ICU: Am I right for it, and if so, how to get into it

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I am a new RN (BSN graduate of May 2009) and took a job on a med/surg hematology/oncology/GI floor. It's been about 4 months since I started, about 5 weeks since I've been on my own, and I'm getting pretty jaded. I am experiencing all of the "typical" new RN-isms...feeling like a blithering idiot most of the time, asking stupid questions to my mostly patient coworkers, questioning if this is really for me, and very frustrated with "the system." The main thing I am sure of is that I really don't like where I am, but I'm not sure what the next step is or the best way to get there. That's where I'd appreciate your help!

The thing that I dislike the most is that I find myself "earning my PI badge" daily in this job--whether it's hoping I'll have the chance to catch a glance at my patient's urine in her hat to assess its quality at some point during the night, obsessively checking a patient's pulse ox and vitals when anything seems even slightly odd, researching his/her history here in the hospital and current plan of care since it gets so muddled as it's passed along each shift and often unclear anyhow, catching when things were passed on as orders to carry out but there were no such orders, catching errors on the med sheets that were missed, etc. etc. I feel like I spend so much of my shift clearing muddy waters and worrying if my patients are silently turning for the worse, and since I'm busy with one or two worse-off patients, I haven't caught the warning signs.

The main things I like about my current job are the straightforward-ness of the surgical patients we get, and that I get to interact with oncology patients struggling emotionally/mentally/spiritually and I can help them through with a bit of insight due to my mom's death to breast cancer when I was 17. But since I'm not chemo-certified yet (they tell me I will take the classes in the spring) I've only gotten a few opportunities to "be there" for those oncology patients in that respect.

Beyond this job and typical clinical hours, I have experience from an externship on a cardiovascular step-down unit, and I really liked it. I am so intrigued by cardiovascular stuff! I liked having the clues at my fingertips (constant vitals via hardwire beds, often with arterial lines, etc.) and at least a few extra moments to critically think about what is, was, and could potentially happen to my patient in their current state and my planned interventions in each case.

So, as you can probably tell, I am a horribly anal-retentive, perfectionist, type A personality. I really like the idea of ICU--having one or two unstable patients that keep you on your toes thinking of interventions, not worrying about keeping 6 patients straight and remembering all of their assessment data when I go to chart, and not spending so much of my time gathering information to analyze--spending most of my time interpreting it. Don't get me wrong--I love the caring aspects of nursing as well, but I feel that I don't have a chance to really be there enough on med/surg--I'd like a smaller ratio so that I have more of an opportunity to really be there for a patient rather than having a chance to really see how they're doing emotionally/mentally/spiritually once a shift.

So here's the real question: as you noticed, I said I like the idea of ICU. Specifically surgical or cardiovascular ICU since I love surgical patients and I love hearts (from what I've read on other forums, I think I need basic ICU experience before I try for CVICU though). I like the idea of PACU and cath lab, too. Are my assumptions of what these positions are like and how I might like it accurate? If so, what is the best way to set myself apart from others applying for these positions? (I interviewed for a few ICU positions right out of school but was passed over for lack of critical care clinicals/experience despite my step-down experience. I have also inquired about ACLS certification courses at work, and was told "maybe in the spring" when I go through chemo certification--the maybe due to budget cuts.) How long should I stay on this med/surg unit gaining experience before actively interviewing? What review courses/additional courses should I look into to really be prepared? And if you don't think I'm cut out for ICU, what would you suggest? Or, overall, am I just an paranoid new grad in shock of reality vs. "what they told us in school" who is stressing herself out and just needs to stick it out in my current position?

Thanks so much--I really really appreciate any advice!!