New Grads going straight into critical care

AnthonyD · Apr 15, 2015

Personally, I believe new grads can thrive in the ICU. I don't mean every new grad can handle it, but being a new grad can actually have some advantages in the ICU:

1. Pathophysiology is still fresh in your mind! You've recently learned all that fancy multi-system stuff (RAAS: Renin Aniotensin Aldosterone System, HPA: Hypothalamic-Pituitary-Adrenal Axis, and all that jazz), and you haven't had a chance to forget most of it by working in a setting where it isn't really relevant.

2. You haven't learned Med-Surg time management, prioritization, and care-planning; therefore you luckily won't have un-learn and re-learn how to manage your assignment. It takes time and effort to develop into good med-surg nurse, but unfortunately the way you prioritize tasks and manage your time on the floor does not usually apply to the care of 2 critically ill patients in the ICU. You will be starting from scratch and will be able to learn how to organize your workload without trying to draw on previous practice.

3. You haven't had a chance to develop shortcuts, work-arounds, and bad habits.

4. You're still excited about learning new things! You've just finished school, and your brain is still in absorbing mode. Use that to your advantage! The ICU will give you endless opportunities to stay excited about learning - I promise.

5. ICU nurses like to teach and explain things. What better place for a new grad than on a unit full of nurses that look for any opportunity to show off what they know? You'll even hear healthy debate on things like different treatment options or medication choices, best practices, fancy new equipment, etc.

And I'm sure there are plenty of other reasons. From my perspective, a nurse does not have to be experienced in some other setting prior to working in the ICU - as a matter of fact, of the nurses I've precepted - the new grads generally seem to do better.

nursepeaches · Apr 26, 2015

Personally, I believe new grads can thrive in the ICU. I don't mean every new grad can handle it, but being a new grad can actually have some advantages in the ICU:
1. Pathophysiology is still fresh in your mind! You've recently learned all that fancy multi-system stuff (RAAS: Renin Aniotensin Aldosterone System, HPA: Hypothalamic-Pituitary-Adrenal Axis, and all that jazz), and you haven't had a chance to forget most of it by working in a setting where it isn't really relevant.
2. You haven't learned Med-Surg time management, prioritization, and care-planning; therefore you luckily won't have un-learn and re-learn how to manage your assignment. It takes time and effort to develop into good med-surg nurse, but unfortunately the way you prioritize tasks and manage your time on the floor does not usually apply to the care of 2 critically ill patients in the ICU. You will be starting from scratch and will be able to learn how to organize your workload without trying to draw on previous practice.
3. You haven't had a chance to develop shortcuts, work-arounds, and bad habits.
4. You're still excited about learning new things! You've just finished school, and your brain is still in absorbing mode. Use that to your advantage! The ICU will give you endless opportunities to stay excited about learning - I promise.
5. ICU nurses like to teach and explain things. What better place for a new grad than on a unit full of nurses that look for any opportunity to show off what they know? You'll even hear healthy debate on things like different treatment options or medication choices, best practices, fancy new equipment, etc.
And I'm sure there are plenty of other reasons. From my perspective, a nurse does not have to be experienced in some other setting prior to working in the ICU - as a matter of fact, of the nurses I've precepted - the new grads generally seem to do better.

Thank you for the well thought out response. I just accepted an ICU position and am nervous, scared, and excited all at the same time. Your post definitely made me feel better! Thanks!

jottrn2 · May 6, 2015

I worked med/surg float pool for a year and feel that I had very little advantage over my ICU peers that started as new grads as far as patient care is concerned. Any advantage I had was probably related to charting, technology used by the hospital, policies, etc.

Dodongo, APRN, NP · Jun 23, 2015

I went right into an adult ICU after getting my BSN. Now I'm in Interventional Cards/Rads. ICU offers you more opportunities than any other area. It's totally doable as a new grad if you're intelligent and hard working. Good luck!

ChipNurse · Jun 25, 2015

I started in the ICU as a new grad, but I did do a 200 hour practicum one on one in an ICU within the same hospital system, so I was already used to the patient population, policies, and charting system. I think there are many new grads that can handle starting in the ICU, but they need to be "self starters" and be very organized. It will require studying at home on your own time. The hospital needs a good orientation, that is an appropriate length of time, for new grads. The unit must also have supportive nurses that are willing to help the newbies along. If you are motivated, the hospital has a good orientation for new grad ICU nurses and if you know that the unit that you will be working in is conducive to learning, then I would go for it! Good luck!

Le2284 · May 24, 2016

Which hospital do you work in that hires new grads into ICU? I am a new grad and looking for a job in an ICU.

tnk11 · Jun 1, 2016

I started out as a new grad in a 16 bed combined ICU. Patients ranged from Open Heart Surgery, to your typical sepsis MICU patients to some big belly surgeries to some neuro patients. It all depends on how self motivated you are to learn. Also, make sure you get an awesome preceptor. Mine was actually in ACNP school while he was orientating me and I learned more in that 6 months of orientation then I did in nursing school.

CrazyGoonRN · Oct 5, 2016

My first reaction is no, new grads shouid not be hired in the ICU. However, if the new grad has an adequate length of orientation and a good preceptor then I think it is fine. However, I know that my hospital is hiring anyone and every one they can find in the ICU's because of short staffing. This means a large number of new grads on night shift in the ICU. It is not safe because the more experienced nurses do not have time to answer questions all night long and take care of their own critically ill patients. I only have 1 year of ICU experience and I still have a lot to learn and I am helping the new grads. It is frustrating. Management is shortening the length of oriention to get nurses on their own quicker. It is very unsafe. I'm not sure how long the orientaion for new grads has been cut to, but I know experienced nurses with no ICU experience used to get 8 weeks and are now getting only 5 weeks.

I wonder if this is happening at other hospitals?