ICU as a new grad

Piggles · Nov 10, 2012

I am in a similar situation and would appreciate any advice. I am also graduating May '13 with 4.0 and I am doing 2 different preceptorships in the ICU. I have heard that it helps to precept in the ICU if that's where you will be applying. However, I worry that I am making a mistake by only precepting in the ICU since these jobs are so competitive. Will this make it harder for me to get a non ICU job? My dream is to work in a burn ICU or any ICU to start, but it is most important that I start working within 6 months of graduation, so I will take any position or move anywhere to make sure that happens.

I am limited because I will have an associates degree, but I see that University of Utah and UCSF both hire new grads into their ICU and you don't need to have a BSN. My plan is to apply to these kinds of schools and to rural hospitals. Good luck to you Francoml, It's going to be an exciting year!

sommeil, ASN, RN · Nov 10, 2012

I just graduated from CNM in Albuquerque. It is nearly impossible to get a hospital job here as a new grad. I have 136 applications with the local hospitals and have had no calls. I am working part time in a SNF just to keep my skills current. I have yet to see an ICU position that doesn't require at least 2 years experience. I am hoping to find a Med/surg job and then maybe move to slightly more acute units. I know there are some rural areas that require nurses and hire new grads like in Idaho. Try linkedin. Recruiters advertise there all the time.

Meriwhen, ASN, BSN, MSN, RN · Nov 10, 2012

With the utmost respect, those wanting to go into the ICU as a new grad should first read the many threads in the forums from/about new grads who crashed and burned when they tried to start out in the ICU--many of them were overwhelmed and couldn't handle the pressure. I've never worked medical ICU, but even I know that these patients are the sickest of the sick, and there's little wiggle room for newbie mistakes.

The same applies to psych ICUs (now these I know very well!). Again, sickest of the sick and little room for error...not really the best place for a new grad to start out in.

This isn't to say that new grads can't be successful in any ICU--they certainly can! But be aware that there is an exceptionally steep learning curve ahead of a new grad. Find a new grad program for the ICU, or a place that will offer you a very long orientation.

Hopefully, medical ICU nurses will wander in here to give you more specific info.

Best of luck in your job search.

Ruby Vee, BSN · Nov 10, 2012

There are various threads on starting in ICU as a new grad -- start by reading them. And there are threads on improving your chances of being hired. Read those, too.

Leilani1983 · Nov 11, 2012

I live in Reno, NV ( I know NV isn't one of the states you wanted) but we have a big new grad program at one of our hospitals here. They hire new grads into the ICU program every 4 month. This time it was around 16 people. Sometimes it's more, sometimes it's less. It's a cool program because you get to rotate through 3 different ICU settings over a one year period. Cardiac ICU, and then two others...one is known as more of a trauma ICU and the other more medical. The hospital is called Renown you can look it up if you are interested.

DysrhythmiaRN · Nov 20, 2012

I know of people starting out in ICU in las cruces.I think most got them because they have already worked there, know someone, or precepted there. So try to request for ICU if you can to increase your chances. Also depending on how many nurses are needed, if they are short staffed or not.

francoml, ASN, RN · Apr 19, 2014

Nov 10, '12 by Meriwhen Asst. Admin

With the utmost respect, those wanting to go into the ICU as a new grad should first read the many threads in the forums from/about new grads who crashed and burned when they tried to start out in the ICU--many of them were overwhelmed and couldn't handle the pressure. I've never worked medical ICU, but even I know that these patients are the sickest of the sick, and there's little wiggle room for newbie mistakes.

The same applies to psych ICUs (now these I know very well!). Again, sickest of the sick and little room for error...not really the best place for a new grad to start out in.

This isn't to say that new grads can't be successful in any ICU--they certainly can! But be aware that there is an exceptionally steep learning curve ahead of a new grad. Find a new grad program for the ICU, or a place that will offer you a very long orientation.

Hopefully, medical ICU nurses will wander in here to give you more specific info.

Best of luck in your job search."

So I know that this thread was from almost two years ago but I was going through my old post and just wanted to give an update. Meriwhen, I know you posted this with respect and I am not insulted or offended in anyway I just wanted to let you know that I was excepted into a nurse internship program in a level one regional MICU. Now a year later I am on our hospitals rapid response team. I just wanted to let new nurses know that if you are dedicated to your career, work extra, study on your days off and pursue all the certs you can it is absolutely possible to be a strong ICU nurse as a new grad.

Concerto_in_C, BSN, RN · Apr 20, 2014

I would say talk to your clinical instructors and ask for an honest assessment. If your instructors include teachers with ICU experience, that would be ideal. My hospital is a teaching hospital and we always have some nursing students on the floor. Their instructor, an ICU RN, actually writes them letters of recommendation for ICU if she feels they are ready. The bad news is very few are ready-she says it takes a very special kind of person.

I just want to remind you there are consequences of screwing up in this profession. Terminations happen all the time--if you are lucky they will let you resign, but that still looks very bad on your resume. I had to resign from my first job in 2008, it was ICU-stepdown, and I had problems later on, because a resignation makes you a high risk candidate.

This is a paranoid industry. Recruiters are paranoid-there is no other way to describe it-because if you hire the wrong candidate she can kill the patient in 10 minutes (e.g. blood transfusion) and the repercussions of this death will reverberate throughout the organization for years, legally, financially and in terms of the damaged reputation.

If you are not sure, perhaps you can try progressive care or ER for about 2 years. ICU managers like ER nurses and I just spoke to a guy who transitioned from ER to ICU and he seems to be doing very well.

Having 3.8 GPA is better than 3.0, but it doesn't tell me if you can work well with others. It tells me you can stay alone in your study for 10 hours at a time until you master the material. This hardly makes you a people person. Some of the overachievers in the program, the alpha females, the ones who always had to get a perfect score on their papers, will never work out as bedside nurses, because they behave like prison wardens and they treat the patients like convicts. Some of them will eventually end up in administration, or informatics, or other capacity that doesn't involve patient contact.

francoml, ASN, RN · Apr 22, 2014

Not being rude but you did not read my last post. I was providing an update. I am now an ICU nurse at a level on hospital and part of the Rapid Response Team.

Concerto_in_C, BSN, RN · Apr 29, 2014

Not being rude but you did not read my last post. I was providing an update. I am now an ICU nurse at a level on hospital and part of the Rapid Response Team.

Good for you, then you must know your stuff well and can keep calm under pressure. Hope everything works out great for you.

Meriwhen, ASN, BSN, MSN, RN · Apr 30, 2014

So I know that this thread was from almost two years ago but I was going through my old post and just wanted to give an update. Meriwhen, I know you posted this with respect and I am not insulted or offended in anyway I just wanted to let you know that I was excepted into a nurse internship program in a level one regional MICU. Now a year later I am on our hospitals rapid response team. I just wanted to let new nurses know that if you are dedicated to your career, work extra, study on your days off and pursue all the certs you can it is absolutely possible to be a strong ICU nurse as a new grad.

Good for you, I like being proven wrong in times like this :)

To be honest, having that MICU internship was probably integral to your success as much as the hard work and off-hours studying that you put in. That internship gave you specialized training and a lot more guidance and support than you would have has as a new grad who happened to get hired into a regular ICU spot--in those instances, that key training/support may not have been as well designed or readily available.