Question for the CCRNs

[akj777]

So, here's the background info. I'm a tech at a large teaching facility and I am one of the few that work with the STAT team. As in, I get called for particularly tricky IVs, help transport ICU patients to CT/MRI and such and follow our stat RNs (who are all CCRNs) to codes and rapid responses. Basically I am there as a go getter and to help them with whatever they need. I am in a unique position as a tech in that I am able to get involved in situations that typically do not involve techs, vents and art lines and swans and balloon pumps are all very familiar to me. I've learned so much working with the RNs. After working with the CCRNs for so long, the idea of working on a Med-Surg floor makes me sigh. I just don't want to do that kind of nursing. I am also a senior nursing student who is made aware daily that being a nurse in ICU involves years of experience. As much as I want to go into ICU I am fully aware that as a new grad, going into an ICU situation would be dangerous. So what I'm wondering is this; how long did you all work on the floors before going into ICU? Any advice? Thanks so much!

[Dinith88]

I've been a nurse about a year, all of it in the ICU. Experienced nurses who meet me and work with me tell me all the time that they assumed I had years of experience. One night, I was floating to a different unit and worked with two experienced nurses. This very subject came up and for several hours, they went on and on about how new grads don't know anything and they shouldn't come straight into the ICU. All the while I kept smiling inside. Later, another nurse came over to visit on a break. These two that I'd been working with introduced me and went on and on about how good I was and how they wanted to talk me into coming on full time. They said it was obvious I'd "been around." I really wanted one of them to ask me, "so how long HAVE you been a nurse? " :-)

I've never had anyone peg me for a recent grad. Experience is certainly important, but in my opinion, nursing places far too much importance on it. Experience is not created equal. I've worked with nurses who have "years of ICU experience" but it is all from a smaller ICU in a community setting. Compare that to someone who worked for a year or two in a busy, high acuity academic setting. The "less experienced nurse" will often be able to run circles around the other one.

Also, I think education certainly plays a big role. I graduated from a 2 year program and I work with several people who graduated from a particular 4 year program. Those 4 year new grads know WAY more than most of the people I graduated with. Am I saying 4 year programs are better than 2? No, just that THIS 4 year program is better than THIS 2 year one.

There are so many variables that go into this. You can't just boil it down to how many years it's been since you graduated.

I disagree about the steeper learning curve. I touched on this earlier, but I've seen many nurses come to the unit from years of experience on the floor or telly and flounder. Almost without exception, the nurses in the ICUs I work in that are the best are the ones who started there. I work with several nurses who have YEARS of floor experience, who came to the ICU before I did and so have more ICU experience than I do, who still seek me out to ask questions.

I'm not at all trying to toot my own horn or say "I'm so great." In fact, I work with several new grads with less than a year experience who I could say the exact same thing about. (and others who have no business VISTING the ICU, much less working there...what I'm saying is, it's a very individual thing.) Orientation matters as well. In the CTICU where I work part time, new grads get 6 months of orientation before they're on their own, combine that with classes to go over all the stuff they may have barely touched on in nursing school (after all, we've got to work Jean Watson in, so sometimes advanced hemodynamics have to go :-). And experienced preceptors have told me that in those 6 months, they only have to teach the right way, they don't have to "unlearn" the things that experienced nurses spent years learning.

Of course, this is only my "experience"...I've been around nursing for years before going to nursing school and I've heard this same debate over and over again. No amount of arguing on a Internet forum is going to change people's mind. We can agree to disagree. But, to the OP, if you want to work in the ICU, work in the ICU. Don't let anyone tell you you can't go straight in or that any good unit wouldn't take you as a new grad. My "experience" says otherwise.

Spoken like a new grad. I'm glad you get confused for a seasoned nurse. Kudos.

[akj777]

I appreciate all your input. You've all had great input!