How hard is it to get ICU position for new grad?

HouTx, BSN, MSN, EdD · Dec 14, 2012

I think your question is actually a two-parter. 1. How can you get in and 2. how hard is it for the new grad. So, I'll address both.

Without previous clinical experience, the only way is through a formal training program for new grads (internship, residency, etc.). Some larger organizations still offer these programs. New grad programs are very expensive so their numbers are decreasing unless they can be proven to add value to the organization. If the program outcomes are not associated with new grad retention, then they are usually eliminated.

Now - as for new grads successfully beginning their careers in ICU. It is definitely possible. That's how I started as a new grad (neuro-trauma ICU) and I loved it. Went on to work in a lot of different specialty ICU settings. It just depends on your own abilities and how well the staff can support your competency development. Even the best ICU internship will not make up for a lack of peer support... and vice versa.

Be warned - ICU nurses consider themselves "the best of the best". Very high levels of performance are the norm. If you have the opportunity to begin in ICU, I would recommend looking for a night job. Much less extraneous activity to interrupt your shift so it's easier to learn to prioritize and hone your skills.

Best of luck to you!

LTCnurse11 · Dec 16, 2012

No offense, but I think it is rather rude to believe ICU nurses are "the best of the best". Really? So how do these nurses consider themselves the best if that's all they've known? How do they know ER nurses, OB nurses, LTC/Hospice nurses, flight nurses....etc....aren't the best? Who the heck finds these trauma/neuro patients first and stabilizes them before they get to the ICU? Since when had this profession become so egotistical? A nurse who works in ICU passed the same damn test as a LTC nurse or clinic nurse.

LTCnurse11 · Dec 16, 2012

I get what you're saying about needing to know your stuff and have strong critical thinking, rapid assessment and analytical skills, but to say ICU nurses are the best of the best is just plain cocky.

IloveNursing2214 · Feb 1, 2013

ICU nurses just have more tools to work with than a regular floor nurse , that doesn't mean they are smarter and better

justluke · Feb 2, 2013

Okay, so it appears that we have gotten off course. I would like to weigh in. As a previous ICU nurse I am not sure that I agree with new grads working in ICU or ER for that matter. They are both very high stress, and have high expectations of those who work there. So, now with the new recommendations that are out there, the thought is, "Is it appropriate for new grads to work in these areas?" The answer is no. New grads do not have the experience or knowledge base that should be EXPECTED to work in the high acuity level areas. I do not mean any disrespect, but the truth is, ICU has a much higher acuity of patients usually and the students do not have assessment skills to know when the patients are getting bad. I hope that you understand, I am coming from about 5 years of also teaching as an adjunct. There is a difference in the mind sets of ICU nurses and students. Get some floor experience first. It will serve you and your patients best.

loriangel14, RN · Feb 2, 2013

Okay, so it appears that we have gotten off course. I would like to weigh in. As a previous ICU nurse I am not sure that I agree with new grads working in ICU or ER for that matter. They are both very high stress, and have high expectations of those who work there. So, now with the new recommendations that are out there, the thought is, "Is it appropriate for new grads to work in these areas?" The answer is no. New grads do not have the experience or knowledge base that should be EXPECTED to work in the high acuity level areas. I do not mean any disrespect, but the truth is, ICU has a much higher acuity of patients usually and the students do not have assessment skills to know when the patients are getting bad. I hope that you understand, I am coming from about 5 years of also teaching as an adjunct. There is a difference in the mind sets of ICU nurses and students. Get some floor experience first. It will serve you and your patients best.

I agree. Where I work a new grad wouldn't get any where near the ICU until they had LOTS of experience and extra certification.

chuckz, BSN, RN · Feb 2, 2013

When I was a new grad I hired in at a MICU at a trauma 1 hospital. For nine months every day I thought I was gonna kill somebody. I would leave and just hate the thought of going into work because i didn't want to mess up or do anything wrong. I went without sleeping because I would be awake thinking of how I could have done better. It drove me and I became a damn good icu nurse. I then left there after 18 months and became a trauma nurse in the er at the same hospital. It is one of the busier ERs in the country and I was overwhelmed. Again the fear. Again the idea that i now had to start every iv somehow someway. The fear that in the resuscitation room I wouldn't be able to get the line or or do something wrong and kill somebody. Again that fear worked to my benefit because I think I am a damn good ER nurse.

If you are a new grad and get a job in icu or ER it depends on you. If you can deal with stress and thrive under that environment I think you can do it. Let me tell you though it is a steep learning curve. I wish you all luck.

prep8611 · Feb 2, 2013

I started on the tele floors and then stepdown before going to icu and i thought the experience was invaluable. Time management and basic assessment skills won't be there for you initially. Like the poster above me said, steep learning curve but it can be done. Goodluck.