Straight to ICU or Tele First

[CarVsTree]

Hello Oh Wise ICU Nurses

I am in nursing school with a scholarship from Lehigh Vally Hosp in PA. They have a 6 month Critical Care Internship which I hope to take after graduating.

After the internship, you are "prepared" to work in a critical care area or step down unit. What do y'all think? Do you think it behooves GN's to do some time in the step down unit or do you think with a 6 month internship, I'd be fine to go straight to a CC unit?

I'm not even sure what position I'd be offered, just wondering your thoughts.

TIA.

Sue who obssesses too much about the distant future.

[mattsmom81]

I worked once with a new grad who took a critical care course in her last semester of school and she was one sharp cookie. She accepted a new grad position in a LTC center's ICU (which is not a full service ICU setting). Her critical care course was mostly classroom/theory...and she passed her CCRN immediately post grad which did impress me. However, she never worked perse in a 'real' ICU...so she failed to put her knowledge base into practice or test herself, thus in her own words 'never developed enough self confidence to work a real ICU." She tried several years later and it overwhelmed her.

So....my advice is make sure you have a good solid clinical component...my friend says hers did not and she regrets that.

If this program of yours has a weak clinical component, perhaps you might consider taking a hospital internship as well after you graduate and pass boards. I've also worked with ICU nurses who failed to solidify their basics skills...struggled and learned the advanced skills, but later were unable to move out of their specialty area. They were not well grounded in their basics.

There are differing opinions on this issue...some ICU nurses feel straight into ICU is fine for a sharp new grad. I'm still a fan of getting the basics down first and growing into the role. But that's just me. Plus it highly depends on the facility. If you do go into ICU immediately as a new grad, make sure you will have a supportive environment to help you ie an education dept and preceptors dedicated to your success.

Best wishes whatever your decision.

[kc ccurn]

If you do go into ICU immediately as a new grad, make sure you will have a supportive environment to help you ie an education dept and preceptors dedicated to your success.

I started out from school in our Critical Care Unit-multispecialty, high acuity. I had an extremely supportive preceptor and manager. We routinely send "new to ICU" nurses to 8 week critical care classes. I am glad that I did go right into ICU, I think I would have burned out quickly on the floors. My respect to those that can care for 8 pts at a time. I would much rather have 2 really sickies in the ICU that are vented than 8 sick pt's on the floor, but that's me.

You have to make the decision for yourself. I've seen both scenarios work out well. What are your strengths. Do you feel comfortable with your organizational and prioritizing skills? It might behoove you to work step down for a while, learn your cardiac rythms, assessment skills etc then move down to ICU.

[Rapheal]

One of my friends went straight to ICU after graduation. She loves it. Best of luck in your decision.

[nay537]

I went to a medical/surgical ICU right out of school 18 months ago and I think it's been the best choice for me. I did an summer externship in ICU before graduating and did my senior practicum on a vent unit. My preceptor was great and I was sent to a Critical Care couse by the hospital. My coworkers are very supportive and a great with helping me sharpen my clinical skills. They also have said they enjoy having youth they can cultivate rather than someone who thinks they know everything.