How do all the experienced ICU nurses feel about....

I am a new grad myself, may 08. I cannot provide the experienced point of view, but I'll give you my 2 cents worth anyway. I started in ICU, but I came in with a VA internship in MICU for a year and clinicals in 2 different ICU's under my belt. And even with all of that, it has been a challenge. I love my job, but if my co-workers weren't so supportive, I would drown. I, like many new grads, have gotten less-than-desirable orientation due to budget and staffing issues. But I have been expected to take 3 ICU patients at times just like my colleagues. At any given time we can have 10 patients with 5-6 out of those being vents. I suggest you ask for time in ICU during clinicals, and seek out an ICU position in a unit that is known for teaching students. I did well in school and in my ICU clinicals, but when you are on your own, the ICU experience can send you to your limits. You will have to assimilate a lot of pieces of information quickly when patients crash, and you have to be ready for anything because your colleagues may be too busy with their own sick patients to help you at every time you think you need it. All that said, it's doable and even enjoyable.

You will want to advocate for the longest orientation you can get for yourself, and from the start, be looking for RN's that you will be able to rely on and trust during your first months on your own. Keep the attitude that you can never learn too much, and always thoughtfully consider the advice other experienced nurses give. Know where your resources are (like drug references, text books, compatability charts or software), and be on the lookout for a mentor. I highly recommend the book Your First Year as a Nurse by Cardillo.

If you are passionate about ICU and believe you have a good base of knowledge about which you are confident, go for it!

Dorie,
I highly respect the med surg nurses that work in my facility. If I got floated to their floor, I'd just die. We had one sent to us to help us out one busy night, and she made all the difference. But with all due respect, a nurse should be taught the difference between a morphine push and an adenosine push in school. I just did my first adenosine push last week, and my patient is alive because of it. I learned that in school.

If you encounter an ICU nurse being rude to you, it's about their own personality and style. I know ICU nurses who have come from many different backgrounds, and some of them ARE rude. But I am willing to bet they were rude before they got to ICU. Rude people are rude no matter where they are.

PS-Your post didn't make me mad. There is truth to it. I just wanted to make a point.

Ok.i am a new grad (as of december 08). I just got my dream job, in the area that i wanted (ICU!!!) at the hosptal i wanted to work at. I did my preceptor and internship there in SICU, and was completely amazed at how helpful and accomodating the staff was..from the CNAs up to the Head Management, to myself and to the new grads on the unit. I knew that is where i wanted to be, but only in ICU at that specific facility, becuase they are the only one i have ever been in that cared about the students and new employes. It simply amazed me, when as a student, i was helping a nurse roll and change a bedbound patient, and the facility director walked into the room, donend her gloves, and began assisting. My jaw almost hit the floor. I have the srongest desire to be in ICU and start Monday, and am hoping for as good an experience as i have had in the past

One factor to consider is the ratio of new grads to experienced staff in the ICU. A good new grad with strong skills can make it fine in most ICU enviornments if the have the right disposition for the job and supportive, experienced staff to assist them through the first 6mos-year. If there is more than one new grad per shift per unit then the chances of sucess are less. When we have new staff working our unit it is often much more hectic to keep pitching in to help them stay on top of thier patients condition. With 2-3 new people it would be impossible without risking my own patients quality of care.

This has been an interesting read. I'm a (soon to be) new grad that just accepted a job in the very ICU I've worked for 4 years as a monitor tech, so I'm hoping for a smoother transition than most.

Um, for one thing, I don't know many med surg nurses who know how to do an adenosine push. That's not something one would typically be pushing on a med surg floor. In fact, if someone needed adenosine on the floor, it's likely an ICU nurse would be the one responding to the rapid response call, thus being the one to push it. Secondly, simple IVP drugs are something a person should have learned how to do in school or during their preceptorship. If not, it's not like it's something too complicated to learn.

I was a CNA in a nursing home, a trauma/surg ICU, and the ER prior to getting my BSN. I had absolutely no desire to work in med surg. I don't belittle the nurses who choose to do so. I actually applaud them because I know how bad it can be out there, and they do have to know a lot to do their jobs.

I have always wanted to work in critical care, and I started in the CVICU as a new grad and I have been there a little over a year now. While I know that I'm not the best nurse in the unit, I do know that I am a rising star. I love talking to the veteran nurses and I do go to them for help when I don't know something. Keep in mind, the questions I usually ask them are things a med surg nurse wouldn't know. I jumped right in and was taking high acutiy patients without difficulty after coming off orientation. Other nurses compliment me on how well I am doing. Doctors listen to my suggestions and respect my judgement (well the ones who aren't jerks...), and I listen to theirs. I'm a team player, and I help my fellow nurses when they're in a bind. I have responded to RRTs on med surg floors when the lead was busy with another one. I feel like I was adequately prepared to be an ICU nurse as a new grad, and I have never regretted not starting in med surg.

I think there are a handful of new grads who are adequately prepared to go straight to the ICU if they choose, and there are definitely those who need more experience first... but don't tell me you don't think I can kick it because I can--and do!

What's funny is, pushing morphine and adenosine have nothing to do with each other.

If you push adenosine like morphine, you'll get laughed out of the room. In fact, most experienced nurses who come to the unit are very uncomfortable pushing something that fast.

This board is like the game we used to play in school, you whisper a phrase in someones ear, and it changes completely before it gets to the end!
I never said pushing morphine is the same as pushing adenosine! My point was: A new graduate nurse needs to learn the basics of nursing before being thrown in to the intensity of ICU nursing. That is only my opinion and the opinion of most older ICU nurses. The younger nurses want to start at the top, and don't even have basic skills perfected yet. They feel making a bed, or giving a bath is beneath them. (except for you few perfect nurses that I'm sure I will hear from).
Also about the Masters program wanting you to have medsurg experience. I was talking about teaching Nursing. Lets all think back a moment from school. Were you taught Critical Care Nursing? Were you taught OR nursing? Were you taught Cancer nursing? NO! You were taught Med Surg Nursing! Soooooo, how in the heck can you teach a clinical, when all you did was went straight to ICU????? Thats why the program wants you to have a rounded nursing history, in medsurg, neuro, etc. If you aren't thinking about going for a Masters in teaching, FORGET ABOUT WHAT I SAID AND MOVE ON!!! Sheesh

I'd like to see the schools curriculum where it states med surg nursing required.

Could you provide the link?

Well, needless to say, I have no inkling of an interest of ever getting my master's in teaching. Fortunately for me, all the grad schools I am looking at want ICU experience, and preferably CVICU.