THanks for the time and thought you put into your message- I was expecting to get deluged.
congratulations and keep up the good work!
But (and there always is one...) a couple points to consider: most new grads do not have your background (The CE classes, ED tech background, understanding how a unit flows and how to prioritize, to name a few.) How much of your ICU comfort level comes from skills you acquired on your own? How much more than your classmates did you get out of your orientation because you knew what questions to ask? You are not a typical new grad and we can't evaluate a typical new grad based on your accomplishments. Most new grads are not ready to assimilate textbook with clinical information and act in a critical care setting.
I graduated when nurses were being laid off. I had the chance to move right into ICU even then, but realized that while I had done well in class and in clinical, real life nursing was different. I did some M/S, stepdown, then got my training in a 28 bed level one ICU. Even with a solid background and being com- fortable working with pat- ients, docs, and families, it was oftem terrifying. Now I am an ICU traveller and feel comfortable walk- ing into a lot of different situations. (BTW, I get great feedback and eval- uations, too..
Missing something can kill a patient in any setting, but the risk is so much higher in ICU, and the time you have to act is so much shorter. You certainly have gone out of your way to learn, and deserve credit for that. With the extra background, you might well be able to function under the pressure and frustration of critical care nursing without time to become comfortable with yourself as a nurse first. But most new grads just aren't able to do it. They can be excellent new nurses with tons of potential, but the risk to patients is too high to offer ICU nursing as an option to new grads in general when most (IMHO) won't be ready for it yet.
I'm glad you have the personal wherewithal to ask questions when you're uncertain. I'm glad you have extra skills that make you more solid in your practice. But it is your outside background that made you a solid ICU candidate- not your nursing school background alone.
In my opinion, new grads need to learn how to be nurses before trying to perform in such a high-risk siutation, both for patient safety and for their own mental health. But I wish you luck.
As for my compassion for new grads, well, what little I have learned I love to share, and I remember how horrible veteran ICU nurses can be to youngins.
While I love to precept students, I decline to precept new grads. I don't think it's fair to them and I don't want the liability.
Would you mind posting updates on your new grad experience? It's interes- ting to see your view. And I'd be interested in how you and your classmates do over time.