The area I'm applying for isn't hiring new grads into the ICU. The recruiter said that they start off in med/surg (step down from ICu, level 1 trauma) and after 1 year exper.then you could go into ICU. I planned on working two years already so it's not that, but med/surg is a scary thought. Anyways, if I were to take this, is there an area ( neuro, cardio?) that would give better experience than a regular med/surg floor? And is this route better than trying to get into a smaller hosptias ICU?
PS: I attended the National Students nurses assoc. conference in Daytona and got to meet the rep from AANA. Her presentation was moving, it was really motivating. It definately made becoming a CRNA more appealing without the $$ issue..
I echo the comments made regarding the tele floor experience. I'm currently a SN on the telemetry floor of 800+ bed inner city hospital. We see renal, oncology, DM, COPD, patients along with their various heart/pulmonary issues. It's a busy floor with lots of interaction between the ER, ICU, OR, and CRNAs and MDAs. Lots to learn. Many opportunities to expand your experience. It is a good place prior to going to the ICU and provides you with access to the people you want/need to know to advance IMHO. Good luck, Steph
A year of med/surge would be valuable. However, working one year in a small ICU would be valuable and then you would have a head start into a big ICU in a year.
The area I'm applying for isn't hiring new grads into the ICU. The recruiter said that they start off in med/surg (step down from ICu, level 1 trauma) and after 1 year exper.then you could go into ICU. I planned on working two years already so it's not that, but med/surg is a scary thought. Anyways, if I were to take this, is there an area ( neuro, cardio?) that would give better experience than a regular med/surg floor? And is this route better than trying to get into a smaller hosptias ICU?
IMHO a tele unit is the way to go. you are going to get a shot at taking care of every diagnosis, just as you would on any other floor with the difference being that at least you aren't going to walk in on your patient one night (or day) and discover them dead. When things go down hill on a tele unit, you usually know about it really quickly.
IMO if you want to work ICU then tell the recruiter that is what you're interested in or look eslewhere. There are enough positions in nursing today that you can work where ever you wish. I had no intention of working M/S when I graduated and would have been unhappy if I had to work it before ICU. This isn't because I disrespect M/S, it's because I loved ICU. It just happens that working ICU was the prereq I also needed for CRNA school. I also believe that working two years of ICU is better than one. You see things more clearly and are able to take care of the sicker patients more often. For example, in my unit you needed a year's ICU experience before being able to take IABP and ABIOMEDS. Because I was in my unit 2 1/2 years I was able to take these sicker patients, which was a positive on my application. There are plenty of new grads who started working out in ICU, including me, and we don't have any problems with organization, in fact I think my organization skills were optimal working there. Are there really no other hospitals in the area that are offering ICU internships?
IMO if you want to work ICU then tell the recruiter that is what you're interested in or look eslewhere. There are enough positions in nursing today that you can work where ever you wish. I had no intention of working M/S when I graduated and would have been unhappy if I had to work it before ICU. This isn't because I disrespect M/S, it's because I loved ICU. It just happens that working ICU was the prereq I also needed for CRNA school. I also believe that working two years of ICU is better than one. You see things more clearly and are able to take care of the sicker patients more often. For example, in my unit you needed a year's ICU experience before being able to take IABP and ABIOMEDS. Because I was in my unit 2 1/2 years I was able to take these sicker patients, which was a positive on my application. There are plenty of new grads who started working out in ICU, including me, and we don't have any problems with organization, in fact I think my organization skills were optimal working there. Are there really no other hospitals in the area that are offering ICU internships?
I would have said the same thing perhaps, but I don't think there are alot of choices where the OP is from, unless they are willing to relocate.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Your ratio in stepdown should be less than a regular med/surg floor. In stepdown, you'll have a lot more telemetry pts, and may have some on titratable drips. Ask the facility what criteria has to be met for pt placement on a stepdown floor as opposed to a regular med/surg floor. Don't know about your area, but where I am (also trauma 1) stepdown and med/surg are not the same. A lot of stepdown pts in a T1 hospital will be like your ICU pts in another facility. Your ratio should be at least 1:3-4, and even less if you have a pt with a titratable drip. Ask how many telemetry beds they have, if they have a telemetry tech (if they do take cardiac drips, and no telem tech- run), what kind of drips they take, and what kind of meds they can push, and what their ratios are for pts with said drips/certain IVP meds.
Lots of T1 hospitals are implementing stepdowns now to free up ICU beds. We're still ironing out the wrinkles at my facility, and are getting few regular med/surg pts on those floors. We do take some titratable drips on our stepdown (things like Cardizem, etc.), but those pts still require closer monitoring than a regular med/surg pt. I think if you have those pts, a 1:3-4 ratio can still be too high, if that pt is relatively unstable and the rest are stable. Consequently, we had no telemetry tech on that floor.
When I graduated from nursing school 9 years ago I also found ICU was a position you had to work to get in to. I worked on a Med/Surg floor and got comfortable. Just keep your goal in mind and that year will fly. Take the sickest patients get in on the codes. I find that most chronic floor nurses do not like the scare of coding patients. Also you get a good gut instinct working on the floors. Learning that there is more to look at other than those swan numbers and your automatic BP cuff. I also agree with the earlier post that telemetry would be a good place to cut your teeth. Good luck in your future endevors!
unless m/s is what you want to do - there is such a need for nurses that you can work anywhere you want.. i and many friend had the same situation and we pushed a little or went elsewhere and were all successful obtaining positions in critical care areas. good luck.
Thanks again for all the wonderful and informative posts. I'm moving from Texas ( were many hospitals take new grads in ICU) to KNoxville, TN were the feelign isn't the same. Telemetry sounds like a good start, or step down. Thanks again.
Toby's mum
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I echo the comments made regarding the tele floor experience. I'm currently a SN on the telemetry floor of 800+ bed inner city hospital. We see renal, oncology, DM, COPD, patients along with their various heart/pulmonary issues. It's a busy floor with lots of interaction between the ER, ICU, OR, and CRNAs and MDAs. Lots to learn. Many opportunities to expand your experience. It is a good place prior to going to the ICU and provides you with access to the people you want/need to know to advance IMHO. Good luck, Steph