Help! Am I being unrealistic trying to get into the ICU as a new grad?
Ever since I started nursing school I have had a desire to work in critical care. Actually it was the encouraging words I heard from critical care and ED nurses two years ago that helped me to decide to get my nursing degree first instead of the paramedic degree I was headed towards. My long-term goal is to be a flight nurse because pre-hospital is where I truly love to be and I knew that I would probably have to work >5 years in a Level 1 Trauma ED and ICU before I had a chance to get in the air. The thought of getting stuck on med-surg has always been, well, awful to me.
Now I am about to graduate from nursing school and have found during my senior preceptorship in a Level 1 Trauma/Neuro ICU, that many of the nurses on that unit think that a new grad will never make it in ICU and should start out in the neuro stepdown med/surg unit. However, other nurses who were new grads in the ICU and ED (at the same hospital) encourage me to not settle for anything less than what I truly want, and to go for it. "There's no sense in making yourself miserable in med/surg," I've been told.
Now that I've had a taste of taking care of patients in the ICU for the past two months, I really, REALLY don't want to start on med/surg. The thought of being stuck there for at least one year just isn't pleasant. I love it in the ICU. (Also, the particular neuro stepdown unit is poorly staffed and I just see myself getting burnt out with nursing if I have to work there for a year.) However, I don't want to be so bullheaded about starting in the ICU that I miss the opportunity to get my foot in the door by starting on a stepdown unit to eventually get into the ICU, if that's the only way to do it.
The hospital I am doing my senior practicum in is projecting that they will have a critical care internship this October (but they do not have any openings right now). It is the place where I would really like to be. I've been told by someone in the employment office that I don't have a chance because of all the internal applicants that want to move from med/surg. I did apply at the other large hospital in the area for their critical care internship this summer, but am unlikely to get in because I did not do my senior practicum there (although I did do more than a year of clinical time on their med/surg units.) I do have additional patient care experience as an EMT for three years on a rural transporting 911 ambulance, a CNA for a year in med/surg, and a unit secretary in med/surg and telemetry for more than two years.
My other consideration is that I do have a guaranteed med/surg position at the hospital I currently work at as a US/CNA, if I want it. I do really love working there, but it is a small hospital with mostly routine stuff and I don't know that I would get the experience I need to get into the specialty area I want (Level 1 Trauma). I also know that if I started there I would likely be moving on in a year, if I could, to a bigger hospital, and would feel bad for leaving after they spent all that money on me for orientation. They've been so good to me over the years that it just doesn't seem right to take the job and leave after a year.
So that is my dilemma...turn down the med/surg position and take my chances on getting into the critical care internship later this fall, or do the time in med/surg and try again in a year to get to where I really want to be. Help!
