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ICU or IMCU for first job?

by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Hi Nurse Beth,

I need a career advice. I just graduated from nursing school and I have an offer as an ICU nurse at a trauma level 1 hospital that is 1 hr away from home

I am a respiratory therapist and therefore has been easier to find a job in ICU, however, its a 2 year commitment and if I leave earlier I will have to pay 10k. The pay is low and I feel the training is being charged in every possible way

I have another option in the IMCU at the current place of work, which is 9 miles away. The pay is better as well
I am confused about what job to take because ICU is my dream job, but I didn't want to start in ICU at the facility at work so I applied for IMCU.

My question is what should I do? Should I take the ICU job or the IMCU one?

Dear Confused,

CONGRATS on having 2 job offers!

Intermediate Care Unit provides care for patients needing close monitoring and is a step down from ICU. You will get good experience but not with pressors, or continuous renal replacement therapy (CRRT), or other modalities.

If you really want ICU, but don't want the ICU at your current facility, then go for it. Two years will go fairly quickly, and you won't regret good training and opportunity.

Best wishes,

Nurse Beth


Specializes in Cardiac. Has 30 years experience.

I am confused, too. How can your perspective employer “charge “ you 10k for leaving early? Is there a sign on bonus that you will have to repay if you leave early? If you don’t think that you want to stay for 2 years, don’t take the bonus offered. Also don’t consider one job over the other based on a bonus and don’t calculate the bonus as part of the pay. You never know what life changes you may experience that may force you to leave before the required 2 years. I also am skeptical of sign on bonuses as I wonder why they can’t get people to come/stay? Think about the conditions/administration that you may be working under. Consider a job shadow at least before taking the job. I also think that new grads do best in the ICU after getting a good grounding on a regular floor, getting familiar with hospital routines and medications before adding in more critical thinking. That said, don’t forget your original goal, and once you are fairly comfortable in your first job, start challenging yourself to learn new things-ACLS, etc to be ready for your move to ICU.