YanMinor

As a new grad, I've definitely noticed that our critical care nurses make the same amount as med-surg nurses. I don't think that it would be fair to pay one more than the other right out of nursing school. Although the skill set in ICUs is greater, there is also a greater demand for ICU jobs, so they don't have to pay as much. However, I've been told that my pay will increase faster than that of a med-surg nurse. On top of advancing to a clinical nurse 2 position by the end of the year, I will also have completed my ACLS and CCRN, all of which come with a pay differential.

This! I was so lost by the second post of this thread. OP, having edited out most of your post and information, it's hard for us to be of much help. I would agree with what most have said in that it is an issue if you find yourself crying every time you are in clinical. If it isn't well managed by the time you graduate, I can see that being a hindrance when you are a a nurse. I would suggest counseling, as well.

So, it sounds like you're asking two questions. First, is critical care the right move for you and possible as a new grad? Second, what can be done to improve your chances of getting into critical care as a new grad? The answer to your first question is based a lot more on personal preference. What do you know about critical care? Have you had a clinical on an ICU? I was personally attracted to it because of a sicker patient population, less task-oriented work, and a desire to know my patients at a more complex level than was feasible at the med-surg or even stepdown levels of care. That is not to say that med-surg or stepdowns are easier levels of nursing. One of the main reasons I avoided med-surg is because I wouldn't be able to handle having six patients at a time, and I would feel like a chicken with my head cut off. Some nurses absolutely enjoy it. I prefer to care for one or two patients and know as many details about that patient as possible, critically thinking and considering concepts of critical care pathophysiology as a I care for them. As for your second question, you're right. It's been asked and answered. But as a December graduate recently hired to an HVICU, I'm happy to share my strategies, as well as the strategies of a number of us who have been hired into critical care. 1. In a class of 88 second-degree students, seven of us have landed adult critical care jobs since graduating in December. Four male, three female. 2. All seven of us had senior clinicals on an adult ICU. I will repeat that: no one from our class without ICU clinical experience has been hired onto an ICU. I imagine a nurse manager would be hard-pressed to hire not only a new grad, but one that has never stepped foot onto a critical care unit. If possible, try to get clinicals on a unit that hires new grads, or at least a unit in a hospital that hires new grads. You don't want to do all of this work to impress people and build a great reputation at a place that won't hire you anyways. 3. On that note, all seven of us worked our asses off to be active during clinicals and impress the crap out of fellow nurses, nursing instructors, and especially the nurse manager. Ask questions and be involved. Do your homework so you can answer questions when your preceptor quizzes you. If you can't answer them, say you'll find out. Look up meds. Draw and help interpret labs. Be clean and organized. Run towards codes, not away from them. Be vigilant about the monitor and catching changes in rhythms. Always show up on time. Don't take shortcuts. Always be safe. Treat every day as a job interview. 4. Of the seven, all of us "knew someone". Nurse managers talk between each other like crazy, and if you leave a good impression, they'll be willing to put in a good word for you. Nurses on the unit are the same way. If I could tell that I was doing a good job, impressing them, or if I received a compliment from them, I would let slip that I would like their recommendation. It would usually go, "Thanks. Hey, I was thinking about giving my resume to [Nurse Manager], would you mind putting in a good word for me?" Towards the end of my clinical, I submitted my resume to the nurse manager at the time. Due to some restructuring issues in the hospital, he wasn't able to hire anyone new for several months, so he recommended that I apply to the HVICU. When I made it down to that NM's office two days later, she said, "Are you that student everyone's talking about upstairs? It's funny, we wouldn't even be talking right now (she doesn't hire new grads) except your nurse manager insisted that I hire you!" 5. People often insist that grades matter. They didn't matter for us. None of us seven were required to submit a transcript. Rather, we had the option to submit our diploma as proof that we have our BSNs. Now, if you're considering graduate school or advanced practice (which we all are), getting into a program is a different story. Purely for being hired as a BSN, RN, our grades weren't looked at. 6. If you don't have it already, get CNA experience. It's the one thing I regret not doing during nursing school, and nurse managers in both of my interviews asked if I had CNA experience. Absence of it won't eliminate you from the pool, but having done so will make you stand out among non-CNA applicants. 7. Fill in lines on your resume. If you're not a CNA, what else are you doing. I had teaching experience from my last job, so I TA'd some basic nursing classes. I also volunteered at some easygoing events that took very little time. Without those, my resume would have been half-empty. 8. Another two nursing students got hired into NICUs. It's pretty detached from my world, so I don't know much about them. All I know is that they moved far away from our state to get those jobs. Some extra vignettes: - A student who ended up in a pediatric cardiac ICU did his senior clinical there. He got the job before he even graduated. - One now in the SICU had EMT-B experience, CNA experience, and was acquainted with the nurse manager. He essentially had the job before he graduated. - One now in the neuroICU impressed the nurse manager on his neuro stepdown and aced the interview - no CNA, volunteering, etc. He just knew someone. It's that important. - I was on the SICU in the same hospital where I now work in the HVICU. I was a TA and volunteered some, but no CNA. - One now in the MICU worked at another MICU in the same hospital system. - Two of them now in the CCU had critical care clinicals in the same hospital.

+1 with what Rose-Queen said. If you bolus an induction agent like propofol, you are now practicing anesthesia. Have I seen nurses do it? Maybe. EDIT: Typically, orders for fentanyl and midazolam drips (among others) also come with PRN bolus orders that allow the nurse to use their own judgment. At my facility, propofol never comes with this, but some nurses see blurred lines. I don't.

As an aside, it's "neurogenic" :)

Therapeutic Touch is a technique that is not evidence-based, nor does it require touching, oddly enough.

Philadelphia area here. My school graduates between 170-200 each year, evenly split between the accelerated BSN and traditional BSN students

That otherwise impressive pass rate is mitigated by the 65% graduation rate... How do schools get away with these kinds of rates?

That is correct. You will apply for licensure in a single state, sit for the test, and get that state's license. THEN, you can apply for reciprocity. Again, if one state is significantly faster at processing than another, you would ideally apply for initial licensure in that state.

WOW! $12k is no joke. That come out to about a $6/hr raise, which some nurses work many years to attain. Still - ask yourself where you want to be in five years. Does ED get you there, or Onc? Have you talked to your family/partner about this?

I'm surprised by so many of the answers here! Having good hand hygiene doesn't excuse you from wearing gloves.... Check your institution's policy. I'm certain that wearing gloves are part of universal precautions - universal meaning they should be taken with ALL PATIENTS.

Actually, this isn't true. While it's absolutely illegal to discriminate based on race, gender, and other qualities, there is no law forbidding discrimination based on "attractiveness". Many companies legally discriminate based on looks (e.g. Hooter's, Abercrombie & Fitch, etc.) That being said, it would reflect very poorly on a hospital to engage in such practice. And, if I was hired at a hospital based on my looks rather than my nursing merits, I would probably want to look for work elsewhere, anyways.

It's crazy how underrated this is, especially to get a job as a new to practice nurse. As I've said in other posts, me and a few of my best friends recently graduated in December, and we've all found critical care jobs in the Philadelphia area, which is notoriously over-saturated. Me and another friend (HVICU, neuroICU) were accepted because of referrals from the nurse manager at our senior clinical site. Another (peds CICU) got a job at his actual senior clinical site. The last was a CNA on his eventual unit (SICU). So much about finding a job, especially in critical care, is less about geography, grades, experience, etc. Rather, it's more about trying to develop a reputation as an awesome, competent, badass nursing student, and then using that reputation to carry you through the application and interview process. Also, don't be shy about asking preceptors if they'd put in a good word with a nurse manager! Many of the hospitals that take new grads into critical care are in saturated markets like Philly, Nashville, etc. It's not easy getting in with a clean slate, unless you have a godly resume to back it up. Try hitting up prior nurse managers, clinical instructors, clin-specs, and preceptors to see if they know of any positions and are willing to write you a recommendation.

I only graduated in December, and three of my best friends are guys I met in the program. All four of us have found jobs in the last three months (all in critical care, no less). It's a bit premature to say that you don't have a job "because discrimination". If anything, I think nurse managers and recruiters look upon male candidates favorably, perhaps with the exception of L&D or Women's Health units.

Regardless of which state you get your initial licensure, if you want a job in Florida, you're going to need a Florida license. There are two ways you can go about this. Your first option is to apply directly for licensure in Florida. You can still take the exam in Tennessee, but you will have to apply to the Florida State Board of Nursing. You will also need to notify PearsonVue that your intended licensure state is Florida. The second option if to apply for licensure in Tennessee and then apply for a reciprocal license in Florida. The advantage to this is that you will be taking the same steps as many of the students in your program who will be looking for jobs in Tennessee, and you can turn to them for advice if necessary. The other factor to consider is time. Some states take forever to approve an Authorization To Test (ATT). Some states are really fast. When I was in school in Pennsylvania, the turn around time was 19 days from application to authorization. Plus, the NCLEX results were submitted within one business day, so there was no waiting-for-six-weeks business. The opposite is true for states like California and New Jersey. Getting and ATT took forever. The program director recommended that we all apply for initial licensure in PA, then if necessary, apply for reciprocity in another state (which is much faster). Hope this helped.