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

Specializes in Critical Care.

This has been an interesting read. I'm a (soon to be) new grad that just accepted a job in the very ICU I've worked for 4 years as a monitor tech, so I'm hoping for a smoother transition than most. :)

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Specializes in CVICU.

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:

Um, for one thing, I don't know many med surg nurses who know how to do an adenosine push. That's not something one would typically be pushing on a med surg floor. In fact, if someone needed adenosine on the floor, it's likely an ICU nurse would be the one responding to the rapid response call, thus being the one to push it. Secondly, simple IVP drugs are something a person should have learned how to do in school or during their preceptorship. If not, it's not like it's something too complicated to learn.

I was a CNA in a nursing home, a trauma/surg ICU, and the ER prior to getting my BSN. I had absolutely no desire to work in med surg. I don't belittle the nurses who choose to do so. I actually applaud them because I know how bad it can be out there, and they do have to know a lot to do their jobs.

I have always wanted to work in critical care, and I started in the CVICU as a new grad and I have been there a little over a year now. While I know that I'm not the best nurse in the unit, I do know that I am a rising star. I love talking to the veteran nurses and I do go to them for help when I don't know something. Keep in mind, the questions I usually ask them are things a med surg nurse wouldn't know. I jumped right in and was taking high acutiy patients without difficulty after coming off orientation. Other nurses compliment me on how well I am doing. Doctors listen to my suggestions and respect my judgement (well the ones who aren't jerks...), and I listen to theirs. I'm a team player, and I help my fellow nurses when they're in a bind. I have responded to RRTs on med surg floors when the lead was busy with another one. I feel like I was adequately prepared to be an ICU nurse as a new grad, and I have never regretted not starting in med surg.

I think there are a handful of new grads who are adequately prepared to go straight to the ICU if they choose, and there are definitely those who need more experience first... but don't tell me you don't think I can kick it because I can--and do!

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Specializes in Cardiac.

What's funny is, pushing morphine and adenosine have nothing to do with each other.

If you push adenosine like morphine, you'll get laughed out of the room. In fact, most experienced nurses who come to the unit are very uncomfortable pushing something that fast.

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Specializes in Critical Care.

This board is like the game we used to play in school, you whisper a phrase in someones ear, and it changes completely before it gets to the end!

I never said pushing morphine is the same as pushing adenosine! My point was: A new graduate nurse needs to learn the basics of nursing before being thrown in to the intensity of ICU nursing. That is only my opinion and the opinion of most older ICU nurses. The younger nurses want to start at the top, and don't even have basic skills perfected yet. They feel making a bed, or giving a bath is beneath them. (except for you few perfect nurses that I'm sure I will hear from).

Also about the Masters program wanting you to have medsurg experience. I was talking about teaching Nursing. Lets all think back a moment from school. Were you taught Critical Care Nursing? Were you taught OR nursing? Were you taught Cancer nursing? NO! You were taught Med Surg Nursing! Soooooo, how in the heck can you teach a clinical, when all you did was went straight to ICU????? Thats why the program wants you to have a rounded nursing history, in medsurg, neuro, etc. If you aren't thinking about going for a Masters in teaching, FORGET ABOUT WHAT I SAID AND MOVE ON!!! Sheesh

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Specializes in Cardiac.

I'd like to see the schools curriculum where it states med surg nursing required.

Could you provide the link?

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Specializes in CVICU.

Well, needless to say, I have no inkling of an interest of ever getting my master's in teaching. Fortunately for me, all the grad schools I am looking at want ICU experience, and preferably CVICU.

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Specializes in ICU, PACU, Cath Lab.

Well I am far from perfect...and the first to admit it. Most ICU nurses I know new and far from thinking they are above a bath or a sheet change and I bet I do more baths and bed changes then most floor nurses. I am also pretty sure if I can learn to do them to a patient on a vent, with drips and in a hypothermia protocol...I could handle one on the floor. JMO.

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Specializes in Cardiac.

We don't have techs or CNAs on my unit. So in addition to the Q1 FSBG, vitals and I/Os that I do on both my pts, I also have to clean them and change their sheets every day-sometimes multiple times a day! Being in charge I also help everyone else do this as well.

Lol.

When did coming to the ICU become less work? So now we can't push IV meds correctly unless we slaved in MedSurg and now we don't know how to give a bath or find it beneath us?

Sorry, I dont' find pt care beneath me. I take care of my whole pt.

Doris, we graduated at the same time, except all of my time has been in the ICU. Do you feel that you learned how to give a bath in MedSurg?

Because when I worked in MedSurg as a PCT we kinda did all the baths, linen changes, vital signs, I/Os, ambulations, finger sticks, foleys, dressing changes (I could go on forever)....

Here in the ICU is where I still have to do them, myself. If anything, I would recommend the new nurses coming to the ICU have experience as a tech/CNA in MedSurg rather than nursing.

That's where you do/learn all the basics of nursing, IMO.

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Specializes in Cardiac.

Oh, and I'd still like to see the link of the college that requires med surg nursing as a pre-req for their Masters to Teach Nursing.

Please provide the link so I can review it.

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Specializes in MICU, SICU, CRRT,.
We don't have techs or CNAs on my unit. So in addition to the Q1 FSBG, vitals and I/Os that I do on both my pts, I also have to clean them and change their sheets every day-sometimes multiple times a day! Being in charge I also help everyone else do this as well.

Lol.

When did coming to the ICU become less work? So now we can't push IV meds correctly unless we slaved in MedSurg and now we don't know how to give a bath or find it beneath us?

Sorry, I dont' find pt care beneath me. I take care of my whole pt.

Doris, we graduated at the same time, except all of my time has been in the ICU. Do you feel that you learned how to give a bath in MedSurg?

Because when I worked in MedSurg as a PCT we kinda did all the baths, linen changes, vital signs, I/Os, ambulations, finger sticks, foleys, dressing changes (I could go on forever)....

Here in the ICU is where I still have to do them, myself. If anything, I would recommend the new nurses coming to the ICU have experience as a tech/CNA in MedSurg rather than nursing.

That's where you do/learn all the basics of nursing, IMO.

I do agree that a n ICU nurse has to be very well rounded in all aspects of patient care, as well as posses great critical thinking skills and know how to think outside of the box. In the unit, a patient is usually more complicated than onthe floor..they may have multiple problems that may or may not relate, and may or may not even be diagnosed yet. The nurse is the one with the patient all day, sees what is going on, and steps inwhen needed. I say this from the standpoint of a new nurse, and the only ICU experience i have really had is from my preceptorship, which was only 90 hours (or 8 days)..i started monday with orientation and will be in MICU starting next week, as a new grad. My director knows i have no real background in ICU, but yet i was hired on the spot, over several experienced ICU nurses, because i was told i had the right attitude, and the dediction to get in there and learn. I dont now how much that will matter once i get in there, but I am determined to make them proud, and leave them no room to doubt their decision to hire me. However, i have to admit i am scared to death, because next week, my first week on the unit....Joint Commission will be there!! I expected them to ask me to not work that week ( i have seen other places do this), because of that, but no..they want me there front and center, and a honest as i can be about my knowledge or lack thereof...sugestions on that??

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Specializes in CV-ICU.

I definitely agree. And would just add find you a strong nurse on your rotation if you start in critical care.

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Specializes in CT ICU, OR, Orthopedic.
Umm, with all your "experience" have you ever applied for a Masters to Teach? Try it and see.

I have never seen med surg as a requirement for any program.

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