Open heart ICU

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How is it looked upon for new graduates to apply for work in an Open heart unit? Did any of you go directly into an open heart ICU after graduation? Do you know of a new grad who did?

I'm a senior and I have a teacher who believes that nobody should even work in the ICU without years of med-surg experience. She said, "Back in my day, open heart nurses were the cream of the crop." I think she may just be bitter that things have changed, but I would like a fair view of how you see this issue in your workplace.

I am planning to do an Accelerated BSN program and then enter an MSN program that requires 1-2 years of critical care nursing experience. Will it be fairly easy to get right into an ICU (PICU, NICU, ER don't count) or will I have to work elsewhere first and then get into an ICU? I'd prefer to get into the MSN program asap or I fear I will lose my drive to go back to school!

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Specializes in CVICU.

I started in a cardiovascular ICU - including open hearts - right out of graduation. I had a 13-week internship in which I attended critical care classes for a month, and worked with a preceptor on the floor. I've been "on my own" since April, and I have yet to hear someone tell me I should have done med-surg first. (If I had decided to do a year in med-surg, I'm convinced it would have been my only year as a nurse!)

At this point I can tell I've gained confidence and critical thinking, and there is always a charge nurse (and usually a few other experienced nurses) around to offer opinions and suggestions if I don't know what I'm doing - or if it just sometimes feels that way! :-p I haven't been trained on CABG recovery yet, but my night charge nurse has urged me to take the class; it seems the only person who doesn't feel I'm quite ready for it is me.

These days it seems most inpatient specialties are more than willing to accept new grads and train them - we're ALL understaffed most of the time, right??

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Specializes in Med/Surg ICU.

We have a wonderful "residency". Six months including rotating through med/surg, tele, oncology then the remaining 3-4months on the unit with a preceptor. For most nurses they start taking hearts about a year later, however, there are some nurses that take hearts sooner. It all depends on their strengths. By the way i should ad that Im a new grad..well out for a wonderful year now:)

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Specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.

Go for it, any area of nursing is doable straight out of the NP.

With the right environment, right preceptor and right attitude you can conquer what ever you put your mind too.

I wanted to just wish you all the very best in your chose field.

Remember if it does not work out for what ever reason there is still a gazillion areas in nursing to tap into.

Nursing is such a mobile work force with opportunities knocking at every door!!

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I am a new graduated nurse also and directly i became ICU nurse and i think that i am doing well.

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I went to a MSICU about a year out of school, and it wasn't till then that I *really* got my assessment skills down. On med/surg you're too darn busy to do more than superficial assessments, and that was even more true that many years ago. I disagree tht you need med/surg first because it's a different type of nursing--I'd describe it as "horizontal" nursing because you have to have an overview of a bunch of patients, whereas ICU nursing is "vertical" in that you have to have a *deep* knowledge of 2 patients. I think the instructor is just jealous because she had to do med/surg first ;)

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Specializes in Adult Critical Care.

I think it takes a special kind of person to be able to handle an ICU environment right out of nursing school. I applaud all of those nurses who are brave enough to try it but as for myself, I needed some step down experience first. A step down unit is a great place to get those critical thinking skills to start cooking and since you'll transfer patients to ICU and from ICU, it gives you a much broader picture of the way Critical Care works

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Specializes in CCU, med/surg (cardiac/tel).

Well I have been a nurse for almost 5 yrs now, and like you I wanted to start in and ICU, but did not think that I would be quailfied to start there. I intially started in a med/surg floor that was surgical/telemetry. I was able to see everything from 18yrs old to 100yrs old, heart, neuro, GI,..you name I was able to see it. In my hospital not every floor was able to do telemetry so you got everything from everywhere. As a med/surg nurse I learn how to do a complete head-to-toe assessment, learned to be very organized (have to be or you won't make it as a med/surg nurse). I believed;) that I became the most well-rounded nurse I could.

After 2 1/2yrs I switched to a CCU nurse. It is a whole different enviroment. On the floor you are not allowed to think as much. If something is abnormal ie.urine out put low (200 in 8hrs), pot 3.4, anything you call the doctor. You don't necessarily fix the problem then call. In the ICU you are allowed a little more freedom and with that freedom responsiblity. The biggest problems I faced switching was whether or not to call the doc and to trust my instincts.

I think that if ICU is where your heart is, then grab it. Be pro-active in your learning/education. Never be afraid to say I don't know and be proud that you have enough guts to say it. I think if you are brave enough and self-motivated enough to start in an ICU-with the right experienced nurses around you, you can start in an ICU and thrive. You just have to want it enough and be willing to work at it. I personally would not trade my med/surg experience for anything. I think that even though I have only been a nurse for 5yrs, my assessment skills and organization skills are as sharp as those around me. In fact I find the more experienced RN's coming up to me asking questions about things that we don't normally see in CCU because of my diverse experience on the floor. No matter where you start, you determine how successful you will become. You have to want it and be willing to be aggressive to get the knowledge that you need to be the best nurse for your pt's.

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Specializes in Cardiac Nursing, ICU.

Hey,

I am a new grad and I accepted a position in an OHICU! I am nervous! However, it can be done, there were plenty of successful new grads that went before me and many that will come after! :)

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Specializes in critical care.

Perhaps I am too old school, I do not believe that any new grad should ever begin in any ICU like setting. As a new nurse, you need to learn the proper ways to triage, and assess your patients. Please begin in a Med-Surg unit, this does loads for your self-esteem, as well as your ability to assess critical patients. I work in an ICU, and there are some very good GN's yet, there are many that are awful, and those of us that are experienced carry the load, for those that aren't as competant.

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Specializes in critical care.

Sorry you don't like that. It is true. If you are understaffed and working with new nurses, some (not all) just don't get it. This makes your day that much harder. Unfortunately, the nursing shortage has made what were once jobs requiring several years experience open to ALL. If you have had to clean up someone's mess despite giving positive feedback as well as 4-5 months orientation, and this person continues to have issues with patient care, perhaps your oppinion would change.

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Specializes in Cardiac Nursing, ICU.

Lorilou22RN,

How many years of MED/SURG have you had before you became an ICU nurse? How has this experience helped you better prepare for your ICU exp, besides build confidence because I believe anytime you step out of your comfort zone, confidence dwindles. How do you personally treat the new grads that aren't picking up their slack? What does it mean to clean up someone else's mess? What types of patient care issues is the nsg having? Also, do these new grads that are having problems, are their problems only evident during days that the unit is understaffed? I believe that 4-5 months of orientation isn't enough...especially in an ICU. I am not attacking you, so please don't think that. I am only trying to fully understand you POV and others that believe the same. Also, I will be starting in an ICU on Monday so any advice does help! Thank You

Sorry you don't like that. It is true. If you are understaffed and working with new nurses, some (not all) just don't get it. This makes your day that much harder. Unfortunately, the nursing shortage has made what were once jobs requiring several years experience open to ALL. If you have had to clean up someone's mess despite giving positive feedback as well as 4-5 months orientation, and this person continues to have issues with patient care, perhaps your oppinion would change.
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