New Grads in the SICU???

[sewnew]

I was wondering how difficult it would be for a new grad to get a job in the SICU? Do SICUs typically hire new grads straight out of nursing school? If the new grad had a MSN/CNL (clinical nurse leader), would that increase their chances of getting the job?

Any information is greatly appreciated. Thanks in advance!

[xtine618]

Wow, you have quite a ways to go, but that can be a good thing. I don't know if you have a job right now, but if you don't or if you can switch, I would work as a nursing assistant/CNA or unit secretary in the type of unit that you want to work at and better yet, if you know which hospital you would like to work at as a nurse, I would try to work there too. I was a CNA and a unit secretary. I think most people say you should be a CNA, but I think I learned more as a unit secretary. I learned how to take off orders, write orders (because I read so many), it helped me become a little more familiar with medicine and procedures that are usually ordered. It also helped me get used to reading MD handwriting, which is usually chicken scratch. I also learned how to communicate with other people in other departments and even doctors which can be very intimidating.

I also worked in a pharmacy which was a good experience. I would have liked to work in a hospital pharmacy though because you get to be exposed to more medications that are usually given in the hospital especially IV meds and fluids. Another good thing is that there are so many pharmacists who are incredibly smart and most of the ones I have met are more than willing to answer questions about what medicine is used for what. you will learn tons there!

Just remember that even if they tell you that they don't hire new nurses in the ICU now doesn't mean that they won't by the time you graduate. In my hospital they won't hire LPNs but if they were really in need and had to, they would start hiring LPNs again.

[geminigirl11]

Thanks for your reply. Any words of wisdom that you can offer about working in the SICU would be greatly appreciated.

No I do not have my MSN/CNL yet, but that's what I plan on pursuing. Basically, the program that I plan on attending is a direct entry program for people who already have a Bachelor's degree in another field (I am currently in an accelerated program to get my BA in liberal arts)...

My hospital definitely hires new grads in the ICU. I joined the SICU with almost 4 years med/surg experience and it still felt very difficult. In fact, some of the new grads I started with may have had an advantage from just finishing pathophys, anatomy, etc.

I am interested in the discussion of whether or not new grads belong in an ICU and whether or not accelerated programs are a good idea. People have argued that accelerated programs don't prepare nurses well enough, etc. But, the vibe that I get when people speak against these 2 things often has to do with the speakers' feelings of resentment that they did not have those same opportunities. It is unfortunate that they did not have the same chances BUT we are in a crisis with our nursing shortage. We need nurses!!!!! I recently heard an 'old-timer' criticize a newbie for being unwilling to "do her time". Not a helpful attitude especially since he sounded so personally cheated & offended.

I know some people who have gone the accelerated route and they are stellar, amazing folks (and they were able to get into these competitive programs!). We need them. And they are required to take & pass the same NCLEX.

One way to look at accelerated programs is, that you can either get your experience first then obtain a higher degree or get the degree then gain your experience. People that graduate from the accel. program here do not immediately hop into higher positions with prescriptive authority...they work as RN's like everyone else and gain the required experience first.

And a final question on new grads in ICU...are there any rational reasons to not have them there? I have heard a lot of blather but no real critical thinking yet. We are supposed to look a things objectively with a researcher's eye . Tradition should not dictate how every person comes into the field of nursing. What do you all think?

[Purple Fairy, RN]

geminigirl11- thanks for sticking up for us accelerated nursing students. I just finished an accelerated program, and while most employers in my area respect my program many nurses are skeptical. we actually do all the clinical time as traditional schools! but we dont have time for internships which would be invaluable. I am actually starting in the MICU in Nov and am nervous about how I will be receievd. I hope the staff will be as receptive as you seem to be!

[jstewart3]

I can, and i have. It was 3 months of hell for me. The stress level almost killed me. OF course it was a very high acuity large hospital and the training I got before hand was nil. I would be sick driving into work. Orieintation would have been so much better if my NOD hadn't been out on another assignment.and i didn't end up with 14 different preceptors...not my nor their choice...just how it worked out...

Now, post a few weeks of being on a floor, I actually like it. I dp have the choice to go back to ICU in 120 days, should I desire. There are alot of things I miss about ICU. too and some stuff is starting to make sense and is now starting tp "clikcK.

I will probably end up back there after awhile of getting grounded in nursing.

[WindwardOahuRN, RN]

I

I will probably end up back there after awhile of getting grounded in nursing.

Again...just why new grads should NOT be placed in the ICU, IMHO.

Seriously....I applaud the enthusiasm of the new grads that wish to pursue an ICU career. Very commendable.

But as an experienced ICU nurse I feel I must point out the negatives inherent in hiring new grads directly into the units.

They have no basic skills. None. Nothing but book learning and the very rudiments of theory. Maybe a bit of practical stuff but nowhere near what would be expected of an ICU nurse.

They have no experience dealing with docs. This is NOT a minor thing---this is a learned skill. Assertiveness, aggresiveness where necessary.

IME we are placing new grads in the ICU because we have no choice. The nursing shortage being what it is we have to take what we can get.

The most awful part? The nurses we are getting think that they are being chosen for the ICU because they are special.

And in reality we are hiring them to save money. They do not get "job rate" for almost two years after they are hired.

The experienced ICU nurses are expected to pick up the slack. It is sooo tiresome. Scary, too....especially when you think of how you would want you or your family members taken care of, should the need arise.

I honestly think we are doing them a gross disservice by hiring them directly into ICU after graduation. It's a sad reflection on what we have become.

My husband was an ICU patient last year. Luckily, they knew who his wife was....

[dopaminequeenRN]

I work at a 315 bed hospital with 32 ICU beds. It is the largest facility in the area and has the busiest ER in the state. We have SICU, CVICU, MICU, and CCU. They are all under one manager and we float to each one. I bet 95% of our ICU applicants are new grads, and that's pretty much all we hire for ICU. I think this is because our local university has a CCRN program and many of our new grads have to have ICU experience before they can pursue that degree. Another reason we hire so many new grads is because the experienced floor nurses are less likely to leave their comfort zone and make the transition to ICU. I started out in ICU as a new grad. I had 3 years of LPN experience, though, and that helped me a lot. Good luck!!

[registeredin06]

Again...just why new grads should NOT be placed in the ICU, IMHO.

Seriously....I applaud the enthusiasm of the new grads that wish to pursue an ICU career. Very commendable.

But as an experienced ICU nurse I feel I must point out the negatives inherent in hiring new grads directly into the units.

They have no basic skills. None. Nothing but book learning and the very rudiments of theory. Maybe a bit of practical stuff but nowhere near what would be expected of an ICU nurse.

They have no experience dealing with docs. This is NOT a minor thing---this is a learned skill. Assertiveness, aggresiveness where necessary.

IME we are placing new grads in the ICU because we have no choice. The nursing shortage being what it is we have to take what we can get.

The most awful part? The nurses we are getting think that they are being chosen for the ICU because they are special.

And in reality we are hiring them to save money. They do not get "job rate" for almost two years after they are hired.

The experienced ICU nurses are expected to pick up the slack. It is sooo tiresome. Scary, too....especially when you think of how you would want you or your family members taken care of, should the need arise.

I honestly think we are doing them a gross disservice by hiring them directly into ICU after graduation. It's a sad reflection on what we have become.

My husband was an ICU patient last year. Luckily, they knew who his wife was....

I hope you're not precepting with that outlook.

[richo_006]

I hope you're not precepting with that outlook.

Lol yea poor new grads...oh wait ...didn't we all start as new and inexperienced nurses???

[RN1982]

Some SICUs hire new grads, some don't. Now the one where I work does hire new grads BUT they must have worked as a Nurse Extern in the SICU otherwise, new grads are not hired. It is a lot of pressure, between critical care classes and your time in the unit. There is much to learn and it can be stressful and fast-paced all at the same time. Do not expect to go into ICU and think that just because you have 1-2 patients your day will be a cakewalk.

[xtine618]

Again...just why new grads should NOT be placed in the ICU, IMHO.

Seriously....I applaud the enthusiasm of the new grads that wish to pursue an ICU career. Very commendable.

But as an experienced ICU nurse I feel I must point out the negatives inherent in hiring new grads directly into the units.

They have no basic skills. None. Nothing but book learning and the very rudiments of theory. Maybe a bit of practical stuff but nowhere near what would be expected of an ICU nurse.

They have no experience dealing with docs. This is NOT a minor thing---this is a learned skill. Assertiveness, aggresiveness where necessary.

IME we are placing new grads in the ICU because we have no choice. The nursing shortage being what it is we have to take what we can get.

The most awful part? The nurses we are getting think that they are being chosen for the ICU because they are special.

And in reality we are hiring them to save money. They do not get "job rate" for almost two years after they are hired.

The experienced ICU nurses are expected to pick up the slack. It is sooo tiresome. Scary, too....especially when you think of how you would want you or your family members taken care of, should the need arise.

I honestly think we are doing them a gross disservice by hiring them directly into ICU after graduation. It's a sad reflection on what we have become.

My husband was an ICU patient last year. Luckily, they knew who his wife was....

WindwardOahuRN, you are correct that the nursing shortage is part of the reason that there are so many new grads being hired for ICU. I mean, what are the options? Hire a new grad and be adequately staffed even though that one of the nurses is new? Or refuse to hire new grads and potentially work with higher nurse-patient ratios or even deny admission into the ICU because of poor staffing. Some hospitals can afford to be picky because they have a larger pool of applicants to choose from. But we are not comparing a new grad to a seasoned nurse. I think if there were a choice the seasoned nurse would get the job 99% of the time. Because it is actually NOT cheaper to hire new grads. Actually, it costs about $90,000 + to replace a trained ICU nurse (I had to do a paper on retention). The months spent on orientation for the new grad puts added cost to replacing this nurse.

But I think it's important to realize that if you are a new grad hired in the ICU, the reason why they did hire you DOES NOT REALLY MATTER IN THE LONG RUN. The important thing is to do the best job possible. Ask questions, learn as much as you can. Be proactive in your orientation and speak up if you think that you need more help or experience in a certain thing. Whether anyone likes it or not, the fact is that there is a shortage and new grads are being hired in critical care. I think I would be completely disheartened if I heard my preceptor talking about new grads the way some people have. Yes many of us do not have all the technical skills mastered, but we want to! Most of us are motivated, excited and want to learn from someone who genuinely wants to teach us and help us become successful nurses in the ICU. With the baby boomers retiring soon, there will be an even greater shortage and us new grads will be the senior staff members in the not too distant future. I think we need good preceptors now, to show us not only how to be a good nurse in the ICU, but also how to be a mentor to new nurses.

[sewnew]

WindwardOahuRN, you are correct that the nursing shortage is part of the reason that there are so many new grads being hired for ICU. I mean, what are the options? Hire a new grad and be adequately staffed even though that one of the nurses is new? Or refuse to hire new grads and potentially work with higher nurse-patient ratios or even deny admission into the ICU because of poor staffing. Some hospitals can afford to be picky because they have a larger pool of applicants to choose from. But we are not comparing a new grad to a seasoned nurse. I think if there were a choice the seasoned nurse would get the job 99% of the time. Because it is actually NOT cheaper to hire new grads. Actually, it costs about $90,000 + to replace a trained ICU nurse (I had to do a paper on retention). The months spent on orientation for the new grad puts added cost to replacing this nurse.

But I think it's important to realize that if you are a new grad hired in the ICU, the reason why they did hire you DOES NOT REALLY MATTER IN THE LONG RUN. The important thing is to do the best job possible. Ask questions, learn as much as you can. Be proactive in your orientation and speak up if you think that you need more help or experience in a certain thing. Whether anyone likes it or not, the fact is that there is a shortage and new grads are being hired in critical care. I think I would be completely disheartened if I heard my preceptor talking about new grads the way some people have. Yes many of us do not have all the technical skills mastered, but we want to! Most of us are motivated, excited and want to learn from someone who genuinely wants to teach us and help us become successful nurses in the ICU. With the baby boomers retiring soon, there will be an even greater shortage and us new grads will be the senior staff members in the not too distant future. I think we need good preceptors now, to show us not only how to be a good nurse in the ICU, but also how to be a mentor to new nurses.

Great post! Couldn't have said it better myself!!!