How do all the experienced ICU nurses feel about....

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How do you feel about a New Grad starting in the ICU? Is it safe for a New Grad? Do you recommend Med-Surg first? Thank you in advance for your feedback.

:heartbeat

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Specializes in ER/ICU/Flight.

What kind of ICU are you thinking of? med-surg, CV, neuro, peds, etc.? The only big problems I've really seen with new grads in ICUs are them trying too hard to seem like they "know it all", and I'm not trying to hurt anyone's feelings but I've given report to certain new grads and had them tell me "I already know all this", but they don't and it becomes painfully obvious when you give them enough time to prove it. Knowing the big picture doesn't really help if you've missed all the fine little details that make it up.

If you're a quick-thinker, enjoy intense contact with your patients and have an aptitude towards critical care then go for it. I don't think there's any rule like "yes new grads are good" or "no, they're not". My only advice is to take extra caution in learning the job. I've had new nurses tell me that they consider themselves an "expert" in this or that and I've said "wow, I've been doing this for 15+ years and definitely don't think of myself as an expert yet."

Congratulations on graduating and good luck wherever you end up.

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Specializes in Critical Care.

I always recommend medsurg or at least a step down unit first. I know some people don't believe in that, but you really need to learn organization skills. Plus, you get to learn more about Iv's, meds, dealing with familys, etc. We have a new grad in ICU, and he is struggling. I do believe there are a small portion of the new grads who could jump right in to ICU, but those are the ones who worked as an aide, or student nurse in an ICU.

Plus, if you plan to go further in your career, some programs won't even look at you unless you have done medsurg. So, you might as well do it right off the bat and be done. It isn't forever, maybe like a year, and then you are done.

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Specializes in Critical Care, Education.

New grads beginning in an ICU can be just as successful as their colleagues on MedSurg if they are provided with a supportive environment and allowed sufficient time for development. Unfortunately, in order to save money many organizations are cutting back on development/orientation time and eliminating special programs for new grads.

I began as a new grad in ICU (back in the Stone Age) without an internship or residency -- but a wise and caring manager and supportive co-workers made sure that I had everything I needed. I was taking a full load after 3 months, and was able to manage complex patients after 6 months.

Go for it!

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Specializes in Cardiac.
. I do believe there are a small portion of the new grads who could jump right in to ICU, but those are the ones who worked as an aide, or student nurse in an ICU.

Yes, this is consistantly the one factor that I've seen be beneficial towards new grads in the ICU. Those without any kind of experience flounder. Those with some experience do well, and those with lots of tech type experience flourish.

. Plus, if you plan to go further in your career, some programs won't even look at you unless you have done medsurg. .

Huh? Lol, I've never heard of this in my life! It literally makes me laugh out loud! So my 4.0 in nursing school, but current 4.0 in RN-BSN program, my charge experience, precerptor experince, and, soon, my CCRN won't mean anything unless I did med surge? That's just laughable.

I'd love to see the programs that require it.

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Specializes in Critical Care.
Yes, this is consistantly the one factor that I've seen be beneficial towards new grads in the ICU. Those without any kind of experience flounder. Those with some experience do well, and those with lots of tech type experience flourish.

Huh? Lol, I've never heard of this in my life! It literally makes me laugh out loud! So my 4.0 in nursing school, but current 4.0 in RN-BSN program, my charge experience, precerptor experince, and, soon, my CCRN won't mean anything unless I did med surge? That's just laughable.

I'd love to see the programs that require it.

Umm, with all your "experience" have you ever applied for a Masters to Teach? Try it and see.

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Specializes in Cardiac.

Why would I care about teaching? We're talking about nursing here. I am finishing up my BSN, then my MSN at the same school-it's a University. And, funny, they've never even asked me about medsurg experience.

And if you met me you'd be suprised at my experience level. Must have been the many years as a tech and EMT.

If my three years of experience is worth "quotes" what does that make your 2 years?

I've stayed at the same place, oriented and trained nursing with many years more experience than me and like I said, I'm in charge.

Any lame school that requires medsurg as a prerequites is stupid for turning away highly qualified nurses (that's me, btw)

I'd still like to see what school has that listed as a requirement.

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Specializes in Anesthesia.

I agree with the other posters, it really depends on the new grad and their past experience. Critical care is a whole new world. You are either born to do it or should stay away, IMHO. We have 2 new grads right now. One will suceed, the other will leave in about 6 months (she's more concerned with the color of a critical pt's poo than the pressors their on or that their tmax was 105.3). One thing to note, you must be able to work well under pressure. (My :twocents:!)

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Specializes in Critical Care.
Why would I care about teaching? We're talking about nursing here. I am finishing up my BSN, then my MSN at the same school-it's a University. And, funny, they've never even asked me about medsurg experience.

And if you met me you'd be suprised at my experience level. Must have been the many years as a tech and EMT.

If my three years of experience is worth "quotes" what does that make your 2 years?

I've stayed at the same place, oriented and trained nursing with many years more experience than me and like I said, I'm in charge.

Any lame school that requires medsurg as a prerequites is stupid for turning away highly qualified nurses (that's me, btw)

I'd still like to see what school has that listed as a requirement.

The post wasn't about you. I'm now on 3 years nursing, now considered an expert.:nurse: But, by example, I know an OR nurse going for a Masters in teaching, and she is scrambling to find some med surg experience because she was advised she needs it. One of our own ICU nurses is going for a nurse pract, and she had to take a job in the neuro unit because she needed it for her requirements.

And from past experience, I don't know how many 4.0 students we had that sucked on the floor. So, you many sing your own praises, I'm wondering if your coworkers do............

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I always recommend medsurg or at least a step down unit first. I know some people don't believe in that, but you really need to learn organization skills. Plus, you get to learn more about Iv's, meds, dealing with familys, etc. We have a new grad in ICU, and he is struggling. I do believe there are a small portion of the new grads who could jump right in to ICU, but those are the ones who worked as an aide, or student nurse in an ICU.

Plus, if you plan to go further in your career, some programs won't even look at you unless you have done medsurg. So, you might as well do it right off the bat and be done. It isn't forever, maybe like a year, and then you are done.

1--Organization skills are very different from medsurg vs ICU.

2--So, you're saying you learn more about medications on the floor than the ICU? I beg to differ.

3--Regarding the comment of some schools won't look at you without medsurg experience.....working in a critical care settings involves everything done in medsurg and so much more.

If you don't want to work medsurg, then don't. I never did and won't. I have seen new grads flourish and fail and I have seen 20 year veteran medsurg nurses do the same when they came to the ICU.

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One of our own ICU nurses is going for a nurse pract, and she had to take a job in the neuro unit because she needed it for her requirements.

This is absolutely absurd. What university is this and what requirement is she meeting by working neuro?

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Specializes in Critical Care.

Ok, forget everything I said about Med surg vs ICU. Here is the best reason to work med surg, and this is going to make all the ICU nurses who went straight to ICU mad, but I don't care. I know in my hospital, ICU nurses have a certain reputation for being mean b's who think they run the hospital. Do you know the ones with that attitude? The ones who never worked med surg and saw how completely swamped and busy they can be. I'v seen many ICU nurse talk down to the floor nurses, Shame on you! I, having worked Med Surg have tremendous respect for those nurses, and if they tell me they can't take report right now, then I understand. I treat them as my equals, not someone below me. Don't email me saying it doesn't happen, I've worked in three hospitals, and it happens in everone. So, work where you want, there is positive sides to both, and good luck.

About the meds, shouldn't a grad nurse learn how to do a morphine push before he needs to do a adenosine push? Shouldn't they learn some basic skills before they come into a high stress unit that expects them to come off of orientation knowing what they need to know? Remember, these are grad nurses who as we all know, most of the learning comes on the job, not in school. I vote for all grad nurses doing a year in medsurg before moving on to any field.:yeah:

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