Old, Old Fashioned Nursing Ideas

[PMFB-RN, RN]

As a new grad I went directly into SICU through a nurse residency program. Nearly all the nurses I worked with the the SICU had come to the ICU as new grads like me. I know several of the larger hospitals in my state have gone to nurse residency programs to get new grads into the ICU.

I have heard manager at my hospital talk about how much better, and cheaper it was for the hospital to invest the training in new grads rather than hire nurses with med-surg experience to be trained as ICU nurses. I have often heard the idea that a new ICU nurse should be a nurse with years of med-surg experience "old fashioned" and not consistant with evidenced based practice.

My question is does anyone know of any evidence to back up what I have been hearing?

[CRNI(R)]

Evidence that supports hiring new grads because it is cheaper or evidence that hiring experienced nurses would be better, or something all together different?

[ihaveaginer]

do u have to be a bsn new grad to be able to do an internship or can adn/asn new grads do internships as well?

[PMFB-RN, RN]

do u have to be a bsn new grad to be able to do an internship or can adn/asn new grads do internships as well?

*** It depends on the hospital. From what I have seen most want BSNs, some hire both. The hospital where I did my residency only hires ADNs into the residency for the SICU, but it doesn't say that anywhere. They do hire new grad BSNs for the other unit residencies. Also they only hire 1-2 into the SICU residency a year nowdays, plus those they hire into the residency for ER, MICU, PACU, PICU & NICU. Back when i did it they were hiring 6-9 twice a year just for the SICU. It has gotten very, very competitive with most of the more recent hire being CNAs who already worked in the unit or the hospital.

[PMFB-RN, RN]

Evidence that supports hiring new grads because it is cheaper or evidence that hiring experienced nurses would be better, or something all together different?

*** I am looking for evidence that hiring (and training) new grads for the ICU results on equal or better outcomes and is cheaper than hiring (and training) nurses with a year or two or three of med-surge experience.

My experience says hiring new grads is better, and certainly the managment of my hospital feels this way. I don't know if it is really true though.

[tablefor9, RN]

Follow the money, honey! But, I don't think you'll find that there are better outcomes (unless you're talking strictly about hospital budget) with new grads.

[BluegrassRN]

It's a heck of a lot cheaper to hire a new grad than to hire someone like me at 7-10 dollars more an hour. While I have 10 more years of nursing experience, I know that's a mixed bag when it comes to a more critical unit. So you have to pay more significantly more for my nursing experience (if I transfer in, as much as you are paying your ICU nurses who have been there for 5-8 years), but you really aren't getting that much more for your money.

[PMFB-RN, RN]

Follow the money, honey! But, I don't think you'll find that there are better outcomes (unless you're talking strictly about hospital budget) with new grads.

*** I think that is incorrect. My observation is that isn't the case at all. However I have no evidence other than anecdotal and personal experience to back it up.

[PMFB-RN, RN]

It's a heck of a lot cheaper to hire a new grad than to hire someone like me at 7-10 dollars more an hour. While I have 10 more years of nursing experience, I know that's a mixed bag when it comes to a more critical unit. So you have to pay more significantly more for my nursing experience (if I transfer in, as much as you are paying your ICU nurses who have been there for 5-8 years), but you really aren't getting that much more for your money.

*** Rate of pay isn't really an issue. A nurse with 1-3 year experience will only make 2-3% more than a new grad at hour hospital.

[tablefor9, RN]

*** I think that is incorrect. My observation is that isn't the case at all. However I have no evidence other than anecdotal and personal experience to back it up.

I get that you don't agree, and surely we can agree to disagree; I also went directly into an ICU position years ago. That doesn't mean it was or is a great idea. Because I'm feeling generous, I'll toss you this: JAMA, 2003, Volume 290, #12, Aiken et al, there are the results of a study that looked at patient outcomes controlled for RN experience, education, workload and whether or not physician (surgeon) was board certified. There was virtually no difference in pt outcome based on bedside nursing years of experience, but showed better outcomes for BSN care, pt load of 7 or less, and board certified MD.

May I respectfully share that in the time it took me to locate this single reference, I found *3* that showed better outcomes dependent on nursing experience?

Have a great day!

[PMFB-RN, RN]

I get that you don't agree, and surely we can agree to disagree; I also went directly into an ICU position years ago. That doesn't mean it was or is a great idea. Because I'm feeling generous, I'll toss you this: JAMA, 2003, Volume 290, #12, Aiken et al, there are the results of a study that looked at patient outcomes controlled for RN experience, education, workload and whether or not physician (surgeon) was board certified. There was virtually no difference in pt outcome based on bedside nursing years of experience, but showed better outcomes for BSN care, pt load of 7 or less, and board certified MD.

May I respectfully share that in the time it took me to locate this single reference, I found *3* that showed better outcomes dependent on nursing experience?

Have a great day!

*** Thanks. I have found some too but not specific for ICU nursing. My observation based on precepting in our SICU is that for some nurses med-surg experience can be a hurdle to overcomes in order to become effective and competent ICU nurses.

[colleennurse, ASN, RN]

Just out of curiosity- what hurdles to overcome for med-surg nurses?