Going into the ICU as new grad

[NURSEJSS]

Hello everyone! I am a new grad and will be taking NCLEX-RN next week! I need A LOT of help with making a choice between two units that have offered me jobs. I would also like to mention I want to be an ICU nurse.

I have a job offer in one hospital for a new grad residency program working in a step down cardio unit. The training program lasts 16 weeks. The new grad program has a really great reputation. I would be working nights (which i dont mind). I also have to work at this place under a 3 year contract, which I would have to pay $10,000 if I break it.

The other job offer is at the ICU at a county trauma, level II Hospital where I precepted for about 3 months. The staff and managers really loved me and offered me a place with them. I would also be working nights. This hospital does not offer a new grad residency training program like the other one, and I would only get 10 weeks of orientation. I also have been working in this hospital for 7 months on the med surg floor as a nursing assistant. Since I had a great experience precepting in the ICU and since management loved me, they transferred me to work in the ICU as an aid so they could hire me as a nurse right after I get my license. I have been working in this ICU as an aid for 1 month now. So total, I have experience precepting here as a nursing student and working in the hospital as an aid.

I am caught between these two options. I really love working in the ICU and I think its a great opportunity that I can go into the ICU right after school. I also have the advantage of knowing the staff already, including the doctors (residents & attendings), RT's and supportive staff. My heart says to go to the ICU but I am scared that I would be turning down a good opportunity if I decline the residency program at the other hospital. I also know many people say not to start in the ICU as a new grad so I am afraid of that too.

I honestly dont want to work at the other place. its in a city where I dont want to live or commute to for the next 3 years. I would only be going for the New Grad Residency Program because I know it's a great opportunity and I feel like it will adequately train me. The ICU I know Ill just get thrown in there and learn how to swim.

Please help! I just want to get some insight. Hopefully some of you have encountered this dilemma. Should I go somewhere else to get the trainng even though its not in a place I dont want to be, or should I go to the unit im interested in even though I wont get the proper training I could get from a new grad program?

Thank you!

[sjalv]

Can I ask why it's asking for trouble?

Would you sign a 3-year lease with a landlord whom you know nothing about? You don't know what the work environment is like, what management is like, what your coworkers are like, if you'll even like working with the patient population, etc. For reference, I signed a 2 year contract with the ICU in which I work and even that was a gamble. Fortunately, it worked out in my favor.

[Postpartum RN]

Take the icu job. It is obviously where your heart is. You will be unhappy with the other job since you are having doubts right now!

In my experience, signing a 3 year contract is not a great sign. Usually they do that if they cannot retain nurses, for whatever reason. Like you said you already know the people and the way that unit works and you like it. If I were you I would take the icu job. Most places will extend your orientation if you ask for it if you feel like you are not ready

[cjcsoon2bnp, MSN, RN, NP]

I would suggest taking the ICU job. It sounds like this is where your heart lies and although the orientation time seems a bit short you might be able to work something out with your manager. Taking a job that requires a (3) year commitment or facing such a stiff penalty seems like a huge gamble to me and not something I would even consider unless I had no other options. Sure, it could end up being a great job that you love but it could also end up being a nightmare that you are stuck in and the only way to leave would result in a financial burden. If you feel like you have a good reputation in the ICU, enjoy the staff and working conditions and see opportunities for personal and professional growth then I would take the ICU job without looking back. Best of luck in your final decision!

!Chris

[VANurse2010]

but would only a 10 week orientation be a concern? Thats all I will get if I chose the ICU.

10 weeks is too short for a new grad. 10 weeks is roughly what an experienced floor nurse transitioning to ICU should get. At my hospital, new grads in critical care get 20 weeks, if that gives you some perspective.

I am not a huge fan of new grads in the ICU, but you can be successful with the right support and orientation. 10 weeks isn't going to cut it.

[Zelda, RN]

Take the ICU job.

1: You already know the charting system. You probably know how to chart things quickly and efficiently, and though nurse charting is different than as an aid, every bit of knowledge helps. Learning to be a nurse + learning a new system makes it 10x harder. I know - I just started my 2nd nursing job, but it's a new charting system from the two I already knew. It's making it so much harder.

2: You already have a relationship with your coworkers. You know who you can go to, who not to bother, etc. I don't make friends easily, so having people around that I already trust makes my job much easier.

3: A new grad residency is useless if you spend the whole time thinking about the ICU job you wish you'd taken. And you'd have to wait THREE years to go back to your beloved ICU!

10 weeks is short BUT you do have a small leg up since you are familiar with the hospital. That means your orientation will be focused mostly on nursing stuff, instead of nursing + little hospital policies/rules + charting etc.

[EllaBella1, BSN]

I also vote to take the ICU position. I'm a new grad who is an ICU resident and while I love the ICU, the residency portion was a pretty big waste of my time. I think I would have a learned a LOT more just orienting on the floor the whole time in my case. That said, 10 weeks is a short orientation for ICU. I would still go for it though and just be diligent in studying and working hard.

[BellionRN]

I went to ICU as a new grad.

Like you, I had worked as a Student Nurse Employee in the same ICU in which I was hired. I did a mentorship program the summer between my third and fourth years of Nursing and picked up during my fourth year.

When I graduated, they encouraged me to apply there as a new grad. And again, like you, I wavered because I didn't think the ICU was any place for a new grad. I had actually initially applied to the General Surgery unit.

I took a critical care nursing program that included a 3.5 wk preceptorship at the end of the 3 month program. After that, I got an orientation to the unit that was approx 8-10 wks (I can't remember exactly).

It sounds like you are already a step ahead because you know the unit and the staff. It also sounds like you have a good rapport with them, so you'll have people to go to when you are unsure or have questions related to certain disease processes, drips, tests, etc. I'd also be very surprised if you were denied an extra week or two of orientation as a new grad in an ICU if you weren't feeling ready to be on your own just yet (keep in mind you won't feel 100% ready... ever! ).

I think you should follow your gut on this one. As much as I didn't think I had any business being in an ICU as a new grad, I wouldn't change my experience for anything. I was careful & I asked a lot of questions. I had wonderful support from the nurses on my unit. I learned an incredible amount.

In ICU, you are never alone.

Good luck! I'm not from the US, but it sounds like you are incredibly lucky to be offered two jobs as a new grad from what I've read on this website re: job shortage.

[RNNPICU, BSN, RN]

I started in the ICU as a new grad and we had a six month orientation, We had a new grad program (residency). It was great. I would ask questions how the ICU orientation would work. You want to make sure you get enough exposure because once you are off orientation you will be expected to function as every one else. You also want to make sure that your learning needs are met.

I do not want to dissuade you from the ICU, new grads can function, survive, and thrive in an ICU. You do need an appropriate orientation, and a pace that will work. Ask more questions regarding the orientation, ask about a schedule of how you will gradually be exposed to sicker and sicker patients, how will your preceptor be weaned off, etc.

Once you have all of that information compare to the other unit. I think ICU is a great place to be a nurse. It is fascinating, rewarding, scary, exciting, sad, emotional, high tech, fast paced.