New grad intent on ER or ICU

[DruidRN, ASN]

Hello there, 

I just graduated with an ASN this past December. I have no experience yet, but I would like to get into the ER or ICU. Does anyone have input about (1) What my chances of getting ER/ICU as a new grad, (2) Advice for how to get myself into those dept. asap (meaning, if I can't get those positions right out of the gate, what should I do first to better my chances), (3) I thought hospitals were short on nurses right now, is this true? Does this increase my chances of getting the dept. I want? 

Also, I would like to live in Honolulu and work at a level 1 trauma hospital. I know that Queen's Medical Center is the only level 1 in the state of Hawaii. Do I have a shot at ER/ICU there or should I stick to the mainland? 

Thanks! 

[RNNPICU, BSN, RN]

Just start applying.  Look for hospitals that have a new grad program.

Hard to say what your chances are as it will depend on the number of job postings and what hospitals are looking for.

The only way to find out is to apply and cast your net.

[JBMmom, MSN, NP]

You are considering to vastly different areas of work. What is it about those areas that specifically interests you? ER nurses (God bless them), have to do a MUCH higher degree of multitasking and you are dealing with everything from people near death (or already dead), to people that don't even need to really be seen in a medical facility. You have people with no real diagnosis, no data about their condition, demanding families that are sure that their family member needs you more than anyone else. You have to be able to prioritize and switch tracks on a dime. (I'm sure there are awesome parts of the job as well, I guess it's obvious why I don't work there) You are there to stabilize and move out- either home, inpatient, OR, etc. 

In the ICU you are dealing with patients that you know are sick. You have labs, imaging, diagnoses, etc. You are working to move their plan of care forward and you need to learn to anticipate what needs to be done next. You will have FAR less patients than in the ER, so you will have time to learn more about them. Depending on the shift you work, the staffing of the hospital, and the level of autonomy expected, you will need to develop proficiency in pressor support, ventilator support, etc. 

As a new grad both are options and these days easier than ever to get into. But try to think about what will best fit your personality and skill set and work towards that. Don't discount the potential benefit to starting inpatient in a med-surg or telemetry unit if you don't immediately get offers in the ED/ICU. Learning time management and assessment skills can be invaluable before adding the additional variables of critical illness or emergency department chaos. Good luck with your decision.