New grad: critical care float pool or ED?

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I have been lucky enough to be offered two amazing new grad positions and am having trouble deciding which would be a better fit for me.

Option 1: ED position at a children's hospital (level 1)

Option 2: Critical Care Float position an adult hospital (also a level 1) - would float between Neuro ICU, Cardiac ICU, CV ICU, and Surgical/Trauma ICU

Both of these are amazing offers, which is why I am having trouble deciding between the two. I have always been interested in critical care, pediatrics, and gong back to school. One of the options I am considering is CRNA school, which is why the float position interests me. However, I've heard that it's difficult to be in a floating position as a new grad.

On the other hand, I have worked in pediatrics as a nurse tech throughout nursing school and absolutely fell in love with peds. The ED would still give me the critical care aspect I'm looking for, but it's not a prerequisite for CRNA school if I decide that's what I want to do down the road.

I keep going in circles in my head about what the better choice is. Someone please help me!

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What is the length of orientation for the second one?

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Orientation would be 2 months with a preceptor on one of the units and then one month on my own on the same unit. After that month on my own I move on to the next ICU and do the same process until I complete all four. It would be about a year before I am fully oriented on all of them.

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Orientation would be 2 months with a preceptor on one of the units and then one month on my own on the same unit. After that month on my own I move on to the next ICU and do the same process until I complete all four. It would be about a year before I am fully oriented on all of them.

That sounds like a really great orientation. Otherwise I'd run far and fast from that job. So now you need to figure out which one interests you the most because they are very different. So start with do you want to do peds or adults?

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Specializes in Emergency/Cath Lab.

Maybe im old fashioned but I dont think a new grad should ever be on the float pool, let alone crit care.

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Specializes in Neuroscience.

I would not do the float pool ICU position. In my hospital, orientation for an ICU position is 6 months. Here you are getting 2 months and one month on your own. It's not safe.

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I worked the pediatric float pool for a large, 11 floor children's hospital...floated to PICU, CVICU, Burn ICU, NICU, hem/onc, NPCN, rehab, ortho, med/surg, same day surgery, overflow, yada, yada, yada. I had ten years of NICU/PICU/peds intensive home health experience at the time. Let me tell you...It was pure trial by fire.

Every single unit did things differently, every unit worried about different things, had unique priorities regarding care, every unit's physicians had a different preference of how nurses interacted with them, what mattered in CVICU didnt really matter in trauma, transplant was a whole different ball of wax than the burn unit, and the expectation was that you would absolutely know all of this as a float nurse. You come in, get your assignment, and hit the ground running with minimal help from the core staff. That's how it had to roll.

I'll be honest. I loved floating. I was an adrenaline junky and floating meant that I was always working on a short staffed unit and the pace would be FLYING. Just my thing. Work 4 hours in PICU, move the next four hours to transplant, hop on over to NICU to finish my shift. Or spend 12 hours in one place. You never knew.

I also know that I would have absolutely been completely sunk in that position as a new grad. I would have imploded in fiery flames of self destruction. I was Valedictorian of my nursing class and that would have absolutely meant zilch, nada, zero if I had tried to be a float with no experience. Holy crow, it would have a been a disaster.

Furthermore, I honestly think it's a super bad sign that they are willing to hire a new grad to an ICU pool, in particular. That's just my personal opinion there. That stinks of pure desperation. Maybe it's not, maybe they will orient you properly and magnificently as they promise and that will be enough time for your needs...but big "but" here...float pools are notoriously hard to staff for a very, very good reason. They usually (and should!) pay a premium for experienced nurses because, even with experience, it's a super challenging job. I've always gotten a huge float pool "incentive"...to the tune of around $8 extra above base. I personally wouldn't work float pool again without a premium pay incentive.

I would run away from that option, personally. Run like the gold medal is at stake and your mama is watching in the stands.

I know that's difficult because, on paper, it absolutely looks like a primo golden ticket to get into CRNA school. And in a way, it certainly is. And it IS a phenomenal experience, let me tell you.

BUT!!!! My fear is that if you take it, you may end up not succeeding, or even just bowing out due to the incredible pressure and stress, and then potenially not have the best references from that job due to not being able to perform up to their standard.

Summary: it's a big risk.

I did float for three years and yes, I really loved it. But it wears on you...always, always, ALWAYS, being on a short staffed unit, always having crazy assignments, and unequivically needing to be an absolute Jack of All Trades as soon as you step on the ground.

Can you shadow a float nurse to get a feel for it? Really talk to them and get a feel for how exactly that float pool operates?

I would take ER, get my feet planted solidly underneath me, and then consider transferring at a later time. Or just go straight into one single ICU. Going into ICU is absolutely possible as a new grad; 16 years ago, that's what I did.

But an ICU float pool as a new grad? I wouldn't touch that with a 10 foot pole. I could be wrong...but I doubt it.

Best Wishes,

Eris

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Personally I would go for the ED job. Working in one department gives you a chance to find some mentors, really get to know how one department works and in ED you get a lot of exposure to different patient conditions. For a new nurse, supportive personal relationships with your coworkers will really make that first year tolerable.

A float nurse is an outsider in every unit. You are the hired help, here to fill in for the shift. That is not to say that your fellow nurses will be unkind or unsupportive, but you are not one of the regular staff. This would be a lot to handle for a new grad.

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Critical care float pool? Not something I would ever have considered as a new nurse. You will be busy learning how to be a nurse, let alone working on numerous critical care areas. I just don't think it is appropriate or safe for patient's.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

ER, hands down

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Specializes in Adult and Pediatric Vascular Access, Paramedic.

ER for sure! Well I am assuming you desire to care for pediatric patient? If you want to care for a adults more than kids go with the float ICU, otherwise I would definitely pick the pedi ER!

Annie

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Specializes in ICU.

Sounds like a pretty extensive orientation. I would take the critical care float.

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