Does a Med-Surg preceptorship placement hinder an ICU position after grad?

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Specializes in Emergency.

Hey Everyone. Advice needed. So I got my preceptorship assignment and I am assigned to med-surg floor. I tried to get my school to get a contract with my current hospital (i work as a tech) to work on the ICU unit. That didn't work. I requested ICU for all the other hospitals. That didn't work either. So my question is, since I am doing med-surg, will that bump me down on the totem pole for chances of starting in the ICU? :bluecry1:

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Specializes in critical care, PACU.

I kinda went through a similar situation and here's how I handled it:

I did PACU (still critical care but differed in tasks and patient population) instead of ICU and was so disappointed when I heard. I think I actually cried because I had no idea what PACU would be like and I was so passionate about critical care. It turned out that I love love loved the PACU and the PACU gave me this amazing familiarity with airways and immediate post op and problems with bp and LOC etc.

I initially went in disappointed but optimistic. I made an effort to maximize what applied to ICU such as dealing with central lines, a-lines, vented patients, IV meds, drips, fluid resusc, etc. They still have most of this in medsurg so you just need to collaborate with the staff and seek this out. You can also focus on maximizing your time management and report giving / communicating with MDs and then tell the future employer. Those skills are definitely needed in the ICU and the interviewers I had always asked about this.

I also made sure that I had all of the patients relative to where I wanted to work (SICU) so I took all the immediate cranis and vented patients. For medsurg, you can try to work with new admits from ICU or patients that will be transferred to the ICU--and the nurses will appreciate you helping them settle the new admits in or watch rapid response team calls or transferring a crashing pt to the ICU.

Just verbalize your learning desires but be respectful and dont act like you got jipped. If you act optimistic and enthusiastic you will find many people receptive to helping meet your learning needs. If you act holier than thou and bitter people wont help you.

Now, I did find it a little harder to get hired into the ICU because I wasnt working directly with them so they werent able to see my work ethic, skills, etc. I just adapted to that. I made sure to get a letter of rec from my preceptor and told to focus on things more related to the ICU. You can also make an impact on the manager and the rest of the staff by helping out whenever you can and being a part of the team. Treat the whole thing like an interview. Then you can use your hospital badge and introduce yourself (with your resume and all your letters of rec) to the ICU manager and be sure to use the staff you befriended in medsurg as references. You can also maximize your hirability (I totally just made that word up) by getting ACLS & EKG certified and getting letter of rec from your critical care instructor.

Im sorry you didnt get what you wanted. I remember how crushed I felt. People kept telling me at the time that everything happens for a reason and it would all work out--and that totally annoyed me at the time, but really it did work out that way. You just have to make yourself flexible and be really enthusiastic and optimistic. Because of the PACU I feel confident with volatile airways, gave report (which I formerly sucked at) hundreds of times, practiced Md interactions, performed complicated assessments and so much more. Im so grateful that I had the PACU instead of ICU--I think it made me more well-rounded and confident in acute situations. I hope you might look back on your medsurg situation and feel similarly down the road. Good luck :)

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Specializes in Professional Development Specialist.

IME a preceptorship these days has very little to do with whether, where, when, if, how, or why you get a job. I had a great experience in med surg (and was happy it wasn't a call center like so many of my classmates even though I had arrainged an ER and an ICU placement that my school declined.) Every nurse on the floor I worked with during that preceptorship was behind hiring me but they flat out weren't hiring new grads no matter what. You don't mention what state you're in but in many areas you will find you cannot enter into specialty fields no matter where you precepted or worked as a tech. I hope your experience is a good one, I encourage you to make the most of it regardless of your placement. Any experience has it's good parts. Make your mark as best you can.

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Specializes in Emergency.

Thanks for the encouragement. This morning, I was really upset. Like REALLY. I just knew I had been screwed over. But now Ive gotten over the disappointment and am just ready to do my work and get it over with. Don't get me wrong, I definitely have to have a good attitude and make the best of it. You guys have great ideas about taking those patients that are either coming in or going out of ICU. I will definitely use that to my advantage. We have another month before we start so I have alot of time to get my head together. Im from Atlanta and the hospital is in the downtown area. Its a level II but carries a great "name". (Im sure you can figure that one out) Unfortunately, they are so adamant about not hiring new grads, its even on their voicemail message "We are not hiring new grads at this time." But I work as a tech at another intown hospital so thats probably my best bet for my full time. Thanks for the encouragement and Ill try to keep you guys posted on this thread of how it goes. Thanks! :redpinkhe

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Specializes in critical care, PACU.

I felt that way too. Like I got the shaft and I got scrwed over. I was very melodramatic when I found out. Because, first I didnt even know that I got PACU. I thought I might even get something outpatient. I wrote up a hilarious email to my peers, inviting us to rise up against our oppressors and I took a long drive down the coast (I live on the coast so this took about two hours...but still very dramatic ;) ).

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Specializes in Emergency.

Haha! But its THAT serious. I totally feel you. At the time, (being this morning), I was like "CRAP! THIS IS IT?! IM STUCK IN MED SURG FOREVER!!!!" LMAO. But its cool. Im sure its the not first time. And besides, I'll have gettin creative, turning a med-surg preceptorship in a full time ICU gig. HEHE! :lol2:

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Specializes in critical care, PACU.

Yeah definitely. It is serious because back when the economy was good the preceptorship was supposed to help you land a job but it is true what JenniferSews said about how even if you dominate you might not get a job in the preceptorship unit just because of the fact that they arent hiring. Just start early and set yourself ahead of the pack and contact unit supervisors directly. Show your passion and youll wind up okay :)

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Specializes in Emergency, Trauma, Critical Care.

My preceptorship was in an absolutely horrible geri-psychiatric unit. I started in ICU as a new grad. Obviously two very different areas, but I was able to wow them in the interview enough to hire me. And I have done fine, but I have worked my butt off!

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Specializes in Emergency.

Nice! Its good to hear a success story! Thanks! :yeah:

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Specializes in Emergency.

*Update* I ended up in Cardiac ICU Step-Down!!! :lol2: Start next week!

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Specializes in critical care, PACU.

thats awesome! good luck to you

make sure to practice talking to doctors and giving report!

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