ICU Help!

Babs0512 · Aug 11, 2008

Hi

IMO a new grad doesn't belong in ICU. Nursing school gives you the basics, you learn to be a nurse on the job. You need to hone your assessment skills, know how the labs, radiology reports, US reports, ABG's, objective and subjective data - all add up to your patients disease process - you know, "putting it all together". New grads tend to be very task oriented, basically, that is what they were taught in school ie: get those VS, do your assessment, get those meds out, get a.m. care done, etc... You now have to re-learn the real world way of doing things.

I recommend a minimum of one year (preferably two) of med surg experience before even thinking of critical care.

Before you apply to a critical care area, you will have to take an Arrythmia course, ACLS, TNCC - if you pass all that, then apply.

Good luck :twocents:

NewTexasRN · Aug 11, 2008

Ok, actually I do agree with you on some level, but I don't follow that "task oriented" protocol as you say. I did an externship on a cardiac med-surg floor and I did learn a lot. I never viewed the experience as "task oriented" for me, it was really about getting comfortable with my patients and practicing my physical assessment skills. Now, I'm not saying doing an externship is adequate preparation by any means, but my long term goal is to become a CRNA and I've been advised to go straight for it. Also, I'm looking for an internship that will last for 6 months. You are right a new grad has no business working in the ICU after 3 weeks of orientation.

Babs0512 · Aug 11, 2008

I"m glad you had an externship, still not the same as taking an full assignment by yourself and caring for critically ill patients. You may be do very well, but I don't think it is fair to yourself, the patient or your co-workers to show up day one without any real nursing experience. It is unsafe and puts a burden on everyone else.

This is just my opinion. This is how I've done it. I hated med surge, but I wouldn't trade all I learned there for all the tea in china.

Use to be, you couldn't find a job in critical care without med surge experience, now, due to the shortage, administration is cutting corners to bring in new grads and get some warm bodies into their facilities. Cutting corners is not always a wise thing to do. When push comes to shove, if anything happens while you are in your probationary period, admin will blame it on you, your preceptor, and possible nurse manager, so they will be in the clear.

Again, do as you like, this is just my opinion. I know a lot of the experienced nurses agree with me - the newer ones don't.

I worked 8 years in the ER, we tried the lengthy preceptorship (1 year) for new grads. Most quit before their year was up, one stayed for 2 months past their year, all left critical care. "too overwhelming" they said. True, it can be, but not as much if you come in with some real life experience.

Good luck and God Bless

Babs

squirtle · Aug 11, 2008

I am not sure how you would go about getting hired right into the ICU without having met the manager of the unit or having had your foot in the door at the hospital. Did you work any where as a tech while in nursing school? I am starting out in the ICU soon but I had my mind set to that while in school and worked towards it. I got a job as a tech in the ICU then made sure that I proved myself to the nurses and other staff that I was someone who would be a valuable member of the team. Then closer to graduation I met with my manager and discussed the possibility of starting out there. At this point, I would say that you need to meet with the nurse managers at the hospitals in your area... But remember that you are interviewing them too. Orientation is going to be very important. You want to know what resources are available to you as a new nurse starting out there. Basically, you want to make sure that you have the things you need in place to succeed because it won't be easy. If you are getting a 3 month orientation I wouldn't even go for it. I will be spending a couple of months on the floor before doing my critical care classes and will then move on to work with a preceptor for 6 months in the ICU.

I do think it is going to be hard for you to get right in if you don't have any experience in the hospital outside of your clinical experiences (not sure if you do or not). If you don't have any luck with getting interviews I would maybe try and work on a tele floor or step down unit and then move into the ICU.

Good luck!

NewTexasRN · Aug 11, 2008

Yes, I actually do have my foot in the door at 2 hospitals where I currently work as a tech. My nurse manager is the manager of the ICU. Also, I have my foot in the door at the hospital where I did my externship this summer.

squirtle · Aug 11, 2008

Yes, I actually do have my foot in the door at 2 hospitals where I currently work as a tech. My nurse manager is the manager of the ICU. Also, I have my foot in the door at the hospital where I did my externship this summer.

So why not call both of the managers and ask if you can come in to talk to them?

One of the things I did before talking to mine was to read the critical care chapter in a nursing career book. It detailed the various things that ICU nurses do and are responsible for. It helped me as far as answering questions like "why do you want to be an icu nurse" etc. I knew why before, but it helped me to add more detail to my answers and showed I was knowledgeable about the position.

NewTexasRN · Aug 11, 2008

I don't know if you've seen my other posts squirtle but I did not enjoy my externship at the other hospital. However, I love working as a tech at the other hospital. My only issue is that the hospital is a medium size community hospital and I'm not sure if it's going to prepare me for the rigors of a CRNA program.

squirtle · Aug 11, 2008

I don't know if you've seen my other posts squirtle but I did not enjoy my externship at the other hospital. However, I love working as a tech at the other hospital. My only issue is that the hospital is a medium size community hospital and I'm not sure if it's going to prepare me for the rigors of a CRNA program.

Sorry! I just thought you were asking for advice on how to get straight in to the ICU as a new grad and I was just giving you the info on what worked for me.

accessqueen · Aug 11, 2008

I wnet to ICU after graduating. It can be done. But you will pay the price. All the more experienced nurses who do not believe that a new grad should be in ICU will not make your life easy. If you have the choice pick a hospital that has a really good ICU preceptorship that lasts a long time. Some hospitals combine some med-surg experience with an ICU preceptorship. good luck, I hopte you have a thick skin.

sundowners2 · Aug 11, 2008

I would definitely recommend starting out in the ICU if you are the type of person that is cut out for critical care. Every new grad struggles with time management, but we all find our way. I know nurses who believe a new grad should start out in a lower acuity level of care, but none of these nurses ever once did anything to discourage me or make my job harder. Those who spend more time in med/surg. floors will develop strengths in areas that critical care nurses may struggle with and vice versa. To be a good ICU nurse, I suggest going straight to the unit. I personally feel that the theory that new grads don't belong in the ICU has been discredited by many new nurses who started out in critical care and have done an AWESOME job. And, harsh though it may sound, those who flounder may find that they fit in better elsewhere.

My 2 cents =)

JP

uscstu4lfe · Aug 12, 2008

hospitals around here (socal) hire new grads straight into the ICU. i think it's pointless to start out somewhere that you don't like (ie, med-surg) to "get experience." IMO, you get your experience in the department you work. Why would you train in med-surg, but then go to ICU? They are two totally separate areas. Try to get in to where you want to go!