New grad. start

Do you have offers from all of these places?

Thanks for responding. I have an offer to ER only. Will apply to the others once I pass NCLEX prior start. Everyone says ER since the opportunity is there but my gut says IMCU for more bed side and priority experience, than make a choice after foundation of practice at a slower pace. Some say you can go IMCU to ICU to ER, but not the other way around. Need others opinion to weigh in on.

Made a decision. Thanks for posting!

We have new grads start in the ICU as of recent and I will say you can tell if they have med/surg background (or any background at all). So if you can I would start on a different floor other then ICU or ER, then work there for at-least a year then make your move!

We don't have a IMCU so I cant speak for that but I think really any experience that helps your prioritize is worth it before the ICU.

Good luck!

I would say go where you want to work and then work hard. I started in the ICU as a new grad, became charge, rapid response, iV team, yada, yada, all in the span of a couple of years (got my CCRN-CMC, and BSN all in that time too), now I'm in CRNA school. You can do ICU or ER right out of school and do just fine. Many of our best nurses did just this. You will not know some basic things like if you came from the floor (like how to fill out an order), but most of that is inconsequential anyways and you can learn that fast. We had a long (4 months) training program for GNs in the ICU, so we actually got better training than some of the floor nurses who had to be off training sooner and forget everything they learned in nursing school. Don't let anyone tell you you can't do it. From what I've seen as a rapid response nurse and code team there is not much to learn on the floor as far as medical knowledge and critical thinking. It seems very task oriented and busy for productivity's sake, not to save someone's life. No thanks

From what I've seen as a rapid response nurse and code team there is not much to learn on the floor as far as medical knowledge and critical thinking. It seems very task oriented and busy for productivity's sake, not to save someone's life. No thanks

You've never worked on med-surg and taken care of more than one or two acutely ill patients; that's obvious. Good med-surg nursing requires excellent assessment skills and prioritization of patient care which in turn requires a high level of critical thinking that is based on very good medical knowledge of patients conditions, ability to understand lab values/diagnostic test results, assessment data, medications ordered (doses, action, expected effects, side effects, adverse effects and action to take, contraindications, lab values, etc.) and treatment plan, all in the context of the patient's diagnosis/diagnoses and co-morbidities, not to mention a high level of proficiency with clinical skills/treatments. Med-surg requires a high level skill set to perform well and provide competent, safe, nursing care.

Thanks for both of your response. Due to I have a Paramedic background and high assessment skills I decided to begin with IMCU (stepdown). This makes me stronger in prioritizing and previous technical skill set adds a plus to my patient care/learning experience.

IMCU is what I'd aim for. Typically gives you a good mix of experience with a little breathing room (acuity wise) to ask questions, take your time, learn, find out what your strengths are and where you want to end up. The ER would be an easy transition with a background in pre-hospital medicine, for sure, but I'd second that it's hard to get from an ER mindset to an ICU mindset. Not impossible, mind you, but the priorities are very different in ICU. Imagine saving a life and getting an email from the boss that you forgot to sign ONE of the 12 blood products you gave in 2 hours out of the blood fridge, or that one of the twelve IV tubing sets in your room was expired by 2h. ICU means you have to pretend to care and promise you'll do better. In my imagination the ER nurse gets to flip their boss the bird and walk away. I know that part isn't quite reality, but you get what I'm trying to say?