NICU or Med-Surg 1st?

NewEastCoastRN · Jun 10, 2005

Go for the ICU. You will get the experience you need there. I work in med-surg, and I think that it was good experience for me, but for your goals, it isn't necessary to work in med-surg. New grads can do JUST FINE in the ICU. Don't let anyone tell you otherwise. Good luck!

ZASHAGALKA, RN · Jun 10, 2005

I'm a strong believer that EVERY nurse should work a general floor for at least a year. Desperation for any 'body' in the critical areas has downgraded the emphasis on 'putting in your time', but not the importance of it.

You have to have the prioritization and time management, and 'critical thinking skills' down pat BEFORE going to critical areas.

Think about it this way: most hospitals consider ICU nurses to be their go to people to work anywhere: if you can't prioritize for greater than 2 patients; you will be lost on every 'float'.

And you will be at a severe disadvantage in ICU. If nursing eats its own, then ICU even more so: we tend to attract 'personalities'.

I worked med/surg for 3 yrs before moving to ICU. I was lost enough that first year without having to do it without any kind of 'grounding' in nursing.

Put in your dues. It'll make you a better ICU nurse and ultimately, a better CRNA.

~faith.

fergus51 · Jun 10, 2005

I have to say I believe NICU is the exception to the rule that med-surg experience is really important. The adult world is completely different and new grads do very well in NICU if they have a good orientation. I know some managers actually prefer them to nurses with experience in med-surg because the new grads aren't stuck in adult mode. It also seems to be an area that leads to opportunities in other units. I've never worked with adult ICUs, but have been offered several positions because of my NICU experience.

ZASHAGALKA, RN · Jun 10, 2005

I agree that NICU is different, but I think she said she was considering NICU only until she could get into Adult ICU.

~faith.

rnbeauty · Jun 10, 2005

Med-Surg first. You will really appreciate it...Even if it's for 9 months to a yr. I did Med-surg first for years before transferring to ICU...I'm so glad I did. Just my own two cents! :rotfl:

CougRN · Jun 10, 2005

no need for the old "put in your dues" stuff in med/surg. that's an old philosophy that won't die. go do what you think you will enjoy the most. that's where you are going to be happy and more willing to learn. anything you need to learn about adult icu you will learn in adult icu when you get there.

AliceMay · Jun 10, 2005

I appreciate all your replies. But my question was not whether Med-Surg was necessary before going into ICU.

My question was since I cannot go to adult ICU first, should I start at NICU (which I think I'd like, but I'm afraid there will be less opportunities for me in the future) or go to Med-Surg which might give me a better foundation later on.

(My ultimate goal is to go to CRNA school. Most CRNA schools want you to have adult ICU experience.)

CougRN · Jun 10, 2005

you will learn more in NICU that will help you for CRNA school than med/surg. titrating drips and calculating drugs is a lot of what we do in NA school. you will get a great foundation in NICU. go for it. there are even some schools that take NICU experience and won't require you to have adult experience, even though i believe the adult experience is helpful if only for 6 months.

Kiwi, BSN, RN · Jun 10, 2005

Definitely NICU! I'm willing to bet that you will get some great experience with hemodynamics, as a large population of the NICU are heart patients.

fergus51 · Jun 11, 2005

I appreciate all your replies. But my question was not whether Med-Surg was necessary before going into ICU.
My question was since I cannot go to adult ICU first, should I start at NICU (which I think I'd like, but I'm afraid there will be less opportunities for me in the future) or go to Med-Surg which might give me a better foundation later on.
(My ultimate goal is to go to CRNA school. Most CRNA schools want you to have adult ICU experience.)

Like I said, I've been offered several adult ICU positions because of my NICU experience so it can definitely be a stepping stone to adult ICU. I would never actually work adult ICU, but every time I spoke with a hospital recruiter about NICU positions they would ask me to interview for adult ICU as well. I don't think NICU is limiting if you work at a large enough unit and get broad experience. We see the same drips (just in smaller doses:)), learn the same critical care skills (vents, lines, etc) and also look after critically ill patients (you'll get experience in code situations, looking after post op patients, etc).

TexasCCRN · Jun 11, 2005

I'm a strong believer that EVERY nurse should work a general floor for at least a year. Desperation for any 'body' in the critical areas has downgraded the emphasis on 'putting in your time', but not the importance of it.
You have to have the prioritization and time management, and 'critical thinking skills' down pat BEFORE going to critical areas.
Think about it this way: most hospitals consider ICU nurses to be their go to people to work anywhere: if you can't prioritize for greater than 2 patients; you will be lost on every 'float'.
And you will be at a severe disadvantage in ICU. If nursing eats its own, then ICU even more so: we tend to attract 'personalities'.
I worked med/surg for 3 yrs before moving to ICU. I was lost enough that first year without having to do it without any kind of 'grounding' in nursing.
Put in your dues. It'll make you a better ICU nurse and ultimately, a better CRNA.
~faith.

I couldn't disagree more. ICU and any Floor are totally different animals. There are two different types of organization and thought processes.

If your goal is to become a CRNA don't waste your time with med/surg. Yes, the nurses in ICU personalities are rough, but that is because of the stress and personality type that tends to be in critical care.

As far as floating goes you usually dont' have to go to med surg from ICU...maybe tele or PCU...The reason most are "lost" on floats is because of how thorough we are in ICU. We try to be the same out on the floor and it is just impossible.

If you are serious about becoming a CRNA I would do everything I could to get into ICU (adult), but if that isn't possible NICU is a good start. I would call the programs that I am interested in and get a feel for what they think of this.

Good luck with starting a new career. Don't let those scare you that say you need all this med surg experience. They tried to do it to me and it's bull. You will get much more IV starting experience, lines, recognising problems, etc really fast. Keep a positive attitude and you can do it.