Do new grads belong in the ICU?

  1. JUST GOT MY FIRST RN JOB!!!

    I got hired to the Thoracic ICU in a major heart hospital...basically my dream job! Interviewed with the clinical manager and just really liked her! The hours are great, the staff has alot of autonomy and gets alot of respect, the pay is blowing my mind, I LOVE cardiac stuff, I am WAY excited and very confident about pt. care, but...

    I am SO nervous! What did I get myself into now?
    I have LOTS of Paramedic experience, so not too much rattles my cage anymore, but there is just so many new pieces of equipment to learn about. The thought of all those monitors and gadgets and drips (oh my) are a bit overwhelming right now. The manager was very reassuring, and I will get lots of training and orientation (months of it actually), but in reality, do new grads do "okay" in an ICU environment?
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  2. 12 Comments

  3. by   llg
    Do new grads do OK?

    It depends on the new grad ... and it depends on the ICU. Some ICU's are accustomed to hiring new grads, have great orientation programs for them, and nurture them along as they make that transition from student to professional nurse. It sounds as if your new employer might be such a place. Other ICU's are not very supportive of new grads and have a poor track record of helping them develop into happy, healthy, competent nurses.

    I would recommend that any new grad interviewing for an ICU job ask not only about the orientation program itself, but also ask how many new grads successfully complete orientation... and how many stay in the job for over a year. I would try to get a sense of whether or not those new grads hired in the past 2 or 3 years are happy, healthy, competent nurses who are satisfied with their careers and with their choice to work in that particular ICU. If the answer is "yes," then I would not hesitate to take the job. However, if the answer seems to be "no," well, fore-warned should be fore-armed.

    Since you have already accepted the job, it might be a little late to ask the question, but you can probably get a good idea from what was said at the interview, what you noticed about the unit as you toured the unit, etc. You should also have an opportunity to speak with the unit educator soon and you could ask her.

    Good luck,
    llg
  4. by   Havin' A Party!
    Quote from LadyBugLass
    ... I am SO nervous! What did I get myself into now?...
    Sorta why I'll be accepting a tech position in our ICU when the spot opens. That way, in effect, I'll be securing an 18-month orientation before earning my nursing degree.

    Most ICUs don't hire right out of school. Our's doesn't, unless you have tech or other relevant experience.

    The fact that you're onboard tells me they've got full confidence in your ability to master the adventure you've committed to. So, gather yourself and let 'em have it.

    Good luck!
  5. by   versatile_kat
    Just a few words of encouragement ... I started out as a new grad in a surgical ICU 5 years ago, and have been precepting new nurses (whether new grad, or new ICU nurse) in my past 2 CTICU's without difficulty. If you are willing to listen, learn, and ask lots of questions, you should have no problems.

    You'll be working with assertive/aggressive nurses who expect you to take your training seriously (which means going home and reading up on material you're learning about) and becoming an excellent addition to their unit!

    I think going straight into critical care from nursing school was the right thing for me to do. Everyone is different, so if you start to doubt yourself too much, make sure you let your manager know. She may be able to leave you on a longer orientation if you think you need it. Good luck!
  6. by   Nitecap
    No
    Last edit by Nitecap on Feb 5, '06
  7. by   a_clay
    Quote from Nitecap
    New Grads do belong in the ICU as long as their are adequate support systems there to allow the new grad to grow professionaly. I grad in May 2003 and got my first job in a major CTICU also. We do 15-20 CT cases a day, we are a 41 bed unit that admits LVADS, RVADS< BIVADS, hrt and lung transplants and well as a large # of TAAA. You can do it do fool yourself. You must be on top of your game though. Put in study hours at home. I strongly recomend you reading the Book titled The Manuel of perioperative Cardio thoracic surgery by Bojar, it helped me alot, still use it. After working in a large unit like that you will be able to work ne where I promise, best of luck.
    Nitecap..at what hospital in H-town did you get your first job out of school in ICU? I am very interested in ICU right out of school and am also considering relocating to Houston from Dallas after I graduate. What kind of new grad pay does this hospital have? Thanks in advance.

    Amy
  8. by   Nitecap
    Go Yo Yo Yo
    Last edit by Nitecap on Feb 5, '06
  9. by   Repat
    Quote from Nitecap
    I work at The Methodist Hospital Debakey Heart center. I really like it here. The Texas Medical Center is great. The unit is very supportive and the pay is great. I would definitly recommend working here.

    Don't hear that too often!
  10. by   BBFRN
    Congrats, Ladybug! You know you're a brain- you'll do just fine. Just keep your eyes & ears open, and ask questions if you need to.
    I'm so happy for you!
  11. by   TennRN2004
    I too am a new grad going to an ICU position. I feel that it will be an excellent learning experience for me as a new nurse. I think what makes me nervous though is that fact the patients are so critical and ICU nurses have to be on top of everything every minute. But that is also a challenge to me, which I love. The other good thing about an ICU is that the ones in my area are very selective about which new grads they take, so only a few new grads are hired on. That means the majority of the nursing staff are experienced, reliable support staff for you to learn and have support from.
    Congrats on your job ladybug! You can do it.
  12. by   LadyBugLass
    Quote from lgflamini
    Congrats, Ladybug! You know you're a brain- you'll do just fine. Just keep your eyes & ears open, and ask questions if you need to.
    I'm so happy for you!
    Thanks for the vote of confidence...I just took boards yesterday and I really needed an ego boost!

    I thought I was ready, but I tell you, those questions DID NOT even resemble the ones in both of my study guides! The test shut off at 75 questions and I think that there were about 5 questions that I KNEW at that moment that I had answered correctly. :uhoh21: I had to throw up in the parking lot afterwards, but I think that I might have a " tummy bug" now.

    Thanks to all for all of the advice; does anyone else have any books or reference material for cardiothoracic or critical care nursing ? I'm not afraid of the patients; just all of the machines that keep them ALIVE!

    Excuse me, I have to go now now so that I can vomit and finish up the rest of my panic attack.
  13. by   EvelynRN-BSN
    I am also a new graduate starting in the ICU. I love a challenge and I feel that I will get that working in critical care. When I did my first rotation in the ICU I was'nt very excited about it because I was clueless about everything. It was my first year of nursing school. The second go 'round I really enjoyed it. It was also at a different hospital than before. My instructor told me that I belong in the ICU, she said I would be wasting my skills in Medical Surgical unit. She really made me feel confident about working in the ICU. There is so much to learn and the hospital that I accepted the position at has a 16 week orientation. I think that is wonderful. They were very competitive. I had to bug them for a month to even get an interview. They kept telling me they already had the new grad positions filled for the ICU. They said I could call back in a week. Meanwhile, I emailed the recruiter a resume and told her to check it out. That night around 7pm she called me and said they were make a position for me. I went in for the interview with her and the ICU nurse manager who hired me on the spot. I more or less interviewed them. They loved it. They said no one has ever came in there so organized with questions typed up for them. I had 22 questions. If you really want something you have to go for it!!!!!!!!! That is what I did. I had several job offers, but not at the hospital I wanted. So I took on the challenge and now I have the unit I wanted in the hospital I wanted to work at. I start in September! I am very excited about it.

    Evelyn
  14. by   Meressa
    Congrats on the news of your hiring folks!

    I just had to share a bit here. I went right into SICU fresh out of nursing school too and have done basically nothing else but critical care ever since (18 years now). I could not imagine doing anything else and would not want to.

    Just remember to ask questions, ask more questions, and then ask MORE questions. Question every tiny detail of what your preceptor teaches you. Make sure you understand exactly why she turned the Fi02 on the vent up to 100% when you told her your patient's lungs sounded like a washing machine and his Sa02 was dropping into the 80's. Why did she call the MD at 2am and hope for a Lasix order maybe? Why did she titrate the Dobutamine drip when his cardiac output started to take a dip? What does that fluctuation or lack of it in your patient's pleural/chest tubes mean? And don't stop asking until you are sure you understand how to apply what you assess to action.

    Those are the kinds of things that ICU nurses focus on. We tend to be a very detail-oriented, often anal-retentive lot even. And one other bit of advice that others here also mentioned. STUDY, STUDY, STUDY on your own. If you have internet at home, after a shift go study the topics that came up for you on that shift and try to apply it to what happened with your patient specifically. These two things helped me more than anything I think and this is what I also teach my own new orientees.

    Best of luck to you! With the sincere desire to succeed, I truly think you can do it.

    An Old ICU Nurse

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