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

.... I vote for all grad nurses doing a year in medsurg before moving on to any field.:yeah:

When I was a new grad, I did med surg for 3 mos, hated it and never went back.

I have been a nurse for eighteen years now, and a traveling/float charge RN for the past four.

Not everyone needs the traditional time in med surg to be a competent, successful nurse. :)

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Specializes in SICU, Peds CVICU.
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?

In my unit those nurses ARE the ones that started out on the floor. Most of us who have never worked on the floor respect how hard and crazy it must be to have 8 patients (or more *shudder*). I try to be patient when the floor nurse tells me "Can I do my med pass and then call you back?" Yes you can if I've got nothing else coming. No you can't if there's a AAA rupture being lifeflighted and will be here in 20 mins.

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Specializes in Anesthesia.
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:

Come on, give me a break. ICU nurses have that same reputation at every single hospital. And I'm not going to lie and say I've never thought along those lines at times. I never worked med-surg and I NEVER will. And why can't every nurse, no matter where you work, understand when another nurse says she can't take report because she's busy that means she's busy. IMHO, I find no positive side to working med-surg - walkie-talkies are not for me.

You learn about meds by looking them up and administering them. Working med-surg and learning how to push morphine is not going to make you a better ICU nurse or more able to push adenosine, or any other drug for that matter. And I guess, then, I'm limited to CRNA because I only have ICU experience. DANG!! I was so hoping to have more opportunities in nursing and thought more doors were open with my BSN, I guess I was wrong. :banghead:

Good luck in all you do, you'll go further because of your med-surg experience. :bow:

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Specializes in Cardiac.
So, you many sing your own praises, I'm wondering if your coworkers do............

They do, thanks for asking!

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Specializes in Cardiac.

You learn about meds by looking them up and administering them.

Exactly.

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Specializes in ICU, PACU, Cath Lab.

Wow...this thread obviously hit someones nerve...

As for the OP. I went directly into the ICU and honestly I feel I have done great...as evidenced by my reviews, what my director tells me and from my coworkers and doctors (since I feel I have to justify my abilites as not tooting my own horn) But we definately do have some new grads that cannot and do not cut it in the ICU. IT depends on the person, their past experience's and their down right drive to do it!!!

As far as being one of the big B***** in the hospital, well I try to be nice, but I will do what I have to to take care of my patients and if that comes accross as being a you know what....well then so be it.

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thank you everyone for all your responses. I am strongly considering going into ICU. I've only had ICU experience during my clinical rotation, and found it very different from Med-Surg, but definitely felt that I learned more in ICU. Thank you so much for everybody's input...this thread was interesting...:D

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I think I am preaching to the choir about this one.

I feel a new grad starting in the ICU- It depends on the person and situation. I had a 6 month oreantation which around 4 months I felt comfortable. We also had classes and preceptors who were great. With everyone I went through oreantation with you can tell others get a lot easier assignments and us who get tougher ones.

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Specializes in ICU.

I am a new grad myself, may 08. I cannot provide the experienced point of view, but I'll give you my 2 cents worth anyway. I started in ICU, but I came in with a VA internship in MICU for a year and clinicals in 2 different ICU's under my belt. And even with all of that, it has been a challenge. I love my job, but if my co-workers weren't so supportive, I would drown. I, like many new grads, have gotten less-than-desirable orientation due to budget and staffing issues. But I have been expected to take 3 ICU patients at times just like my colleagues. At any given time we can have 10 patients with 5-6 out of those being vents. I suggest you ask for time in ICU during clinicals, and seek out an ICU position in a unit that is known for teaching students. I did well in school and in my ICU clinicals, but when you are on your own, the ICU experience can send you to your limits. You will have to assimilate a lot of pieces of information quickly when patients crash, and you have to be ready for anything because your colleagues may be too busy with their own sick patients to help you at every time you think you need it. All that said, it's doable and even enjoyable.

You will want to advocate for the longest orientation you can get for yourself, and from the start, be looking for RN's that you will be able to rely on and trust during your first months on your own. Keep the attitude that you can never learn too much, and always thoughtfully consider the advice other experienced nurses give. Know where your resources are (like drug references, text books, compatability charts or software), and be on the lookout for a mentor. I highly recommend the book Your First Year as a Nurse by Cardillo.

If you are passionate about ICU and believe you have a good base of knowledge about which you are confident, go for it!

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Specializes in ICU.

Dorie,

I highly respect the med surg nurses that work in my facility. If I got floated to their floor, I'd just die. We had one sent to us to help us out one busy night, and she made all the difference. But with all due respect, a nurse should be taught the difference between a morphine push and an adenosine push in school. I just did my first adenosine push last week, and my patient is alive because of it. I learned that in school.

If you encounter an ICU nurse being rude to you, it's about their own personality and style. I know ICU nurses who have come from many different backgrounds, and some of them ARE rude. But I am willing to bet they were rude before they got to ICU. Rude people are rude no matter where they are.

PS-Your post didn't make me mad. There is truth to it. I just wanted to make a point.

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Specializes in MICU, SICU, CRRT,.

Ok.i am a new grad (as of december 08). I just got my dream job, in the area that i wanted (ICU!!!) at the hosptal i wanted to work at. I did my preceptor and internship there in SICU, and was completely amazed at how helpful and accomodating the staff was..from the CNAs up to the Head Management, to myself and to the new grads on the unit. I knew that is where i wanted to be, but only in ICU at that specific facility, becuase they are the only one i have ever been in that cared about the students and new employes. It simply amazed me, when as a student, i was helping a nurse roll and change a bedbound patient, and the facility director walked into the room, donend her gloves, and began assisting. My jaw almost hit the floor. I have the srongest desire to be in ICU and start Monday, and am hoping for as good an experience as i have had in the past

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Specializes in Post Anesthesia.

One factor to consider is the ratio of new grads to experienced staff in the ICU. A good new grad with strong skills can make it fine in most ICU enviornments if the have the right disposition for the job and supportive, experienced staff to assist them through the first 6mos-year. If there is more than one new grad per shift per unit then the chances of sucess are less. When we have new staff working our unit it is often much more hectic to keep pitching in to help them stay on top of thier patients condition. With 2-3 new people it would be impossible without risking my own patients quality of care.

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