Starting off as a New Grad in the NICU--bad idea?

Specialties NICU

Published

Hi, and thanks in advance for taking the time to read my post and offer your advice/opinions.

I'll be graduating this January (Diploma), and as my mother is also an RN, I have been given what I consider somewhat of a golden opportunity for... being her daughter, I guess.

I've been offered a job in a level III NICU, which would include cross training in the Nursery, and Post Partum should I so decide. However, I'm concerned that if I take a job in an area so specialized, I won't be marketable in other areas if I decide to change my career and...do OR, for example. Coming from a school whose clinical experience heavily focuses on Med-Surg (at least 6 weeks per semester--usually more) I've been trained to feel it's necessary to have that sort of experience under my belt to be considered valuable. Is that really true?

I don't want to be a Med-Surg nurse, ever.

Eventually, I'd like to move into research nursing, and possibly Nurse Education (I think, anyway).

Anyway, the point of this post is... There are just sooo many paths in Nursing that I'm overwhelmed and don't know where to begin, and am afraid that if I go into the NICU, I'll be stuck there forever. Of course, once I get there I may like that idea! LOL

Your thoughts?

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Do you /want/ to be in the NICU? If so, and they offer a decent (16week+ orientation, no less than 12) orientation, sounds good to me. (I volunteer in a NICU/PP/L&D range of units).

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I honestly don't know. In my school I haven't spent much time outside of Med-Surg, with maybe the exception of a few weeks here and there, so I really haven't been very exposed to ANY field of Nursing. I did spend an evening in the NICU at the hospital where I was offered the job, and it seemed like a nice place to be, but as we all know, looks can be deceiving. But when I was in there... something just felt "right."

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I'm a new grad starting out in a level II NICU and I was also told in school to have med-surg experience before you specialize. However, from speaking to other nurses and nurse recruiters, this isn't really the case. If you want to switch out of NICU later on then I'm sure you can speak to the HR/Nurse recruiters to facilitate that. NICU is a critical care environment and you will be learning skills that are easily transferred to other departments. For example, instead of having a preemie with CHF you may have a 65yo adult with CHF :D

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Specializes in L&D, OBED, NICU, Lactation.

Don't listen to anyone who tells you to have med-surg experience before going into the NICU. If you want to do something and you have the opportunity to do so, why wouldn't you take it? As for being stuck in the NICU, remember that as an intensive care nurse (of neonates), you are learning valuable critical thinking skills, organizational skills, time management, crisis management, technology including ventilators and monitoring (many hospitals use the same models of equipment throughout the facility).

Hiring practices have changed significantly in nursing and everywhere else with companies looking to hire, train, and promote as much as possible from within. A nurse that wants to transfer internally always has a leg up on getting an interview and if you are strong in the key characteristics needed in the specialty, they should be willing to invest in training you in the patient specific knowledge. At least, companies worth working for thinking this way. It is less expensive to retrain you than to seek out and hire someone from the outside.

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Hmmm, never looked at it that way. I guess the skills I learn in the NICU can travel over to other departments, especially basic things like time management, etc. And anyone can be trained to use different machinery... Well, maybe. Thanks for your input! I feel much better. :)

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Hey there,

I did the transition from New grad straight to the icu (level one trauma, teaching hospital, etc etc.) I was a solid student in nursing school, but not a star. I never worked in a hospital as a CNA. If you want to work in the ICU, go for it. Many nurse managers I've had the opportunity to meet say that if they had to train someone in the ICU, they would rather have a new grad than an experienced med surg nurse (training them to critically think vs. task-oriented thinking). The old "put your time in on med-surg" before you go to a unit doesn't really apply. But you got to put the time in outside of work, you may not feel like cracking a book and studying stuff when you get off a 12 hour shift, but its necessary. Its a helluva learning curve, but its worth it. Good luck

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Specializes in NICU, Infection Control.

JMO, but I'd rather see a new grad starting out in NICU than have to "untrain" someone who's had that magic year in med-surg.

Neonates and grown-ups are almost not the same species. Go for it. BUT. Be sure you get an extremely good orientation-12 to 16 wk minimum. If not, don't do it. New grads are a valuable resource and should be treated as such.

Best of luck, whatever you decide to do.

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The hospital I'd be going to has a 16 week orientation, and has quite the supportive atmosphere for new employees (it's also located in Montana, a place where people in general are just so damn nice). In addition I'm told they even have a free charge nurse, with no patients, who rotates around to each nurse, asking if she needs help. The nurse manager is so nice, she works overtime regularly so the nurses under her can take a vacation. Whoa.

This is why I think it's a golden opportunity--instead of being thrown into the fire, I think I'd get a really solid background before I decide to move on--likely, back to New Jersey (where I'm from), a place whose hospitals have as of late been ripping new grads off a decent orientation to save the almighty dollar (and putting many patients in danger).

For those of you who were new grads and went into the NICU, how long did it take for you to feel competent? I read a lot of these posts about new grads going into Med Surg/ICU/ANY floors, and how awful their first year is. Is it the same in the NICU?

Thanks for all the well wishes!

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Specializes in NICU Level III.

For those of you who were new grads and went into the NICU, how long did it take for you to feel competent? I read a lot of these posts about new grads going into Med Surg/ICU/ANY floors, and how awful their first year is. Is it the same in the NICU?

Thanks for all the well wishes!

About a year is what it took me to feel more comfortable and I still don't feel competent even though I've got 3 years down and my RNC. My first year was pretty darn crummy (I guess that's why they have a forum for first year nurses!) but it's much better now.

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I started in a NICU as a new grad 27.5 years ago, and have no regrets. I would NEVER want to do any other kind of nursing. I have never had a problem finding a job in any part of the country. I got an MSN in Nursing Education in 2007 and have done some clinical teaching (in Peds) at a community college in addition to doing a lot of staff education in my NICU through the Best Practice Commitee.

Listen to your gut; you will make the right decision for you!

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Specializes in Neonatal ICU (Cardiothoracic).

I did NICU as a new grad, and have done some per-diem work in PICU and peds. While I had to "remember" a lot of things when working peds, since my brain had been on NICU overload for awhile, the transition between the two fields was pretty seamless.

You still get skill development like IVs, meds, fluids, time management, critical thinking, etc...

And just to warn you, in my 5 years of working NICU, I've seen maybe 3 NICU nurses leave for another department, and 2 of them came back to NICU. This is out of hundreds of NICU RNs I've worked with over the years. You probably won't want to leave. Ever. :)

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