, 07:48 PM

Re: Looking for a good MI hospital for ICU

Originally Posted by poppy07

Katie,
Could you tell me about this test? Is it about different pressors, what rates you would expect them to run at and when their maxed out, etc.? Also, mcg/kg/min vs. mcg/min, etc? Could you also tell about the kind of patient problems the step-down handled. Being at the hospital I am, I was very surprised to see what patients they let stay in the unit vs. shipping them to a floor or step-down relative to the last hospital I worked at, when I was on a really busy med-surg floor.

COPD, cancer patients, we had patients on vents, insulin, heparin, cardizem, dopamine gtts. There was a wide variety of patient problems that we saw, almost too many to list. The patient ratio to nurse ratio when I was there was 3 or 4-1 which is way too heavy for the type of care that the patients need.. I am actually working on the unit Tuesday since I am still contingent there, but from what I have heard, the patients are just very heavy, some patients are not appropriate for stepdown and need to be in ICU but the docs won't send the patient to ICU. The unit is just crazy. The families are very demanding.

As for the test, yes pressors, mcg/kg/min and mcg/min..stuff like that. Cardiac dysrhythmias and interventions for each.

CandyGyrl · Apr 27, 2008, 10:35 PM

Re: Looking for a good MI hospital for ICU

Katie...

I am appreciative of the suggestion however, I really don't plan on doing a step down or at least I hadn't planned on it. I know ICU is very very challenging unit but I'm highly motivated and hardly intimidated.

However... you said that you worked at HFH which is of course where I'll be contracted for 3 years is this new grad rule pretty consistent across the board like in MICU, CICU, TICU etc... If this is the case I may have no choice but to maybe work a med surge floor for 6 mos or even...gulp... a year?

If not I may just have inquire around and find out which ICU units will hire new grads, and which units are resourceful, supportive and receptive of new nurses.

Any other alternatives provided by HFH... classes?

Do they offer summer externships?

I'd like to look into a PCA or NT position on nights to familiarize myself with the unit, the nurses, allow them to get familiar with me, and in turn, gain an understanding of the type of support which is needed by the dept, what I will need to work on... basic nursing care, time mangagement, compartmentalization,etc.

It is my understanding that although very challenging in terms of critical thinking, and application of knowledge and procedures under highly stressful and critical situations-- ESPECIALLY for a new grad--there have been many new grads that turn out to be great ICU nurses and that it has lots to do with the support of the team the learning style, comprehensiveness, personality, and motivation of the individual.

All of these things {and more} were a few things I had anticipated mentally as a future ICU nurse and mapping out a blueprint of means to prepare myself {at least slightly} for ICU. Are these options?
How long do you intern with preceptors once you're hired?

I know that this is a lot much but I am very passionate about this. VERY.

poppy07 · Apr 27, 2008, 10:39 PM

Re: Looking for a good MI hospital for ICU

what's the dress code at HFH ICU? I bought all these different colors for the place I work now, and I hope I can continue wearing them there.

*TurnLeftSide* · Apr 28, 2008, 03:12 AM

Re: Looking for a good MI hospital for ICU

In the SICU, the manager will not hire new grads unless they've been an extern. I think MICU/CICU/Neuro ICU hire new grads. As far as dress code, nurses where ceil blue, the top can be a print top but is suppose to have ceil blue in it.

*nrsang97* · Apr 28, 2008, 07:10 AM

Re: Looking for a good MI hospital for ICU

Candy Girl,

Being a new grad in the ICU can be too overwhelming. I know a new grad who now works oncology since the ICU was too much stress.

I did work med surg for 5 years before moving to the ICU. That was the best thing I ever did for myself. After 6 months to 1 year in med surg you can go anywhere.

In med surg you can sharpen assessment skills. In the ICU good assessment skills are important because your pt can change in seconds.

You can extern in the ICU and see if it is the place you would want after you graduate. I actually really suggest this. Remember SICU won't hire new grads, so you will have to work MICU, CICU, or neuro ICU, or a stepdown unit like 6 Center.

As far as orientation you will be with a preceptor for 12 weeks, and 8 weeks of critical care class.

Remember starting out is med surg dosen't make someone a failure. I really think it will make you a better nurse in the long run. You will also learn good time management skills which are essential.

Good luck to you in whatever you decide.

*TurnLeftSide* · Apr 28, 2008, 10:03 AM

Re: Looking for a good MI hospital for ICU

[quote=nrsang97;2804443]Candy Girl,

Being a new grad in the ICU can be too overwhelming. I know a new grad who now works oncology since the ICU was too much stress.

I did work med surg for 5 years before moving to the ICU. That was the best thing I ever did for myself. After 6 months to 1 year in med surg you can go anywhere.

In med surg you can sharpen assessment skills. In the ICU good assessment skills are important because your pt can change in seconds.

You can extern in the ICU and see if it is the place you would want after you graduate. I actually really suggest this. Remember SICU won't hire new grads, so you will have to work MICU, CICU, or neuro ICU, or a stepdown unit like 6 Center.

As far as orientation you will be with a preceptor for 12 weeks, and 8 weeks of critical care class.

Remember starting out is med surg dosen't make someone a failure. I really think it will make you a better nurse in the long run. You will also learn good time management skills which are essential.

Good luck to you in whatever you decide.[/quot

Anyhow, I don't care how motivated someone is, learn basic skills before coming to the ICU. You put yourself and your patients in danger.

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Looking for a good MI hospital for ICU

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