Advice For 'Wanna-Be-ICU Nurse' (new grad)

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Hi!

I will be graduated in next week, and am seeking a job.

I want to be an ICU nurse but couldn't get offers so far.

Now I am waiting for the results from PCU, and got an offer from a med-surg unit--I need to reply back for my acceptance/decline offer for the med-surg by tomorrow, but didn't decide yet..

I read someone said, to be an ICU nurse, becoming a PCU nurse could be really a great pathway. Then becoming a med-surg nurse will be harder to become an ICU nurse?

Also, personally, I don't like to work in the med-surg, but the hospital is good..so I am debating if I just get in my step first and then change the specialty would be better OR waiting for the specialty I want would be better..

Would you please give me some advice? I really don't know what to do..

Thank you!

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Take the job! You could be waiting for a long time. Experience will make you more appealing for an ICU job.

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Specializes in NICU.

My standard advice for getting the job that you want is to widen the net, if you are able to. There is a hospital somewhere in the country that is willing to give you an ICU residency, you just need to find them.

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Specializes in ICU.

ICU is not a place to learn basic nursing, you have to put an ever-changing puzzle together all day long.  Get some med-surg time behind you, a year or more.  If nothing else, you need to learn how the hospital works.  

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Specializes in Advanced Practice, Critical Care.

Starting in Med-Surg has no bearing on your ability to eventually transfer to ICU and is a great place to get your fundamental skills, prioritization and time management skills down cold. Starting in ICU means not only are you learning basic nursing, you are learning critical care nursing at the same time. If you are a stellar student, critical thinking comes second nature to you, you pick up skills and knowledge quickly and you can move with a sense of urgency, then ICU may be a good fit for you. However, if the hospital you like has a high acuity PCU you will learn a lot there that will be of benefit to you in the ICU. Many times PCU nurses will float to ICU to take patients that are ready for stepdown/PCU but there is no bed available. If the staff see you are capable and curious, they will start asking for you and/or encourage you to transfer. Then they will fight to precept you! Best of luck with your decision.

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Specializes in Surgical/Trauma/Neuroscience/Cardiac ICU.

Usually after 6 mos, you are allowed to transfer to different unit. Hopefully by then, you are comfortable with your time management and prioritization. Really, coming from med-surg/gen surg to ICU helped me with fundamental skills but also with the confidence to deal with stressful situations. I chose transitioning to a Level 1 Trauma Center teaching hospital in their Surgery/Trauma/Neuroscience ICU. You could choose PICU, CVICU, or MICU depending on your goals. 

ICU is a different world in terms of acuity that is why there is orientation to integrate basic to advanced nursing skills. I'm working with new grads in the ICU right now and they are thriving. The orientation for them is 6mos or more if needed. It also helps that my workplace caters to teaching/learning opportunities with helpful culture and not to blame culture but to improve. Accepting constructive feedback is also beneficial for growth. I learn a lot from Daily Patient Rounds and the Residents are very accessible to approach in the unit. 

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Specializes in Emergency Medicine.
On 4/25/2022 at 8:45 PM, Nursetom1963 said:

ICU is not a place to learn basic nursing, you have to put an ever-changing puzzle together all day long.  Get some med-surg time behind you, a year or more.  If nothing else, you need to learn how the hospital works.  

This is a very antiquated thought process, and many hospitals have residency programs these days in ICU, ER, L&D and other specialties and the nurses do great! 

On 4/28/2022 at 10:03 PM, hypnotizer90 said:

I'm working with new grads in the ICU right now and they are thriving. The orientation for them is 6mos or more if needed. 

Exactly this! There are New Grads in the ER where I work at, and they are doing wonderful. There is an extensive orientation and mentoring program available to them. No med/surg required!

On 4/25/2022 at 7:55 PM, NICU Guy said:

There is a hospital somewhere in the country that is willing to give you an ICU residency, you just need to find them.

ABSOLUTELY! Lots of places willing to hire new RNs into specialty roles with great orientation programs, and even residencies. If you are willing or able to relocate, this would be a great option. Sometimes rural hospitals are a great place to get your foot in the door, and a wonderful place to learn as well.

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