yes or no

I think new grads need some experience first, I worked in several different capacities as a nurse over the span of 10 years. Only then did I consider critical care as an option (after much prodding from colleagues) Not many new grads survive going straight into critical care. At least from my experience.

I'm a new grad (December, '08) in an ICU. I just finished 6 months of orientation and have been on my own for about 3 weeks. Two nights ago, I had the shift from hell and was fairly certain that I, nor any other new grad, should ever work in an ICU. I was ready to throw in the towel, call my boss and quit, then find a new career. After talking to my (wonderfully supportive) co-workers about this situation, it sounds like it's fairly typical, especially for us 'nubes. So, following that, here's my thoughts:

1. New grads must be willing to fail. Miserably. It's a hazard of being in the ICU from the start; we are task-oriented and just not experienced enough to see "the big picture" in a lot of cases. There will be many humbling experieinces. Check your ego at the door. Being on orientation is a walk in the park compared to the "real thing," even on the days when you're given a long leash by your preceptor.

2. Stress management and care of YOURSELF. The ICU has changed me in many ways. I am still learning to adapt my life to the new person that my job has made me. It might mean making some changes outside of work. It's a traumatic environment for nurses, too...I've started seeing life differently.

3. Asking questions. It's a given, I know, but after my super-bad day, I realized I hadn't been asking ENOUGH questions. Ask stupid questions. Ask smart questions. Think of something to ask another nurse at least once an hour. Just ask them. If you're on a unit that doesn't support this process, I would suggest running away as fast as your little legs can carry you.

It is a very, very steep learning curve, and I almost feel like I'm starting from scratch now that I'm off orientation. I was very antsty (by the end) to be "free" and while I'm still glad to be on my own (finally,) it is more stressful and difficult than I could have ever imagined. I've been fortunate enough to have been blessed with the genes and the work ethic to excel at most things I set my mind to...the ICU is whole different animal. There is no flying under the radar when people's lives are on the line.

Best of luck to you!

You want the quick and dirty or you want the neat and nice?
Quick and dirty? NO. Just...no.
Neat and nice? NO. Just....no.
Yes, YEARS later, new grads "have done well" in ICU. But honestly, no holds barred? They are a massive burden to experienced nurses who feel obligated to save them and, not incidentally, their patients.
Those of us who have any conscience at all can not look the other way while these very-well-meaning newbies screw up left and right. It's tremendously draining but dammit, we do it, time and time again.
No offense meant to the new grads who mean well and are trying their very hardest to do right. But you have to start with the basics and ICU is NOT the basics.
You simply have no idea what you do NOT know. Trust me on this one. I was there once, with years of med-surg and other experience behind me. I was humbled and humiliated, appropriately so. Absolutely no sense of entitlement, no cockiness. Scared poopless. Those who had knowledge vastly superior to mine took me under their wings and taught me. Had I shown the very faintest bit of cockiness they would have shot me on sight. Gotta love the NY county hospital ICU environment, LOL.
Get your basics down pat and then venture into critical care. Lives depend on it. Truth be told? I don't want you taking care of me or anyone I love. I've seen way too many mistakes made to trust a newbie with my loved ones.
Yes, once again I suppose the folks who went into critical care as new grads will declare that they did amazingly well yada yada yada.
And once again we will see a dearth of posts from experienced nurses who beg to differ.
So sorry if I failed to contribute to the usual support group atmosphere.

*** Our hospital has a 7 month long nurse residency program for new grads going into the ICU. It includes two months of three 12 hour shifts a week on one of the med-surg floors with a preceptor to gain time management and prioritization skills before they come up to start their clinicals in the ICU. I regularly serve as a preceptor to these new grads and they are great. I much prefer them to the stream of experienced med surg nurses I used to train. I find them easier to train, less "ya I already know that" attitude. In my view the biggest hindrance some of the med surg nurses have is their instinct to call a doctor or somebody else with an emergent problem rather that heading strait to the bedside to intervene RIGHT NOW. Usually our patients don't have time to wait while a doctor calls you back. We have protocols and standing order for nurses to interviene immediately without first seeking medical direction. It can be a big leap for some of them.
We stopped recruiting med-surg nurses. They are still considered on a case by case basis if they seek us out and apply.