Do you hire new grads in you ICU?

Specialties CCU

Published

Sorry, but I just have to vent here...

:angryfire

My manager (who I think is an idiot) just hired 4 new grads for full time nights. The 3 she hired a few months ago just got off orientation.

We only staff 9 nurses on nights to begin with, so now there will be nights when your vast majority are new grads. I can't believe she's going to add to the problem. They aren't ACLS certified yet or IABP checked off. We've had multiple incidents were patients our endangered because of them (wedged swans for 4 hours, incompetent line pulls, not recognizing vital sign trend changes, etc.)

Do you hire new grads in your ICU?

I am a new nurse, passed my boards in April. New nurses should be screened, and preceptored. I know from personal experience that being inexperienced things go real wrong, real quick, and someone needs to be there to answer questions at all times. I want to learn, and always ask questions, but from my side I do get a huge amount of sarcasm and invalidation. It does shut me down, and I suffer to keep my head above water. I think everyone needs to take more responsibility and speak out when situations put patients in danger. I wish my unit would be more responsive to me and stop trying to weed me out, by telling me I NEED med surg experience before I get there. I feel I need support, education, and real feedback so that I can improve..

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A personality test?

I KNOW I would flunk that one!

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Specializes in ICU, Cardiac Cath/EPS Labs.

[moved this post from another thread]:

Do New Grads Miss Anything by NOT STARTING in MED/SURG? I have an interview for step-down Cardiac Critical Care, which of course is less intense than Cardiac ICU itself.....BUT: will I be foreclosing certain career options in the future due to having skipped Med/Surg? Will a Visiting Nurse Service or Doctor's Office REFUSE to consider me since I never did the standard first year in Med/Surg where a lot of shots/IVs/manual blood pressures are done??? Thanks everybody. This site is terrific--I'm finally getting around to becoming a dues-paying member---This site has been of immense help BEFORE & DURING Nursing School...and NOW that I'll be studying for the NCLEX and interviewing, I'm sure it'll be just as great! I love being a part of the nurse community--Thanks to the Moderators and all participants on this site!

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Specializes in CVICU, Education Dept., FNP Student.

I was hired as a new grad into a CVICU. I had an extensive orientation process with all the required Critical Care Classes, sheath pulling classes, IABP classes, etc. I think it's do-able with the right nurse and the right preceptor. However, nothing teaches like experience.

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Specializes in Everything but L&D and OR.
I am a new nurse, passed my boards in April. New nurses should be screened, and preceptored. I know from personal experience that being inexperienced things go real wrong, real quick, and someone needs to be there to answer questions at all times. I want to learn, and always ask questions, but from my side I do get a huge amount of sarcasm and invalidation. It does shut me down, and I suffer to keep my head above water. I think everyone needs to take more responsibility and speak out when situations put patients in danger. I wish my unit would be more responsive to me and stop trying to weed me out, by telling me I NEED med surg experience before I get there. I feel I need support, education, and real feedback so that I can improve..

I am sorry for your experience calico, but if you like what you do, you need to speak up and let them know you are in it for the long haul and would like some respect! If you don't speak up for yourself, they will continue and unfortunately I can tell you that ICU nurses do ( a majority anyway) have a bit more attitude than other nurses. Med surg experience helps, but it is not always necessary for all nurses. Good luck!!!

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Specializes in CCU/ Tele.

I agree with christymwinn. We as new grads need to stick up for ourselves! If we think we are cut out for ICU than we should at least be given the oppurtunity to try if not than we can always go into another specialty.

I am glad my nurse manager saw something in me and has taken the time to give me a proper orientation and preceptorship. I am learning so much in ICU and I don't think I necessarily would have gotten this from Med-Surg. Just my opinion.

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Specializes in Med onc, med, surg, now in ICU!.

In three short months I will be a new grad, and I desperately want to go in to ICU. My feeling is that a new grad will not handle the complexities of ICu well enough - there is too much to learn too quickly, and we need the basics. Now, to toot my own horn a bit, I am a good student, and I have good reasoning and critical thinking skills. I am confident in my practice (mostly) and I am not afraid to ask for help - hey, I'd rather look stupid than kill someone. I just don't think ICU would be a good place for a new grad who only has school as their experience.

I'm in ICU as a student now, so I know of what I speak. I absolutely love it, but I know I have a ways to go before I could adequately handle a ventilated patient with critical injuries/illness by myself.

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Specializes in Cardiac.
I agree with christymwinn. We as new grads need to stick up for ourselves! If we think we are cut out for ICU than we should at least be given the oppurtunity to try if not than we can always go into another specialty.

I am glad my nurse manager saw something in me and has taken the time to give me a proper orientation and preceptorship. I am learning so much in ICU and I don't think I necessarily would have gotten this from Med-Surg. Just my opinion.

I agree completely!

The things I learn while in ICU couldn't have been learned in MedSurg. I've been working in ICU for 2 months now fresh out of school and I am doing very well. I love it, and I would never, ever consider going anywhere else. I split the assisgnment with my preceptor, and I am responsible for all my work. If I make a mistake, then I have to deal with it. I don't get any special treatment.

Not all new grads are created equal. Being a tech before hand helped me tremendously! I already knew how to read EKGs, was a phlebotomist for 10 years, can slip an IV in just about anywhere, and already knew how to wedge a swan (and why) and how to set up A-lines.

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Specializes in Cardiac.

but I know I have a ways to go before I could adequately handle a ventilated patient with critical injuries/illness by myself.

That's what orientation/preceptorship is for! You can't handle a pt by yourself yet, not even on medsurg. Go for what you want and you'll do great!

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Not all new grads are created equal.

I agree 100%. I have known new grads that are better nurses after one year than some experienced RNs after five. Depends on the motivation of the new grad.

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I think we're missing the OP point. With the influx of new grads in this unit there will be shifts when over half the nurses have less than a years experience. In an ICU with sustained high acuities, this is a recipe for disaster. I was a new grad who went straight into critical care in a unit that didn't take new grads but accepted me because of my work as a tech prior to graduation. I was the only novice for two years when the unit director decided that new grads in small doses could work. I now have 11 years of critical care experience and firmly believe new grads can thrive if the resources and training are available-but the majority of hospitals don't have the time or patience to invest the necessary resources to do this. Read the first year in nursing section and get a sense of the frustration level of new grads with their orientations. I currently work in a unit where the hospital administration has decided that three patients per ICU night nurse is a safe ratio. And yes we have a current influx of new grads because the veteran nurses know this is a bunch of poo and a major disaster is around the corner and we're bailing for something safer. Do I think we should bring new grads into this environment? Absolutely not. It's not fair to them and certainly not safe for the patients. My bottom line is that new grads have a place in critical care as long as patient safety is not compromised. That means having an overwhelming majority of experienced nurses on every shift, a reasonable period of orientation(I believe 6 months should be the minimum), and a preceptor program that teaches experienced nurses how to precept. I am forever grateful to my first unit director who took a chance on me for hedging her bet by providing a very experienced(and patient) preceptor and the resources needed for me to be successful. I hope all you new grads have that same opportunity. Bless you and welcome to the team.:welcome:

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as a new grad recently hired into a CVICU at a major academic hospital, i am less worried about my personal ability to perform the work than i am about the "old" nurses ability to accept new grads as peers. Of COURSE i have tons to learn, but a 3 month preceptorship on the more stable patients followed by gradual increase to more challenging patients should allow me the ability to learn what i need to know to safely care for my patients, and for some of us, the ICU is really the only option. i always want my hands in everyhting, i am not cut out to work on the floor...and just as many other new grads hired into ICU positions feel this way. remember there is something to be said for motivation and having your head in the academic mindset as new grads do... don't eat us alive!

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