ICU before Trauma?

Some facilities have new grad training programs that require you to commit to a certain period of time in the critical care area, which should include and intensive preceptorship. Other than that, as a new grad that wants to do critical care, I can honestly say that I will use every little skill I am learning in Med-Surg right now when I get there. I'm better skilled for it. Don't disregard the old advice that you should do a tour of duty on the floor.

In my opinion, start where you can find a job you like. Many places do hire new grads into critical care areas, I just finished a 2 year position on a busy telemetry unit that hired 14 new grads in the last 16 months. A few of the new nurses did quite well, some had trouble with time management on daylight with all the chaos so they went to nights and did well. 3 went to other units within the orientation period, 2 quit within their first year...too stressful. One went to the ER and loves it, one is going to bone marrow transplant and is looking forward to research nursing. One went to an outpatient dialysis clinic and one to a womans hospital fto work in a cancer treatment area and hopes to transfer to ob-gyn and then newborns in the future.

Your first two years are still a learning experience, if your job really isn't for you then be honest and find one that is.

I started in Med-surg then transferred to ICU/CCU then on to flight nursing. When I worked ICU I found that most of the new grads hired were headed toward CRNA training and simply needed 2 years of ICU experience to apply for anesthesia school.

I worked on a trauma floor for 10 months after graduating followed by a yer in the ICU and then moved to the ER. Having followed that path I can look back and say it gave me a great grounding for the ER. I would recommend not going straight to the ER from school unless you have prior experience in a healthcare setting as a CNA os similiar...and even then, it would depend on where you worked. The ER is demanding and doesn't take any prisioners. More expereienced nurses want to help you but sometimes, unfortantly, the pressures of the department are such you are left to your own devices. I hate to use the term 'sink or swim' because that implies intent. That isn;t the case, but when you are short staffed and you have trauma and codes going on, the new grad can be left feeling deserted. Now, this obviously varies unit to unit but is an unfortant side effect of ER life.. From my experience and I don't mean to speak for anyone else, the newbies who have prior experience, especially in crtical care, fare far better under these stresses and strains than those who have no experience. I am not saying it cannot be done as it can and I am sure there are nurses who will tell you that but it does depend on who you are as a person. If you are confident and ballsy enough to work( while understanding that you are new and have LOTS to learn) in the ER stairght form graduation than go for but if you are having any doubts (and the fact that you posted this thread tells me that you might) then, I would humbly suggest getting some expereince first. The ER will stil be there and you will have great grounding on which to build your skills.

Hi All,

I will be graduating form my BSN program in May 2009. I am really really interested in ICU or Trauma/ER. I would love to work in a Trauma center (we have 4 Level 1's in the Bay Area, but I refuse to work at one of them). Anyhow, some of the nurses I have talked to said that if I want to work in ER (and esp. Trauma) that I had better start in the CCU or ICU first.

My question is: Is ICU or CCU in fact the best preparation for Trauma? Also, I was under the impression that ICU's and CCU's don't really hire new grads anyway....what do I do then?

Thanks in advance!! :)

You dont need ICU before ER. Or vise-versa(sp?).

If i were you i'd go where you can get a job. You'll be lucky to find a place (er or icu) that will hire you as a new grad. If the place you go does hire new grads routinely, i'd be warey of the place...they're chronically understaffed for a reason

If the place you go does hire new grads routinely, i'd be warey of the place...they're chronically understaffed for a reason

Or they are a progressive hospital that feels that would rather educate and train their own new nurses from the ground up, rather than trying to unlearn bad habits learned elsewhere. I've heard both sides of the coin. As a new grad, I was looking for hospitals that had experience hiring new grads, and the support for new grads already in place. I sure wouldn't want to be the first new grad they've ever hired, and have them scrambling to figure out an appropriate orientation program.

Or they are a progressive hospital that feels that would rather educate and train their own new nurses from the ground up, rather than trying to unlearn bad habits learned elsewhere. I've heard both sides of the coin. As a new grad, I was looking for hospitals that had experience hiring new grads, and the support for new grads already in place. I sure wouldn't want to be the first new grad they've ever hired, and have them scrambling to figure out an appropriate orientation program.

You could think of it this way...

ahh... the innocence (naivety?) of youth (baby nurses)...

I went directly into the ER from RN school and I'll tell you the learning curve is pretty huge. I used to wake up still processing patients in my dreams. sheesh. The place I worked at while in school before the ER only had about 8 employees at any given time and the ER was huge and had about 30 employees. IF you like the ER, I would look into getting a job there as a tech now, like tomorrow. If you want to learn more pathophys and have a bigger grounding in caring for vented and post-op pts and the like then take the floor job. I could never do that, the pace alone -- yikes! As a tech in the ER, you'll have the benefit of being in that environment without all the responsibility and you get to observe the role of the RN and doctor. I would particularly encourage you to get as much tech trauma experience as possible. When you're precepting this will take you lightyears ahead of someone coming cold into that environment which can often be quite intimidating. Good luck ! And looking back, this is what I would have added to my education.

Thanks all - I appreciate the advice!!!