Go to ICU without MedSurg Experience?

  1. I hear it all the time from experienced nurses when I say that I want to work in critical care, "You need at least a year of med-surg experience because you will get to see and learn sooooo much". It worries me.

    Right now, I am a nursing tech at two separate hospitals....one in ICU, the other in Med-Surg. I thoroughly enjoy my ICU job and enjoy each day I get to go to work. I dread my med-surg job and feel like I am wasting valuable experience that I could be getting from my other position. However, I am cautious not to throw out more experienced opinions about the needed med-surg experience. I want to be the best nurse I can be.

    Do you think that it is wise to go straight into ICU after graduating, without first having worked a med-surg floor?
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    About nurse4theplanet

    Joined: Mar '05; Posts: 1,783; Likes: 107
    staff nurse
    Specialty: Critical Care, Pediatrics, Geriatrics


  3. by   Sleepy 7
    went straight to the ICU after nursing school, they had a 3 month precepted
    orientation . That was 2.5 years ago , NO problems CVICU/CCU.
    Never worked any other floor or type.
    good luck

    I received a BSN w/ my RN
  4. by   Stella-Ohio
    There is another post on this subject. Basically it says go for it if the hospital has a good track record for precepting new grads into the ICU.
    I agree, there is no reason not to jump into the ICU if the hospital has a good program to get you started in the ICU. You are going to learn all you would learn in med/surg as far as the technical stuff and then a million times more. What you wont' learn to do is manage 8 patients at once. You will learn to handle fewer, but more closely. It is a different kind of time managment. But the nursing skills you will learn, well...........go to ICU.
  5. by   swanganz
    I went right out of school to the ICU. It was scary and nerve racking but I would do it again! Just don't be afraid to ask questions and please please please let someone know if you aren't comfortable with doing something or if you have never done something before. I have been in ICU for 3 years and will still ask as will nurses who have been there for 20 years. Good luck you will be just fine!
  6. by   Lacie
    I also went directly into CCU/ICU and have never regretted it! That was 24 years ago and I have yet to work on a regular floor unless I was pulled due to short staffing and there is no where else to pull from. I must say I did do an externship in the very same CCU for over 1 1/12 years prior to graduating with my BSN and once I took my boards it made the transition much easier as I was already very much oriented with the unit but in a different capacity. If you are comfortable with it and they have a good preceptorship then go for it. I have never regretted it nor have I ever been treated differently for not having the med-surg experience. In fact the unit manager felt it was easier as there were no "bad habits" to break and enjoyed starting her staff from what she called "scratch". It further helped me move into management areas swiftly and was definitely my niche so to speak. I was fortunate and had a great bunch to work and learn from right from the start. I encountered more attitude from people when I was pulled to a different area such as med-surg then I ever got from those in the ICU/CCU.
  7. by   cardiacRN2006
    I agree, I went straight into the ICU. I'm still on orientation. I have a 6 month orientation. I can't imagine doing any other kind of nursing. Go for what you want.
  8. by   tde1992
    I also went straight to an ICU with no problem. I could not imagine working on a med-surg floor. Which ever floor you go to you will be oriented for 3 months. Don't be afraid if the ICU is what you want go for it.
  9. by   nurse4theplanet
    Very encouraging.

    I thought nursing school was tough...but now that I am approaching graduation and beginning to consider all the overwhelming possibilities of nursing...it's just so hard to make a decision about which facility to work for, what area to work in, what benefits are the best, etc. But my gut instinct is screaming ICU!
  10. by   Loni
    I worked med-surg for almost 2 years right out of school. I did learn a lot, but then went to work in the operating room. I enjoyed the O.R. so much that I stayed and worked there for the last 13 yrs. The biggest regret I have is that I did not ever work in ICU, because thats where so much knowledge and experience can be gained. Now, I don't believe I could ever go to ICU, because too many years have passed. So, definately, GO FOR ICU!!!
  11. by   CyndieRN2007
    OH my goodness this thread is encouraging. I want to go straight to ICU as well. I havent found a job yet....but I'm really hoping Ill get in at a great ICU after I graduate this DEC. Yikes!!
  12. by   tencat
    Go for it! I chose the 'get the med surge experience' route, and though I'm not too far into it (6 weeks) I really don't like it that much. I don't feel like I'm wasting time, but it's not my cup of tea. If you feel ready, go for ICU!
  13. by   nurse4theplanet
    I have definitely decided that I'm going for ICU all the way!
  14. by   ZASHAGALKA
    The options are there to go straight to ICU. But, let me give one caveat:

    If you choose to learn to drive on the nascar circuit, don't be surprised when some of the drivers run you down. It happens. It happens, alot.

    I'm not saying don't do it. But, it IS a choice that YOU are making. As a result, you really can't complain about being 'eaten' when there are obstacles and attitudes to overcome based on your choice.

    I'm an advocate of a year on med surg. I had 3 before moving to ICU 10 yrs ago. Did it stop me from being run over by assertive nurses there? Oh, no, not at all. My first year in ICU was far from certain and mostly due to a few key personalities.

    But I WILL say this. I had 3 yrs of experience in time management, meds, skills, critical thinking AND maybe most important, unit politics. I wouldn't have survived that without those previous skills.

    You hear that a year of med surg is recommended for a reason. Yes, you will hear voices that say otherwise. But different perspectives help inform the whole picture, and not necessarily the one perspective.

    I know this was such an encouraging thread before I posted. But, a reality check is in order:

    IF you go right into CCU, you will meet some resistance from a few of your peers. While most might be accepting, it is the few that can undo your world and taint your experience. That will translate to some "assertive" behavior. If anybody tells you that such attitudes don't exist in THEIR unit, or in most units, then they are whitewashing it for you. I'm not saying it's right, just that it IS an obstacle to overcome in order to persevere.

    On top of that, you will have a higher learning curve because you are learning BOTH critical care AND basic nursing.

    It's a large amount to bite off. If you choose to do just that, then you really can't complain later about how difficult it is. Learning to be a nurse is difficult enough (and school doesn't teach the real skills, experience does). Go to the first year of nursing threads and read about how difficult it can be. Now, add at least a 20% premium to that difficulty.

    For some people, this is a challenge, and they rise to such challenges. That's fine. My point is this: are YOU that type of person.

    But all these people telling you how great it is to go straight into critical care and how they did it and do fine, ask them this: what is the attrition rate that they've seen over the years, generally, and for new grads specifically?

    In my group of 5 critical care students, 10 yrs ago, I'm the ONLY nurse to my knowledge that is still practicing as a critical care nurse. 3 never made it through the first year. The other quit after about 4. I will confess that THAT unit, 10 yrs ago, was a difficult place for new critical care nurses to excel. But, that is a common, if not universal or majority, reality.

    Sorry to be the 'keep it in perspective' voice. I wish you well.

    Last edit by ZASHAGALKA on Oct 2, '06