New Nurse Graduate - GMS vs. ICU

[Casey_93, ASN]

I did my preceptorship in the ICU, and my main clinical rotations on the GMS floor at my local hospital, and new openings have become available for both units.

In your opinion, which unit would be a better fit for a graduate nurse?

I know I want to do ICU and pursue a critical care path in my career, but I also acknowledge that a basic year of GMS experience would lend a lot of flexibility to my career in the long run, should I ever change my mind.

Basically, my heart says ICU, but my brain says GMS.

Any input will be appreciated.

[Ruby Vee, BSN]

I'm with your brain, but I suspect I'll be in the minority here. Back when I started, you had to have two years on Med/Surg (or something similar) before the ICU would even consider your application. So that's my dirty lens.

Working on Med/Surg gives you the opportunity to learn basic nursing skills -- you'll need to be able to throw in an IV, an NG and a Foley while doing an assessment and taking a history when you're in the ICU. It's easier to multi-task when you already know how to do each of those tasks. You'll learn to talk to patients, family members, ancillary services, physicians and pharmacists -- so calling a doctor won't be as much of a big deal when you go to ICU. You'll learn how to communicate clearly and concisely with other health care professionals -- you'll learn what is important and what is not. Nurses who start out in Med/Surg seem to last longer in ICU without burning out. But that's what I've noticed in my career.

The most important consideration is the support you'll have as you learn to be a nurse and not a nursing student. You want a manager who is fair and who is willing to work with you, supportive co-workers who will have your back and a preceptor is able and willing to teach. Really, the patients don't matter nearly as much as the support you'll have.

Good luck!