New Grad as an ICU nurse?

mauxtav8r · Jan 25, 2009

I think this depends largely on the organization. Some are set up to accept new grads in units, but in others, they have an expectation that you are seasoned to the hospital before you arrive.

This varies greatly by region, nursing shortage conditions, etc.

nursbee04 · Jan 25, 2009

A lot of it depends on the individual, but I think mostly on the environment you will be in. Is it a supportive environment with established preceptors/mentors? Will you be with the same preceptor every shift or will it change from shift to shift? Will you have enough orientation? How long will the orientation period be? Is it guaranteed? Will you be taking a Critical Care course or other education such as Rhythm/EKG Interpretation? Will you be expected to learn these things on the job?

I am a preceptor at my facility and a firm believer that new grads should get AT LEAST 4 months orientation in ICU. Currently our new grads get three months, then they are evaluated at the end of that period. They are either taken off orientation or they get another month, at the end of which they are evaluated again.

I believe a strong orientation period is key. ICU is a fast paced environment where prioritization and critical thinking skills are a must. New grads need time to develop these skills. Wherever you decide to work, ask the questions above.

You may get more insight if you post this in the MICU/SICU forum.

Good luck!

allnurses Guide · Jan 25, 2009

I agree, try a search in the ICU forum - there have been tons of posts about it.

caliotter3 · Jan 25, 2009

I met an ICU nurse who came there as a new grad. She went through a nine month training program and told me she had no problems at all. Her co-workers accepted her and provided support. She said that being accepted by her peers was the key to her success.

jedimasterr · Jan 25, 2009

I started in ICU right out of school and I am glad that I did. All the questions people above asked are important and for me, I had continuity of a single preceptor for the whole time and I went to a unit that was embracing of new grads. All I would add to what has been said here is that I think attitude is important too. I wanted to go to ICU because I was hungry to learn and wanted to work with that population. Conversely, I have since talked to and occasionally filled in as preceptor to some new grads who actually said they weren't really sure what they wanted and came to ICU because the pt to nurse ratio's were better then on the floor. Those nurses are getting by, but their work shows they aren't completely satisfied being there.

Lifesaver1 · Jan 25, 2009

I think that if the facility has a comprehensive orientation/preceptor program, it is an excellent place to start as a new grad. However, ICU has to be something you enjoyed when you were in school. I started out in ICU, because that was my favorite semester.

In school, you should have gotten get some sort of sense of what area of nursing you would enjoy. Is that the case with you . . . Did you enjoy Critical Care in school?

marilynmom, LPN, NP · Jan 25, 2009

I started in ICU as a new grad and I'm glad I did, it gave me great skills and I learned to think fast, etc.

It really really depends on the unit you will be working on.....some units love new grads and some don't! You need to ask around and find out the reputation for new grads in the unit, talk to some nurses who work there, etc. The unit I worked for was fantastic with new grads. We had 12 weeks orientation and then we were on our own with the easier patients (chronics, pt's going to the floor soon, observations, etc), 6 months later I was taking any patient (fresh hearts, etc) which was scary but I still had plenty of support. The staff was very helpful and great with teaching.....if not for that there is NO way I would have made it.

neatnurse30 · Jan 25, 2009

I started out as a new grad in ICU as well, but didn't like it at all, and the nurses were not too supportive and encouraging. I was very stressed out, and at the end of my 3 month orientation I knew I wanted out badly. I switched to regular med- surg floor and that was a good move for me. But my preceptor in ICU started as a new grad there and loved it from the beginning. So I guess it depends. In general, I would not recommend ICU for new grads, there is too much to learn and it causes additional stress.

Scrubby · Jan 25, 2009

I started out as a new grad RN in the ICU. It was a four month placement as part of my graduate nursing program. I absolutely loved my placement because they had a really good training program in the ICU. There was always an experienced person nearby you could ask for advice and they really looked after me. There were some personality types in there but you get that anywhere. If I didn't love OR nursing I would have reapplied to go back to ICU.

dorimar, BSN, RN · Jan 25, 2009

This question has been posted on this very forum with much debate and response! There is lots of input still valid from prior posts. It is a shame that some cannot control their emotional responses and lose professionalism when passion is involved. Many people feel strongly both ways, when going back and reading responses, try to objectively view responses from the side of each poster--there are a lot of good points on both sides. We can learn alot from each other if we try to be open minded.

eriksoln, BSN, RN · Jan 25, 2009

Bad News: Had a close friend in school who went to the ICU right out of school. Lasted less than a year after signing a 3 year sign on bonus contract. He is out of nursing now.

Good News: I dont think it was the ICU experience that drove him away as much as nursing in general. His complaints were about things that happen on every level of care (call offs by other nurses, getting admits right at shift change, constant changes in policies/procedures).

He started at the same hospital I did. I never saw him, he didnt get breaks. I know the unit I started on, a M/S unit, had a number of nurses who were superior preceptors. My wife, who was already a nurse, did some investigation before each job I interviewed for and found the this M/S unit to be a very good choice for GNs. The ICU unit my friend went to on the other hand was infected with low moral and disgruntled nurses and they took their frustrations out on the new people a lot of times.

I think, more than what specialty you go into, the character of the first unit you work for decides the quality of your first experience.

My advice, dont get caught up in the sign on bonus game. Dont go to a high needs unit just for a little higher sign on. Take the smaller sign on but pick the unit you are going to based on how well they do with new employees. Also, before accepting a job, ask to shadow a nurse on the unit first. I've seen people do it. While there, get a feel for the character of the unit. Are there signs all over the place warning about "changes in call off policies" and things liek that. Is everyone walking around complaining about this nurse that nurse or the other shifts? Be assertive, start conversation with the other nurses and see if you hear "You wont make it here" or "I'm getting off this unit the first chance I get" comments.