New Grad decision: ICU vs Step down vs CCU

Specialties MICU

Published

I am a new graduate nurse deciding on what position would fit me best as a new graduate. My choices are ICU, step down, and CCU.

My shadowing experience in both CCU and ICU ensured my interest and passion on both units. My shadowing experience on the step down unit did not interest me. I know there are MANY different opinions on new graduates starting in ICU or step down.

I would appreciate any new graduates that started on either unit sharing their experiences, mistakes, thoughts, encouragement, etc. I suppose I am looking for a positive outlook on beginning in the ICU because that is what I am truly passionate about, but negative experiences are welcome also. All opinions are appreciated.

P.S. I have only two days to make this decision. Thank you.

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Specializes in Family Nurse Practitioner.

More info about the different units please!

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We need more info....are these units at the same hospital? If not, what is the commute for each hospital? How much orientation time would you get on each unit? What would the orientation consist of? Would you be part of a nurse residency program? What is the pay for each position, and what shift would you be working for each? What are your long term goals (or where do you see yourself in 1, 2, or even 5 years)?

Congrats on having 3 job offers!! :up:

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#1 ICU, #2 CCU, #3 Step Down

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All three are at the hospital for the same pay and about 45 minutes drive (doesn't bother me). ICU orientation is four months, while the others are three. More time is provided if needed. I would be part of a residency program for each. Long term, I have not decided at this point, but from what I have gathered, ICU puts you in a great position to start many different paths. Should have included that in the first post. Let me know what you think and thanks for responding!!!

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I provided additional info to the comment below. Please let me know what you think! Thank you!

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Specializes in Family Nurse Practitioner.

What about unit culture? Mix of staff (seasoned vs new)? Shift? Types of patients? Did you like the manager/other staff?

The longer the orientation the better, however the above factors also make a difference.

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The staff was great on each unit, but I especially liked the larger group of younger staff on ICU balanced with more experienced RNs. I know if they have many new grads, that they must have a lot of experience precepting. I realize that sounds like I answered my own question about which unit to pick. If you are familiar with ICU, do you have any advice for or against/encouragement/tips?

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ICU provides a great broad experience for critical care

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Specializes in Family Nurse Practitioner.
The staff was great on each unit, but I especially liked the larger group of younger staff on ICU balanced with more experienced RNs. I know if they have many new grads, that they must have a lot of experience precepting. I realize that sounds like I answered my own question about which unit to pick. If you are familiar with ICU, do you have any advice for or against/encouragement/tips?

I know that it is probably easier to relate to younger staff but a lot of new grads on a unit is a red flag. The staff probably do have a lot of experience precepting, but they may be overburdened with precepting and just plain tired of precepting for months on end with no break.

It sounds like your heart is with ICU, but if CCU has more experienced/seasoned staff than the ICU, I would choose CCU.

What are the unit ratios?

Does the CCU take only cardiac type patients? In some hospitals CCU is coronary care unit or cardiac care unit (AKA the cardiac ICU/CICU, and in others it stands for critical care unit.

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Cardiac care unit is CCU. Unit ratios on both are 1-2 patients per nurse. I believe the unit hires about the same amount of new graduates each year (it is a HUGE ICU), but that is something to think about. I should have stated that differently: there are many younger nurses- some one or two years of experience and they are absolutely amazing at what they do as in precepting and caring for patients from what I have heard and seen. The reason I would say there are less new grads on CCU is probably the smaller size (less beds), but again, it is quite possible that you are right.

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ICU provides a great broad experience for critical care

Thats great to hear. I hope it can provide a good background for more specific ICUs in the case that I am ever interested.

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