New Grad RNs in ICU

juliaann · Jul 11, 2012

I received a job offer for the ICU of my 1st choice hospital while in my third semester of nursing school. My inexperience did not seem to concern them. I will have a long, thorough orientation and am so excited to be starting where I want to work!

Trilldayz,RN BSN · Jul 11, 2012

Is it unheard of to have new grads go directly into critical care? I'm in Connecticut and most of the hospitals stress "NO new grads will be hired in ICU"! Why has this changed? I know plenty of nurses that went straight to ICU upon graduation and are some of the best nurses.

Well, I was hired as a new BSN grad in both an ICU and CVICU (right next door to each other). I am no expert but I am certainly competent and have gained the trust of my coworkers and physicians. The docs and seinor RNs have complimented me over my year as a novice RN. BUT prior to graduation, I already had my ACLS cert, PALS cert , TNCC prepared (but couldnt get the cert, due to not being licensed yet), and worked as an RN intern at a level 1 trauma center (most of my time spent in their ER)....that probably helped my confidence level and got me hired). I think it's possible to be hired as a new grad in critical care, it just depends on the new grad. I think if they have pertinent health care experience, confidence, physical speed, and willingness to ask TONS of questions, they might be a good fit. I'd be a little more weary of a new grad with NO critical care experience, certs, not even any job experience that involves multitasking, etc. , IMO.

pinknblue82 · Jul 11, 2012

The director of the ICU at my hospital said she usually hires one new grad every May. It's typically someone who has worked for her as a tech or secretary. Would you consider doing tele/step down/pccu until you're eligible for a transfer?

ventgurl, ASN · Jul 11, 2012

Well, I was hired as a new BSN grad in both an ICU and CVICU (right next door to each other). I am no expert but I am certainly competent and have gained the trust of my coworkers and physicians. The docs and seinor RNs have complimented me over my year as a novice RN. BUT prior to graduation, I already had my ACLS cert, PALS cert , TNCC prepared (but couldnt get the cert, due to not being licensed yet), and worked as an RN intern at a level 1 trauma center (most of my time spent in their ER)....that probably helped my confidence level and got me hired). I think it's possible to be hired as a new grad in critical care, it just depends on the new grad. I think if they have pertinent health care experience, confidence, physical speed, and willingness to ask TONS of questions, they might be a good fit. I'd be a little more weary of a new grad with NO critical care experience, certs, not even any job experience that involves multitasking, etc. , IMO.

@Trilldayz,SN: I've been a Registered Respiratory Therapist for 12 years now! I'm part of the Code/Trauma/Rapid Responce Team. I'd say I have pretty good critical care experience/exposure. I'm trying to be patient, but it's the ICU that I love, not med/surg float pool!!

ventgurl, ASN · Jul 11, 2012

The director of the ICU at my hospital said she usually hires one new grad every May. It's typically someone who has worked for her as a tech or secretary. Would you consider doing tele/step down/pccu until you're eligible for a transfer?

@pinknblue82: Yes, if I cant get into my ICU, I'd settle for Tele float, we don't have a step down unit!!

kbuzzRN · Jul 11, 2012

Hello! Well I can say first hand I was lucky and went straight to ICU as a new grad! However. I love challenges and loved ICU in my clinical rotations,luckily the director had several good reviews from the nurses I followed! It's not impossible but you do have to have thick skin, ask lots of questions, and at first I studied my meds outside of work. Most of all, you will definitely have to gain the respect and trust of everyone around you. DON'T be timid!!! Watch once then jump right in and have someone watch and correct you! Hands on is the best! ICU is a huge responsibility because you are taking care of people at the most vulnerable state in their lives and what you do or don't do can change their outcome! Do not settle though challenge yourself and if you want ICU then let them know! :) GOODLUCK!

MommyandRN · Jul 12, 2012

If you want it, keep looking! I started ICU as a new grad and I survived! In fact, most hospitals I have worked have all hired new grads. A lot of them. Most new hires were new grads in fact. A good program is 3 month orientation, including classroom time.

ventgurl, ASN · Jul 12, 2012

Great news, I was notified today that got the job as ICU float!! Thank you all for your advice!!

NewbieNurse78 · Jul 15, 2012

Glad to hear you got some good news. But to answer your original question I have heard that it is more and more unusual for new grads to go to specialty units like the ICU, ED NICU etc because of the cost in training involved. Essentially a new grad requires about 2-3 months of training and preceptorship JUST to hit the floor on Med-Surg or Tele, now factor in the extra training that is involved in teaching a nurse about the ins and outs of Critical Care. Over all it really boils down to cost and time and with the economy down all over the US even hospitals are being hit hard.

I was lucky and was offered a position as a new grad in our ICU, but I was told it was only because I had already had vent experience when I was an LPN. My hospital also had an established training program that was a 5 week in class course that taught "new ICU" nurses the ropes, even then I STILL had a 3 month preceptorship. My employer certainly invested a lot of resources in me and I am trying my very hardest to make sure they don't regret it.

ventgurl, ASN · Jul 16, 2012

Glad to hear you got some good news. But to answer your original question I have heard that it is more and more unusual for new grads to go to specialty units like the ICU, ED NICU etc because of the cost in training involved. Essentially a new grad requires about 2-3 months of training and preceptorship JUST to hit the floor on Med-Surg or Tele, now factor in the extra training that is involved in teaching a nurse about the ins and outs of Critical Care. Over all it really boils down to cost and time and with the economy down all over the US even hospitals are being hit hard.
I was lucky and was offered a position as a new grad in our ICU, but I was told it was only because I had already had vent experience when I was an LPN. My hospital also had an established training program that was a 5 week in class course that taught "new ICU" nurses the ropes, even then I STILL had a 3 month preceptorship. My employer certainly invested a lot of resources in me and I am trying my very hardest to make sure they don't regret it.

That's probably the reason I was hired as well!! I have plenty of vent experience from being an RRT, I know the hospital, and know the computer system, so I would consider myself a shoe-in for a new grad position. I'm am looking forward to learning in critical care units as a RN!!

Pheebz777, BSN, RN · Aug 2, 2012

Not to berate new grads but I personally would advice new grads (even experienced RT's, MOnitor techs, EMT's, etc) to start your nursing experience with floor nursing. There is a lot of learning that can be taken from the floor and once you've developed basic nursing skills and knowledge base then you can concentrate on more critical areas once you've reached the ICU.

For example on the floor, you can develop your IV skills since you're handling a higher number of patients. Many are healthy enough to have good veins to start with unlike the ICU where since most patients are critical, practicing your IV skills on severly dehydrated, septic, or nearly inaccessible veins using large bore needles (20 gauge above) would really discourage egos. Mostly PICC lines would be inserted for the severely inaccessible thus furthermore diminishes your chances on practicing.

You've never inserted a suppository before? Ambulated patient's in hallways? Inserted a foley? Discharged a patient home and provided health teachings? These are basic skills and learning experiences that should be mastered before going into ICU thus your concentration can be centered more on learning new critical care skills that a regular floor does not provide.