Path to ICU

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Hi All,

I am an RN who has been working in an outpatient setting for several years. I am interested in getting back to bedside nursing and ultimately working in a critical care unit. I am one who likes to learn new skills sets from the ground up. Having been out of the inpatient setting for a while, does it seem like a logical sequence to perhaps start on a telemetry floor, perhaps progress to a Progressive Care or Step-Down unit, and then ultimately pursue the ICU? I'm looking to lay a foundation that is as comprehensive as possible - I'm not a huge fan of "winging it" or the "fake it til you make it" approach. I'd like to have a good foundation of applicable experience as I move along. Does tele to step-down to ICU seem like a logical approach? Thanks everyone!

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Specializes in Cardiac/Transplant ICU, Critical Care.

That path that I took was Cardiac/Vascular/Thoracic Stepdown first as it will get you moving fast, thinking on your feet, using your time management, prioritizing, and getting familiar with EKG readings. After that I went directly into my Cardiac/Transplant ICU. I will be honest, I would not be a better nurse today had I gone directly into the ICU. The floor experience has helped me immensely and lays a very strong foundation for you to build the rest of your nursing game on.

So to answer your question, the Tele to ICU path is the most logical approach and in all honesty following that path makes some of the best nurses. Overall it really just depends on the nurse, but after seeing it time and time again, I can attest to its effectiveness. Good luck in your endeavors!!!

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Thank you for two very helpful replies, Mysticookiebear! :)

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I would get your feet wet somewhere in the hospital like progressive or tele and then move to icu. Oncology or tele are the traditional paths. Or you might try float pool. Get the education and certifications if you can also and take the tougher tales or step downs when you are ready to see if you like this work.

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Thank you pedseraprn!!

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Specializes in ICU, Postpartum, Onc, PACU.

People go from school to critical care as new nurses. I don't think I could have (even though I wasn't thrilled about doing a year or so on a regular floor initially) because it's really tough. However, a lot of new grads do it that way and my cousin was one of them. He went from school to PICU and even though he was sick to his stomach before every shift for the first 4-5 months or so, he's done extremely well. It's up to you and only you know how you learn best. Some hospitals will take you fresh out of school and others want the experience of a year somewhere else under your belt. Best of luck and I hope you find a way in, since it seems like you really want to pursue this.xo

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Thank you Maevish. No, I don't do well with the sick-to-the-stomach approach. If anything, I'd run the risk of trying to learn too much and trying to be more comfortable than is realistic before applying to the unit. I'm a little on the Type-A side and have a tendency to want to understand as much as I can before I even approach anything new- which can be paralyzing. I see myself doing maybe 2 years on a take floor and then perhaps advancing to intermediate level care and so on. Thanks so much for your insight!

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Specializes in Critical Care.

I am a new grad and went directly to cardiovascular icu where we have open heart surgeries. I've asked around and a lot of nurses say that the floor didn't really do anything but help learn manage time. My goals go beyond bedside nursing so I wanted to get started as fast as possible. You will realize that you are never alone. Charge nurses are extremely helpful, your peers will help, and it will be an amazing experience. I think no one should walk into the icu feeling relaxed until you really know your patient bc things can quickly go sour if we let our guard down. I say do it. If you get an icu offer, they will train you and if it's a short training, trust me, they don't expect you to know everything. Blessings!

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Thanks so much, EMNMRN! Is your plan to become an NP or CNS?

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More questions for you, EMNMRN- so then I take it that you learned telemetry/reading rhythm strips, all the different lines and all the meds on the job? Did you have a fairly long orientation? How was your nurse preceptor? Do you typically have just one patient or two? Does your ICU team work fairly well together helping each other turn patients for cleaning up, etc? And lastly, do you work nights? Is it pretty much a rite of passage that you have to start on nights and work your way to days? Sorry for all the questions!! Thanks so much!

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Specializes in Critical Care.

My plan is CNS but! I'm not sure yet 100% I love how we can do anything in this field. I'm thinking CNS bc I love research and I love the clinical side as well as administrative. I work night last and I now have a day shift offer open. Our team is VERY team oriented. I'll admit there's always that nurse or 2 that don't appreciate new grads in the icu so they'll be hesitant to help but that has never been a problem for me bc the amount of nurses that are super awesome is greater. I learned everything in the job. My orientation was 7 weeks...I know I know it's a joke lol but it is what it is and I learn something new every day. I just got an offer with another hospital in trauma icu who will train me for a year, you'll see how doors open when you go in as a new grad. My preceptor was ok, your learning depends on you really. I only have 2 pts or less. Above all I just have to say, I pray a lot ;)

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Thanks so much, EMNMRN! So you're really learning nursing from the ground up in ICU! I would think you'd have to ask a TON of questions!! Hopefully your colleagues are patient with you. I keep hearing ICU is hard on your back- are you finding that to be true? Thanks for your time in responding to me!

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