Any new grads that went into the ICU?

petulip in Alabama · Feb 28, 2001

Kim,

I was a unit secretary in an ICU when I was attending Nursing school...and as graduation approached, I was being pressured to go right into ICU..I graduated at the top of my class...and so I had no qualms about the challenges..but like you I was unsure...so I went and asked a nurse I thought highly of what she thought I should do...she gave me the best advice of my career...do 1 year of Med Surg first ..then dabble...when we graduated over 1/2 my class went right into specialty areas and they too went thru the courses you described...one of them was a very good friend of mine and a good nurse to boot....in less than 6 months she lost her job because of her inexperience..not with the actual duties...but with how to handle crisis..one of the docs, knowing she was new,changed his story to cover himself..she struggled for years until her termination was a thing of the past...last I heard very few remained in ICU. too much pressure as a new nurse...too much responsibility in ICU...really think on this..it can determine your future.find a nurse you respect..even one of your instructors and ask them. I know you are probably " biting at the bit"...but a year in Med Surg really did prepare me...good luck!!!

Charles S. Smith, RN, MS · Feb 28, 2001

Originally posted by KR:
I am in the process of interviewing for a new grad into the ICU fellowship program. The hospital has 2 ICU. The program is 4-5 months long. We work with one nurse in the one unit for 20 hours a week, and work a different nurse in the other unit for 20 hours a week. We have the same two preceptors throughout the entire program. We attend a 120 hour Critical Care Class, 45hr Trauma class, a BAsic EKG class, and a ACLS class by the end of the program. I know there is a lot of controversy over new grads being in the ICU. This is really where I want to work. I work in a different hospitals ICU now as an assistant and I love it. I was just wondering if there was anyone out there that went through a similiar program to talk to. If anyone has I would appreciate a post or email. Thanks. Kim

Yes, i went immediately from nursing school into critical care at a huge medical university...but this was a loooooong time ago. The trend soon after was to have new grads work in med/surg prior to specialty areas. Now the trend is reversing again. I will be teaching in a critical care course designed specifically for hand-picked new grads. Yep, is do-able and can be successful.

regards

chas

MD_Rn · Mar 1, 2001

I have to agree that the old stand by of 1 yr of med surg is really a good idea. You can do the ICU thing, I am sure, but I think you would be more sure of yourself if you had a yr of med surg under your belt. I worked for a few yrs on a neuro floor and then moved to the neuro icu it made the transition very easy. Good Luck!

PS... out of curiosity what hospital are we talking about?

[This message has been edited by MD_Rn (edited March 01, 2001).]

jbradleyRN · May 10, 2001

I am also a new graduate nurse entering into the nurse internship program offered at my community hospital. I also worked as an LPN on ortho-neuro and soon transisted into an RN program. I am very excited about this internship program and feel that it will be very successful and a rewarding experience for new graduate nurses. Go for it and make the best of it KB!

:cool:

[ May 10, 2001: Message edited by: Johnys Bradley ]

jamistlc · May 10, 2001

Greetings,

I went directly to a neuro/surg floor upon my graduation. I found my skills were right on target! But then again I am a LPN! And as such my duties were more or less to asess and document. I had little time to eat bananas! My duties were bedside care, medications and treatments! It was the RN who checked labs, called the Docs, and guided me in my duties. But I am very grateful for the experience as I am a better nurse for starting in a Med/Surg type enviroment compared to working Neuro ICU or something!

Peace,

Jami

imaRN · May 18, 2001

KR,

Our hosp.Rn's voted down New Grads in the units,with a similar program planned. And after the day I had today, 3 Rn's working 7 hours to save a crashing neuro. pt.(without success) We were saying "and they want new grads in the unit?" It really is not fair to You or Your patient, Your "best" patient can become the units "Worst" patient in just minutes!My advise is (not that your Really want to hear it) #1 Watch for the Trends! #2 What you Don't know is what should worry you most! #3. Good Luck to you and your patients you both will need it, because ICU patients are not the same as they were just a few years ago...#4. You must be ready to be "aggressive" and to "push" for what your patient needs from the docs.(because the resident docs will be looking to you for the answers and ideas on what to do next! ...imaRN :)

hope17237 · May 19, 2001

Hi! I have almost completed the first year in our hospital's Neuro ICU..I work in one of only 2 Trauma centers here in Houston, and this past year has been very exhausting. I came to this unit after 3years of LVN experience in LTC, and 3 months of med-surg as an RN..I missed out on the intern program, however you get a standard 3 mo. with a preceptor...I haveand am learning so much, but I feel so inadequate especially when some of the senior staff would rather watch me fail than to help me.

I had a bad experience about a month ago where I had had a very busy night with ICP issues,etc. the next morning, the nurse that relieved me kept me in report for almost an hour, being very sarcastic, and asking for the most minute of details. Feeling frustrated, I went home with my tail between my legs. When I came back in that night, I found that my assignment had changed. I asked why, but no one said anything. The charge nurse for our shift changed my assignment back, and the nurse I relieved became angry. To make an even longer story short, I had forgotten to document what time I gave Tylenol and Morphine, as well as the 6am finger stick results..basically this nurse had spent her 12 hour shift looking for any mistakes that I had made, and unfortunately I had given her enough of what she wanted. She gave me a very stern lecture/warning, advising me to seek employment elsewhere..that "my kind" wasn't needed there. I cried for 2 hours..then I noticed that she did not write a telephone order regarding the ventric. on a pt. Then I realized..you do the best you can, if you don't know, ask, and most of all..no matter how much experience you have..you are capable of making a mistake, just learn from all of them!! :confused:

PhantomRN · May 19, 2001

RULE #1 - You NEVER let someone walk on you.

RULE #2 - refer to rule one.

Hope17237, You Have done your time now leave. Go to the other hospital/trauma center. If after you have been there a year and that is the best they can treat you than let then have the job. You work nights!! Any place will jump to have you!! You have over a years experience so you are no longer considered a new grad by anyones standards. So when you apply at the other hospital just hand them your resume and say nothing let them start first. Dont apologize for only having a years experience. And when they ask why you want to leave (if they even do,,,,they will be so thrilled you are applying) just tell them you feel its time for a change with new challenges.

And if your hospital uses floats well, those girls will need to float into nights to take your place. AMEN

iamme457 · Jun 11, 2001

I have seen new nurses start in ICU CCU and Trauma and a few in ER. Some make it and some give up others just burn out. The same thing happens in Med/surg, the number of patients can be overwhelming just as the acuity of two or three in critical care areas can be. A good orientation and a prepared RN to orient you are important. You are going to have good and bad days, it takes about 2 years to become comfortable in a critical care environment. Give it that much time to see if it really is for you.

Good luck, I hope you do well.

johnboy · Jun 18, 2001

I graduated in 1993 from a BSN program, while attending school full time and working nights full time at the local university hospital/trauma center as a "nurse tech" This was during the Humana/Galen/Columbia days, and I basically got my first RN job in another state in the ICU only because i happened to work for the "company."

It was a full-blown trial by fire experience. This hospital decided not to have a critical-care training class due to "unexpected operating expenses." (Note: they've since gone out of business!) So I basically was thrown into the mix--really into a den of wolves of scheming, bitter nurses, and even nastier scheming, bitter doctors! I'll never forget the time I pushed IV Dilantin into a patient's line. I went innocently up to the charge nurse wondering why his blood pressure was so low ("huh, you're supposed to dilute it first? But i did a really SLOW IV push, i swear...")

Needless to say, I was literally having palpitations even on my days off while at the Barnes and Noble! I only survived that one because I was determined to tough it out with the help of some great older nurses who took me under their respective wings. I wouldn't wish that on anyone, and hopefully you won't be in that situation.

I tell this mainly to illustrate that it CAN be done. If some recommend Med/Surg for a year, why not just go to Medical ICU? or Surgical ICU? My heart lies more toward Medical though, because you get a much greater variety of stuff coming through. But if you're set on Neuro, I suggest getting a feel for a couple of experienced yet cynical nurses on the unit. In return for listening to them ***** and moan about everyone else, you're bound to get some invaluable tips, build close bonds, and have some fun in the process.

It helps having either a)supreme confidence, or lacking that, b)sheer bull-headed stubbornness. At times I had to bite my lip when dealing with some people, but I kept on repeating to myself, "It's all for one purpose." You can take away a "pearl of wisdom" with every interaction with another medical professional or any average idiot.

If you think that's bad enough, after two years of ICU experience (no floor work at all), I let some fool talking me into "traveling nursing." Perhaps I was a full-blown masochist by that time, i dunno. I enjoyed that too. Besides it got me my job in the Bay Area, which is where I wanted to be all along.

When it comes right down to it, I think it all depends on your personality and how you react to "curve balls" that life throws at you. Certain people thrive on this type of thing. I'm not talking about that "adrenaline" rush that "code junkies" adore, but a sense of pushing yourself and pursuing goals. Common sense and a little "sweet talk" never hurts either!

Good luck, don't let anyone play mind games with you, and always try to clean your room before the next shift. Because even if they swear they don't, they really WILL talk bad about you!

zapperbapper · May 19, 2002

I graduated 4 years ago and struggled with the same decision. There was no fellowship program only a lengthy orientation. I decided go directly into the ICU because there I would have only 2 patients (max 3) that I knew were critical and would need a high level of care. On the floor I would be faced with 8-10 patients, any number of which could become critical at any time. I could not imagine the stress level of being responsible for 8-10 sick patients. Let's face it, if you're in the hopital these days you are REALLY sick and floor nurses are pushed to the limit.