Where are the new grads in ICU?

BSNbeauty, BSN, RN · Jan 21, 2013

Myself and my other nursing school classmates got ICU jobs right out of nursing school. I live in MD. They are out there.

xoemmylouox, ASN, RN · Jan 21, 2013

I have heard from several new grads that they landed jobs in ICU/PICU/CCU right out of school. Some places like to train you "their way" and don't want to deal with any "bad habits" someone has from working elsewhere. Best of luck!

PMFB-RN, RN · Jan 21, 2013

New grads in the ICU, when properly trained and supported, doesn't sound crazy. In fact it's standard in the better hospitals in my area and in the country. A number of hospitals have nurse residency programs to train new grads directly into ICU. However if you have already graduated and haven't applied you are too late. One of the hospitals I work for has a 7 month nurse residency for ICU but all slots were filled months ago. A side question: Why did you wait so long?

There is some evidence that new grads in the ICU are preferable to experienced med-surg nurses. It was presented to us at a confrence but I can't remember who did it.

Apply to the highest level ICU you can find and keep applying. Also apply for jobs in tele. Many older thinking hospitals prefer to hire their ICU nurses from tele floors.

Next, keep your desire to apply to CRNA school to yourself. Many ICU nurse managers hate to lose trained nurses right at the point they are becoming useful to the unit (1-3 years). I have known them to go as far as contacting your nursing school instructors and asking if a canidate ever expressed an intention to go to CRNA school.

PMFB-RN, RN · Jan 21, 2013

pretty much every nurse out there has done something, probably more than one something, that has jeopardized pt safety. You have to live with the knowledge and always be aware that you can and WILL do something like that, esp in the ICU. People accidentally pull out lines, bleed out, extubate themselves, give too much narcotic and stop a person from breathing etc etc. When you can be a little more relaxed at work is when you feel competent on how to quickly fix these problems so they do not become life threatening...when you know how to handle any possible thing that could happen, and you feel comfortable jumping in on the new person in the next room too, then you may start to look at how far you have come and see if you are ready to apply to school.

*** Oh ya, a number of times. I think the first time was when I was titrating nipride and intended to go from 0.5mg/kg/min to 0.6mg/kg/min and forgot the decimal point at the pump and set it for 6mg/kg/min. I had been working my butt off all shift and had to pee really bad. I ran out to the restroom immediatly after setting the pump. I came back to find half the nurses in that room and alarms going off like crazy. We almost didn't get that patient back. Nowdays I regularly run drips without a pump at all, sometimes without BP monitoring for short periods of time (transport and rapid response) but now the drips are good friends of mine, not scary monsters just waiting for me to make a mistake and kill some poor patient :)

Nurseboy1 · Jan 21, 2013

We are building an ICU bed tower at my hospital and have to staff CTICU, Neuro ICU, SICU, MICU, plus expanded stepdowns. We still aren't fully staffed and the managers are hiring new grads and experienced nurses

Stephalump · Jan 21, 2013

The great hospitals in my area all seem to be full of new grads in ICU. It seemed counterintuitive to me, but I guess I can see the "grooming" benefits to it.

Ideally that's where I'd like to start out. We shall see where life takes me.

tigerlogic · Jan 21, 2013

Look at nurse residency programs. They are also competitive but seem a good way to get into specialties.

NSJodi · Jan 21, 2013

I work on an SICU at a University hospital and we hire new grads. However, my manager only hires a few at a time so the skill level is balanced and they do get an extended orientation. You may also have better luck at a teaching hospital, might get you experience with higher acuity patients.

berms123 · Jan 22, 2013

Kika,

Hi, first let me say do not get discouraged. When I finally had my ICU clinical and internships in nursing school I found out how much I loved it and that is what I wanted to do, then eventually pursue my goal as a CRNA. I know a lot of experienced nurses will frown upon a new grad entering the ICU but I could not see myself being happy in a med-surg unit. I applied to well over 100 ICU jobs (I am from Chicago) and kept on getting turned down so I took the matter into my own hands. I started to research directors in the large teaching hospitals in my area (Rush medical center, University of Chicago medical center, Northwestern University, University of Illinois) and explained to them that I am more than a piece of paper and would like to simply talk with them. This got their attention. I got an interview at the University of Illinois Chicago and eventually was hired a week later in a very high acuity and stressful Neurosurgical ICU and as of now we get a lot of regular Surgical ICU patients. One thing that stands out in my interview my boss told me that there were over 500 applicants for 1 position and what stood out was my email. Or else he would have never even taken a second look at my application.

When people say that we should not be allowed to start in an ICU, I disagree. Yes, there is no substitute for experience and wisdom, but you can learn a great amount of information from a great preceptor. I am very successful in my unit being a team leader in our hospital wide task force and being charge nurse. It does take a great deal of hard work and keeping calm under pressure, but if that is your dream go for it and do not let anyone tell you any different.

The best of luck to you! If you have any questions let me know!

WildflowerRN · Jan 23, 2013

Med/surg is NOT necessary to become a good nurse. If you have the drive, the desire, a modicum of intelligence and critical thinking skills - after a nursing internship, you will do fine in a critical care unit. Parkland and Baylor (both in Dallas) take new grads and put them in their critical care internship and straight into the ER and ICUs from day 1.

Don't let anyone discourage you. Your age can actually be an asset in nursing. Nursing so lacks authentic leadership on the floor, and your age and determination can make you a real star on your unit. Real world experience goes VERY far in nursing. After all, studies show that hard skills comprise only 20% of your job. It's the soft skills that you learn in the 'real world.'

Go for it! You've got what it takes.

WildflowerRN · Jan 23, 2013

btw, Parkland created the country's first nurse internship in 1957, and has it pretty much perfected. Parkland (and Baylor) are both level 1 trauma centers and university teaching hospitals. Parkland is the Regional Burn Center as well.

Good luck!!

kika72 · Jan 23, 2013

Thank you all so much for your replies! I really appreciate your guidance and suggestions.

PMFB-RN - I know I'm a bit late in the game in regards to residency programs. The reason is that I had a different plan!

I thought I was too late for a career as a CRNA. I thought about the experience I needed and the time spent in school full-time and almost gave up. BUT, being the stubborn person that I am, I don't think age is a good enough excuse for giving up what I really want to do, so I decided to go for it!

Berms123 - Thank you so much for your advice! I think what you did is brilliant and personally, I would have followed the same route. Your approach showed creativity and determination and many employers admire that. I worked for 12 years in the luxury hospitality and entertainment field, dealt with a great number of celebrities, lived in 5 large cities across the world and I speak fluently 4 languages. One thing I learned from all that is that there is always someone better and younger than you who can do the job, so it's all on how you market yourself. Your post gave me back that little kick in the behind I needed to remind me that creativity and individuality goes a long way!

WildflowerRN - It is because of people like you that I have been following this board for a while now! Thank you for your encouragement, you completely red my mind. I rather go in to work everyday, give my 150% and do something that i truly enjoy, rather than doing something because "I have to do it" to get me to where I want to be. I know if I get a chance to be trained in ICU, I would do my best ever, because that is the type of person I am. I know it's gonna be hard and trying for a while, but I am sure I will come out a winner. I have a natural tendency to perform well under stress and I know this may raise some eyebrows among the more experienced nurses, who know ICU like the back of their hands. But I truly believe that some people are cut for it and if well trained, they can achieve the same standard of care of an experienced nurse. I went into nursing because I grew up listening to the amazing stories my mom and my aunt, who are both nurses, used to tell me. It took me so long because I know exactly how much it takes to be a good nurse and I didn't feel ready in my younger years. So I truly believe that if you feel ready for something, go for it!