How to land a new grad ICU residency?

jmroh, BSN, RN · Mar 5, 2020

I would say try to get ICU experience somehow. Whether through being a nursing assistant or even working something close to it like a step-down. Sometimes it will take a year to get where you want to be. Getting into step-down or med/tele first and then transitioning into ICU after maybe a year. Many of the interviews I received for ICU nurse residency programs asked questions about my time in the ICU as senior practicum, so I do think that weighed a bit more on my resume.

Hoosier_RN, MSN · Mar 5, 2020

You say you have a short list of locations where you want to work. Depending on the new grad situation, you may need to be more open to other locations for that first job. Realistically, if the market is saturated in the locations that you desire, persons who have established contact with facilities will have a better chance at placement. I agree to get work as an aide or tech in ICU to get some marketable experience

ICUity · Mar 21, 2020

Hi,

I thought I would contribute the parts I have experience with. I got an offer earlier this month for an ICU residency, and I can share what I encountered in my various interviews and what I think helped. I also did 3 other ICU interviews in other hospitals and have progressed in those applications, but I'll be declining them since I accepted the first offer.

I did senior Capstone clinical at a nationally-ranked pediatric cardiac ICU, which was an incredible experience. I learned so much about how to monitor the patients, the types of devices, heart procedures, etc. Being able to talk about all of these things during the interview showed that I had been exposed to an ICU setting with intubated patients, ECMO, ventilated, had seen/helped with codes, trachs, etc, and was familiar with the specific things they monitor for in ICUs as far as hemodynamics and labs. I did all or most of the charting for my preceptors on the shifts I was there, and became very accustomed to hourly charting, and I was able to participate in rounds and give report, which was very helpful as well. I think things like this can make you a more appealing candidate to managers and directors at an ICU, I would imagine. (Only able to speak from my own experience and speculation though.)

I think another thing they seemed to look at is they really want to know why I want to work in an ICU. I would imagine because it is a stressful, high acuity setting where patients' health conditions are typically unstable, and it can take a lot out of the nurses from what I observed. If you show them you know what you are getting yourself into and have really put thought and consideration into why you want to go into the ICU, then that would probably make you more appealing versus someone who isn't sure but just wants to do it to go back to school for CRNA or something in a year or two. My BSN will be my 3rd degree, and I had to explain at one of my interviews why I had a career change. They also specifically asked me if I would be wanting to go back to school, so I think they are aware of that happening, and probably are less interested in someone that is just going to leave in a year or two after the hospital invests in their training.

I was also asked quite a bit of in-depth interview questions, more than the typical behavioral assessment type questions, so it would be good to understand as much as you can about the ICU, patient deterioration and outcomes, etc.

That's what I can offer as far as my own experience interviewing in this crazy residency process. Good luck to you!

KimboLimbo, ADN, BSN, RN · Jul 22, 2020

First of all, congratulations for making it this far in your BSN program! That’s a huge accomplishment but don’t get senior-itis, keep trucking! I’ll share my experience with you in hopes that you can take something from it!

I recently graduated from an ADN program and just accepted a ICU Nurse Residency position in a level 1 trauma center. As a ADN nurse graduate, I knew going for critical positions would be difficult considering most hospitals won’t even consider ADN graduates (BSN graduates were “highly preferred.”) By graduating with your BSN, you’ll have a significant advantage, kudos!

During my second semester, I was lucky enough to score a PCT position at a highly renowned Children’s hospital. There, because I was resource, I was able to float to all of the CC units (PICU, CVICU, ED) and gained valuable experience. Most nurses are aware that a lot of PCTs are currently in, or planning to pursue, a career in nursing. In my experience, they've were extremely helpful... educating on disease process, nursing process, assessments and even allowing me to assist in procedures. This is a huge advantage. If you’re able to, I’d highly recommend securing a PCT job in critical care. If the unit likes you enough, they’ll hire you!

In my case, I new I wanted to start in Adult Critical care, so while in my last semester of nursing school, I applied to an Adult MICU at a high volume L1 trauma center and was able to score that position. I believe having both these experiences had a huge impact on my resume.

I also tried to set myself apart from other candidates by ramping up my certifications. By the time I started applying for ICU residency positions, I already obtained my ACLS, PALS, BLS and even random certifications such as NIHHS (stroke assessment). I made sure to bring that up in my interviews and they seemed fairly impressed. The trick is to set yourself apart. TRUST me, they’re going to get HUNDREDS of applications and interview a ton of people, especially if you live in a metropolitan area like I do.

I’m a timid, soft spoken person at heart. So adjusting to the ICU environment was difficult for me. Let me tell you, if you’re not loud and confident in the ICU, you either won’t be heard or high stress situations will cause you to panic and blank. Confidence is an absolute must. One thing I absolutely love about the ICU is that it’s full of nurse autonomy and patient advocacy. You have to be confident. Show this confidence in your interviews! Sit high, answer every question in detailed, thoughtful answers. Brag about yourself, SHOW that confidence. They LOVE that.

I’d make it a point to show to your interviewers that the ICU isn’t all about saving lives either. In fact, most of your patients will be terminal. Another beautiful thing about ICU is using your patient advocacy skills to have a palliative approach. This is extremely important and a good ICU team will appreciate a new nurse willing to accept a palliative mindset. Burn out is high not only because of the high stress, but for the high patient death occurrences too. Self care is huge, show them that you’re a human being outside of your nursing career. I told my interviewers that I play guitar for my child as part of my self care routine.

On the other hand, be ready for a lot of rejection and a possibility of having to start your nursing career in a Med/Surg setting. I was rejected from my very own unit but ended up getting a position at another hospital. This is NOT a bad thing. You’ll gain valuable experience with patient assessments and skills on any floor. Most importantly, never forget why you started nursing in the first place. It took a lot of compassion, dedication and grit to get to where you are now!

Lastly, you’ve got this! I wish the best of luck to you and hope that you’ll be able to take something from this loooong post.

Cordially,

Kimbolium, RN

How to land a new grad ICU residency?

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