IS MICU/SICU too much for New Grad?

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Hello fellow nurses! I am a new nurse to this community! Graduated in May and licensed in July. It's been a long and tiring job hunt process but things seem to be finally coming together. I have been going through the interview process for an ICU position. I was very surprised to have gotten this interview because I know they rarely hire new grads. The interview went great overall, but to be honest it made me absolutely terrified. The intense amount of training, testing, and certification the nurse manager was discussing with me was very overwhelming. I really am looking to start my nursing career as soon as possible, but if offered the position, I'm skeptical of even taking it because will I be good enough? My biggest fear is failing. Can a brand new nurse make it?

Any and all thoughts/opinions/advice is greatly appreciated.

I'm in MCSICU as a new grad. I only got 12 weeks of orientation, wish it would have been more but I seem to be doing ok. It's important to remember you're never really alone and to ask for help when you need it and to go home and study. I could never go out and do floor nursing after this- we have so much autonomy with physicians and I don't think I could handle more than 2 patients. I plan to transfer to L&D after another year or so, hoping this ICU experience makes me marketable.

Your autonomy is perceived autonomy, and a lot of floor nurses exercise the same also.

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Specializes in Critical Care at Level 1 trauma center.
Your autonomy is perceived autonomy, and a lot of floor nurses exercise the same also.

I have to respectfully disagree with this statement. I have way more autonomy as a ICU nurse then floor nurses do. I have standing order sets that allow me to give multiple drugs without first contacting the physician if my patient is quickly deteriorating. I can order just about any diagnostic test (labs, cultures, CT, EKG, ABGs, ect.) with out contacting physicians. I can also give ativan for seizures, reversal agents, and fluid boluses. Further more I can give atropine and start vasopressors if a patient drastically declines and a physician is not available. If a patient is hemorrhaging I can initiate mass transfusion protocol before consulting the doctors. Granted these are all standing order sets and only used in emergencies but they are at my discretion none the less. As far as access goes I can place large bore (16g and 14g) ultrasound guided arm and EJ lines if fluid resuscitation is needed. Although great floor nurses have great clinical judgement I highly doubt floor nurses can do all of these things. Much love to floor nurses for what they do but the scope of practice is drastically different.

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I have to respectfully disagree with this statement. I have way more autonomy as a ICU nurse then floor nurses do. I have standing order sets that allow me to give multiple drugs without first contacting the physician if my patient is quickly deteriorating. I can order just about any diagnostic test (labs, cultures, CT, EKG, ABGs, ect.) with out contacting physicians. I can also give ativan for seizures, reversal agents, and fluid boluses. Further more I can give atropine and start vasopressors if a patient drastically declines and a physician is not available. If a patient is hemorrhaging I can initiate mass transfusion protocol before consulting the doctors. Granted these are all standing order sets and only used in emergencies but they are at my discretion none the less. As far as access goes I can place large bore (16g and 14g) ultrasound guided arm and EJ lines if fluid resuscitation is needed. Although great floor nurses have great clinical judgement I highly doubt floor nurses can do all of these things. Much love to floor nurses for what they do but the scope of practice is drastically different.

That is not true everywhere one may work, and I speak from personal experience that I had more autonomy when I worked the floor. And P.S. protocols do not equal autonomy. The scope of practice is NO different between ICU and floor nurses. You have some bizarre and dangerous ideas about scope of practice there.

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Specializes in ED, SICU.

The ICU has more bells and whistles. Of course with the whistles comes more knowledge base; however, trauma docs and residents that I worked with loved to micromanage. *shrugs.* However, I would say the on ICU I had more autonomy but then again I had good rapport with the docs.

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I also old school and believe new grads benefit from some time in a med/surg or even step down unit. However, depending on the individual a new nurse can step in and be an excellent critical care nurse.

The big issue for a new nurse is to be given the proper amount of orientation. At minimum three months and that can be extended depending on the needs of the individual. Some pick it up quickly and three months may even be too long - it all depends on the individual.

As a new ICU nurse I would hope your facility offers echo or something equivalent.

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Specializes in MICU.

Honestly, it depends. I started in MICU as a new grad three years ago. I also worked as a tech in an ICU for 3 years, and did my school practicum in the unit I work in.

I highly suggest working as a tech or even job shadowing in a critical care unit, or even multiple ICUs. That way you know what you're getting yourself into. School clinicals aren't enough time out there To really see what it's like.

The people I've seen struggle are the ones with very little exposure to ICU that probably didn't know what they were getting themselves into. You also need to be aware of the personality of most ICU nurses. Yes, we generally have a reputation of being mean, but it's usually not true. In a code or emergency situation, I am very direct and will say what needs to be said to get things done. Be aware of that and don't take it personally.

You also need to be open to learning and know your place as a new grad. People that ask a lot of questions are great. The ones that constantly say "I know" are the ones I worry about. We all learn something new every day in the ICU.

Also know that if it doesn't work out, it doesn't mean you have failed. Work a year or two in the floor, develop your skills and confidence, and then think about applying for an ICU position.

Good luck!

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

Well this is tough. I believe that getting a couple years of med surg makes you a MUCH BETTER ICU nurse than you would've been otherwise. Because then you have that much more relevant nursing type thinking under your belt.

That being said, there are plenty of new grades that come straight to our ICU and do fine, though the first few months can be rocky. The most important part of ANY job in nursing is showing up and giving a damn. If your dream job is being handed to you on a plate, don't worry about FAILING. Just think about what you have to do to SUCEED. And then do it. :)

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Do nurses in the ICU get paid more than other units?

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Specializes in Critical Care.
Do nurses in the ICU get paid more than other units?

Not at my hospital

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Do nurses in the ICU get paid more than other units?

Typically no, nor do they deserve to.

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Specializes in Critical Care.

I started as a new grad in the ICU where I currently work, and I picked up on things quickly. I have been working over two years (still really new), and I learn something new everyday. Like others mentioned, its all about how well you can manage stressful situations and knowing when to ask for help. There's not a whole lot scarier than someone coming off orientation thinking they know it all.

It also depends on the hospital where you work. My hospital offered 3-4 months of ICU orientation after a 3 month hospital orientation where I was able to learn time management and charting. The extra month of ICU orientation was based off preceptor recommendation.

I came off orientation scared as hell but also ready to learn as much as possible. I showed up 15 minutes early to read through charts and know the ins and outs of my patients before I got report. I quickly learned who on the unit was a go to for information - everyone can do the right thing, not everyone can explain why. I had a med surg nurse start ICU orientation with me - she had about 1yr under her belt, and she didn't make it through orientation. Everyone later said she was too focused on the tasks and wasn't thinking about the big picture - something the more experienced nurses said can happen working med surg when you're super busy and have to get certain tasks done by a certain time. Personally I thought I gained a lot of time management skills from my 3 mos on med surg / tele.

Lot of factors go into it and I'm not sure if my experiences are helpful. I'm just thankful we have such a kick ass orientation process, a supportive manager, and experienced staff that love teaching

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Specializes in Critical Care.

Oh.. Also, I worked 2+ years in EMS so I think that helped me stay calm in stressful situations.

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