New Grad in ICU?

CNL2B · May 5, 2010

I have 10 years of nursing experience, 8 of it in critical care. I started on a cardiac stepdown and that was a good choice for me - I spent 18 months in that practice area. If you do eventually want to do critical care, I would definitely go somewhere where you have telemetry monitoring and some drips but critical care is not always the best choice for new grads. I do know some that have done it successfully -- I would say the best ones that I have seen succeed straight out of the nursing school into the ICU have other relevant experience, e.g. I know someone that was an army medic, and another that was a respiratory therapist that did just fine. Some new grads with no medical experience do fine too -- but I would say that is a crapshoot. Most are very, very green and need a lot of assistance and don't function independently for well over a year. Honing your basic nursing skills first I think is the best way to go, but opinions will vary on that.

I would also make sure you look at your hospital and the education program they have in place. If the ICU orientation a well-developed, well supported process, your chances of success earlier are better. If you are looking at small community hospitals where they want to give you two weeks of orientation and throw you to the wolves, I would think twice. In that situation, the likelihood that you would actually do something harmful or dangerous as a new grad is high. Also think of yourself and protecting your license -- you have a career ahead of you to consider too.

whit16 · May 5, 2010

Thanks for the feedback! You made many good points!

Chisca, RN · May 5, 2010

Fraught with danger but it is possible. Do not let them shortchange you on education or training. You should not be included in any staffing pattern until your orientation is finished. I would get it in writing because if staffing gets desperate watch how quickly your orientation will end. Alot will ride on how good your preceptor is and how willing they are to fight for you. If possible find out who the preceptors are and what are their attitudes towards new grads. Nothing worse than having a preceptor that thinks you don't belong.

jennysong81 · May 7, 2010

Hi there! Congratulations on getting through nursing school! Well, almost! :)

Being a fairly new nurse myself, I don't think you need to start from med/surg in order to gain experience. I tell my friends who are still in nursing school to choose carefully where they start their first career as a nurse. I applied for critical care residency program and started working in PCU because I eventually wanted to end up in ICU. I recommend starting out in tele or step-down unit since you'll be able to get good experience in caring for maybe not "critically ill" patients but patients who are "sick enough" to be on different drips and need lots of critical thinking/decision making on your part to intervene in various situations.

But you know, there are lots of other "variables" that play huge role in helping new grads become competent clinicians in ICU (or any areas in nursing). Just like MissBecky said in earlier post, you've got to have strong support from your unit - solid residency program for new grads (this is especially true for new grads starting out in critical care area), well-arounded preceptors/mentors, continued support from management and colleagues, nursing educator dedicated to your unit who REALLY cares about your professional growth, and etc. Make sure you do research and ask appropriate questions to recruiters before you make any decisions.

Good luck on your NCLEX and job hunting!

icurn09 · May 7, 2010

I started in a M/S ICU as soon as i graduated last may and i wouldn't change it for the world. I have learned and experienced more in one year than i ever could have imagined. I had an amazing preceptor, and an amazing team that have helped to shape me into the nurse that i am today. If i were to give you any suggestion it would be this, to start on nights. ICU's are hectic 24 hours a day, but a little less so at night. Well, most nights anyway :). Good luck!!

LoveActually · May 7, 2010

I think a big factor in success or not has to do with your orientation & amount of education (duh). I had 6 weeks orientation on telemetry & 8 weeks in ICU both with amazing preceptors. I went to more classes & had more education in the first few months, than I did in nursing school it felt like. I went to an 8 week critical care academy with classes and simulations while on orientation. I also went to endless classes at my facility...wait I still go to endless classes

I have been off of orientation now for about 6 months. I was well-prepared & I never feel alone at work. Oh, and I work nights - that helps too.

I don't regret going to straight to ICU - it has felt like the 'right' place for me since I stepped through the door for my first night of orientation .

=)

PMFB-RN, RN · May 7, 2010

If you can get into a nurse residency program where the hospital will spend some serious time and effort teaching you to be a critical care nurse then yes, by all means go directly into critical care. My hospital had a 7 month nurse residency program for new grads going into critical care that has been very successful in turning new grads into ICU nurses. If you do not have the opportunity to receive very good training in ICU then I would recommend some time in a telemetry unit or step down first.

A part of my job is to train new hires. I would much prefer to train a new grad into ICU than a nurse with significant med-surg experience. I find that some of the experienced med-surg nurses have trouble making the leap to much more autonomous practice setting. In ICU when there is a problem with the patient you often must deal with it right now. Your calls to the physician are often after the fact telling them what you did, not asking them what they want you to do.

pinkynbd_99 · May 12, 2010

Hey I graduate this week and have an job interview for an ICU position. I haven't gone yet but after reading all the posts I really have alot to consider when I interview with them. according to the nurse recruiter, I will get 12 weeks training with a mentor, preceptor and classes as well. They help pay my school loans and give me tuition re-imbursement if I go back to school for my BSN/MSN, etc. The only thing I was little uncomfortable was they require a 3year contract. again, I haven't gone to the interview yet, so I don't know any more details and I've never really went to do clinicals in this hospital but it's close to my house and they are part of the Tenet Hospitals. So we'll see what happens, I figure I would go and "scope" it out with the unit and see how what vibe I get. But thanks for the posts, It's given me alot to be prepared to look for and ask for.

pebbles, BSN, RN · May 12, 2010

This is a VERY common thread topic if you go back a few pages.

You might want to look at some of the other "new grad ion ICU" threads as well....

It's a mixed bag and it really depends on the supports in place and the expectation of your employment.

In *my* hospital, a new grad out of school would never be a safe consideration for ICU because we aren't set up to preceptor and educate them. Others are different. We are a tertiary care centre, but the smaller community hospitals in my area have always hired and trained new grads. Therefore, opinions will vary. You should not go by what people from other places and the internet tell you, you should look into what programs there are in your location and whether other new grads have been successful in ICU's there.

Tips for getting into ICU as a new grad? - Nursing for Nurses

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

i want to start off my career in icu once i graduate - Nursing for Nurses

New Grad BSN to start in MICU - Nursing for Nurses

New Grad starting off in ICU - Nursing for Nurses

Good luck!

keyotinkel · May 13, 2010

Hi,

Congrats. It may be imperative to learn critical math calculations because this specialty area uses a lot of critical thinking skills. I found the "Intravenous Math Workbook to Reduce Medication Errors", self help practice math was very helpful. The IBSN is 978-1-4363-7524-5. Good luck.

keyotinkel · May 13, 2010

Hi,

Congrats. I think the specialty area uses critical thinking skills and medication administration is pertinent in nursing care. I found "Intravenous Math Workbook to Reduce Medication Errors, very helpful with self-practice calculation problems. The ISBN is 978-1-4363-7524-5. Good luck.