Is it wise for a new grad to start in ICU?

IV-PUSH · Oct 28, 2005

3 years on med surg?? Sorry, but that is some old school thinking. I know more than a few recent grads who went directly to ICU/NSCU/Burn unit, and they are doing just fine.

If you are a new grad who wants critical care, find a good program and do it, don't "put in your time" on a floor you have no intrest in, your everyday will be miserable, and patients don't need miserable nurses.

geekgolightly, BSN, RN · Oct 28, 2005

Although nurses can survive and become good ICU nurses with no floor experience, I do think that floor experience is invaluable if only to retain a deep respect and awe for floor nurses and all that they do on a daily basis for five to ten patients at a time with no monitoring.

bluestar · Oct 28, 2005

Many new grads start in the ICU and do fine. The key is the orientation and preceptorship that you receive. You will be fine if you look for a good ICU where they already hire new grads. Talk with them first.

I agree. If you really want to do ICU, go for it.

nsgstudentjen · Nov 12, 2005

I have been wondering the same thing. I am graduating in 5 weeks :uhoh21: with my BSN (accelerated program - 15 mos) and critical care really appeals to me.

I am currently doing my preceptorship in a Burn ICU, and although I am learning and enjoy it, it reinforced to me I do not want to start here when I have my license. I need an environment where I can feel confident, and having had my program be so fast, I think I am aiming for tele for starters.

Some people will have the confidence and quick learning ability to go right into ICU, but I think I will wait a year or so.

best of luck whatever you decide!

dorimar, BSN, RN · Nov 16, 2005

IVPUSH, I see nothing wrong with "OLD SCHOOL". It is very diffiuclt to train a nurse that is learning how to make a bed and do basic drug calculations, how to run CRRT or what exactly the hemodynamics mean & what she should do about it. Don't get me wrong, I 've trained em, & some of the the new nurses are great. However, it has always been much better when the nurse had experience in basic care and assessment that i could expound upon and then facilitate critical thinking.

dorimar, BSN, RN · Nov 16, 2005

i have to add, IVPUSH, that the only reason you know so many new grads who went directly into ICU is because of the nursing shortatge. That does NOT make it ideal (newschool or not)

IV-PUSH · Nov 16, 2005

That is correct the nursing shortage has opened up some great opportunities for new grads where they may not have existed before. It no doubt makes some people bitter that these new grads can (with extra time and training) transition directly into a positions that typically in the past took years of experince to obtain.

New grad programs do work . I absolutley object to unessacarily spending 3 years somewhere you don't want to be, we have all worked with someone at some point who consistently hates their job, its a drag on everyone. The OP stated they really wanted to do ICU.....there is no reason to discourage that.

HappyJaxRN · Nov 16, 2005

WOW! Think of it! With this experience, you can write your ticket anywhere! Awesome! :nurse:

dorimar, BSN, RN · Nov 16, 2005

i'm always thinking what is best for the patient NOT the nurse

HappyJaxRN · Nov 16, 2005

i'm always thinking what is best for the patient NOT the nurse

Who am I to deter someone from doing what they want, but I tend to agree with you. I started out on an advanced floor and feel that I wish I had learned the basics first. I learned everything backwards, the hard stuff first. I think the patient does suffer some from an inexperienced nurse (speaking for myself only). But like somoene else said, if you have a good preceptor and supportive staff, anything is possible. :rolleyes:

geekgolightly, BSN, RN · Nov 17, 2005

Who am I to deter someone from doing what they want, but I tend to agree with you. I started out on an advanced floor and feel that I wish I had learned the basics first. I learned everything backwards, the hard stuff first. I think the patient does suffer some from an inexperienced nurse (speaking for myself only). But like somoene else said, if you have a good preceptor and supportive staff, anything is possible.

I think if an ICU nurse could get the eight month intensive training like they offer at Boston Mass, a new grad could take on patient care at the end of it without giving lesser care to the patient. But frankly speaking, most hospitals don't offer that.

I turned down a Level I Trauma SICU position here just recently, despite having a couple years on the floor, because when I asked what sort of education they offered, they said 12 weeks with a preceptor. No formal education offered whatsoever. And because I was already "experienced," I probably wouldn't need that much time with the preceptor. I thanked them for their time and said I would love to work there when they hire an educator or when I have ICU experience under my belt.

I feel that it's dangerous to get a 12 weeks of preceptorship with no formal training. We are expected to go in there with IABPs , swan's, CRRT, art lines, hemodynamic monitoring, read EKG's, and care for the sickest of the sick. I know my limits... especially after having worked on the floor a while. Before I graduated, I felt much more sure of myself; and I think it's because I knew so little about patient care by the time I graduated.

I took a new job in progressive care, where we do everything but art lines and vent weaning where they offer formal training plus preceptorship, and are excited about transitioning me to their ICU within a year. This kind of learning enviornment is important, IMHO.

IV-PUSH · Nov 17, 2005

Origianlly posted by dorimar

"It is very diffiuclt to train a nurse that is learning how to make a bed and do basic drug calculations, how to run CRRT or what exactly the hemodynamics mean & what she should do about it. Don't get me wrong, I 've trained em,"

"i'm always thinking what is best for the patient NOT the nurse"

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Than perhaps you should stand by your morals and refuse to train these new nurses whom you feel are so unsafe.:imbar

I hate it when these boards turn into a personal grudge match and become uninformative, so I will excuse myself from this thread. To any new grads who are reading always remember these posts are only opinions...do what you think is the right thing for you and in the end and you won't go wrong.