CVICU, as a new grad?

JzK CCRN, BSN, EMT-I · Jun 7, 2023

Hi. Congratulations on the upcoming graduation ?

I'd like to give you a simple answer, ? but is be cheating you, so bear with me...

Like many, coming from EMS into nursing, I wanted nothing less the critical care right away. I'm turns, my RN career first started out in homecare hospice. Then an opportunity came for a hospital medsurge/vent/infection disease/tele(ish)/geriatric/psych unit. The only thing we didn't do were acute vents (those were sent to acute vent floor) and cardiac gtt (also sent to that floor). Got tell you, I've got pretty comfortable there and reached my level of seniority and boredom there. Once in a while, we'd see an interesting case but otherwise, 7-9 pts on average, it became mandane.

However, on 2020 between Feb and June, I've seen enough "action" that I was FOREVER thankful that I was in the medsurge floor. Side disclaimer, I'm a nerd ? I'll do self learning, I'll take a class or even a full course for my self, for fun, just to learn. BUT being on medsurge floor and learning the basics, learning fundamentals of acute care, gave me a very strong foundation. I'd avoid calling an RRT like a plague, meaning I'll do everything possible that needs to be done and learned to anticipate what could be done, all to avoid an RRT bc I HATE the paperwork. One of the biggest compliments I got from hospitalists, during a RRT is "why aren't you in ICU?" - At that time, the right scheduling opportunity wasn't there.

It was during those 3 months, I realized, that had it not been for fundamentals of medsurge, I'd probably not survive hospital career as RN.

Moving fwd, I finally did get into ICU. At this point, almost a year and a half later, I probably ask the most Qs on biochem/pathophysiology/treatment, etc etc... Sure, docs and PAs are saying that it's OK and good to ask, but even I feel that sometimes they just want me to shut up LOL.

My simple answer is, do medsurge, learn the basics and get strong with it, then go on.

HOWEVER, when you get your RN license and if an opportunity comes to jump into critical care - yea, it'll be tough, but make sure that on top of why you're learning there, you're investing as much time into getting the basics/fundamentals under your belt.

A friend of mine, she's been an educator in my hospital and now does precepting as well as ED RN .... Her biggest pet peeves, is that new grads m, especially lately, don't have good fundamentals and that's because over last 2-3yrs, RN students spend more time on zoom classes then seeing actual patients. So the challenge that you'll have for your self, is learning both critical care all while getting basic medsurge under you're belt.

Good Luck!

Motonurse45 · Jun 25, 2023

There is a hand full of new grad programs that offer specialty units. The best thing you can do is get a preceptorship in ICU and start looking at new grad programs asap. I agree with Jxk RN that you need a good foundation, but it depends on the new nurse's experience and background. We don't know what you know or experience. As for CRNA, I recommend shadowing some and documenting your experiences, and most programs would not accept PACU of ED experience. Do not say that you are interested in CRNA in your ICU interview. Best of luck.

JuicyJ95, BSN, RN · Aug 11, 2023

Times have changed, new grads are getting into these specialty units ALL THE TIME. The trick is, get into a nurse residency program. These programs are rigorous, usually have you orienting for 6 months on the unit, and they really put the focus on your education and the fundamentals to give you a great basis to start in these units. I would look into that, and if critical care is what you're after then go get it! You spent good money on your education, so go out and use it the way you want to. That said, if and when you do get into a program, be a sponge and never stop learning! They expect you to be on the top of your game at all times in these programs.