Thoughts on a new grad RN going straight to ICU?

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I am currently a nursing student that is set to graduate in August 2020, as time is approaching to be sort of gauging on where I potentially would like to work and considering my long-term nursing career goals, I am seeking opinions on whether or not a new graduate RN should get a job in an ICU. I have some professors telling me going into ICU straight out of school is not a big deal, and then I have been told the complete opposite. I can very much understand the rationale of not jumping straight into ICU, however, I am looking for more thoughts pertaining to this as it seems to be a very debatable topic.

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Yes, it is very debatable..

Some hospitals have great orientations, lasting several months, set up for new grads in ICU.

Some new grads are just super nurses right out of school, (not me!!! I ended up in ICU after several years med/surg), and are quite competent to go straight into ICU with or without a great orientation.

Some ICU's won't even consider new grads in ICU.

Some ICU'S hire new grads but don't have good orientation.

Some new grads go straight into ICU and have great nursing careers and don't regret it.

Some new grads go straight into ICU and even if very successful there, regret not doing some med/surg or other areas first.

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I can say I have heard exactly those same words! There is one hospital in my area that does hire new grads straight into ICU, however, the orientation aspect I hear is not that long. Thank you for your input!

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Specializes in Critical Care.

I went into ICU right out of school. I had a long and supportive orientation, a critical care residency, and did great. My current place of work will hire new grads but something about our orientation process just isn’t right, maybe it’s the lack of residency? Maybe it’s too short? I’m not sure.

You need to be passionate about critical care, require at least 16 weeks of orientation, take every class you can get but respiratory/ventilators, hemodynamics, and ekg are a must, know that it will be a full year before you stop feeling in over your head.

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I appreciate the response!

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There are too many variables to be able to accurately gauge the success of a new grad who goes straight into critical care. As mentioned before quality of orientation is a biggie but so are the graduate’s aptitude, critical thinking and social skills. Add into that the unit culture, skill/experience mix, support systems, etc. A big deficit in any one of those may (or may not) cause problems. Frankly, with all those factors it’s a wonder anybody thrives.

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Thank you for the response. I would 100% any day of the week rather be safe than sorry when it comes to these subject matters. I was just "brain picking" for some unbiased answers.

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Specializes in CVICU.

I went straight into the ICU as a new grad. Honestly, it's challenging! But ANY nursing job straight out of nursing school is going to be challenging. I'd say if your hard working, open to learning and can cope with stress well, you'd be fine! It's a lot of self growth and wanting to learn for the betterment of your patients. I think a well structured residency program and a unit with good dynamics is helpful (ask them about this stuff in your interviews!!)! If you start in the ICU and feel like it's not a good fit, then you can always move to a different unit. That is what is so wonderful about nursing, you have so many options! Our hospital helped people get jobs in other units, for if it just wasn't a good match and that isn't anything to be ashamed of. I personally feel like life is too short, so go out there and do what you want! I also completely understand the value of having experience before the ICU because when I get floated to med-surg floors in the hospital, its an entirely different ball game! But, that being said, people have lots of opinions on what you should do before going into ICU, or if it's okay to go straight into ICU. I just tell myself there are like hundreds of routes to Fred Meyer but if you're meant to get there, it doesn't really matter what route you take! You'll still end up at Freddy's! I guess thats my input!

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Wow, thank you so much for the insight! Very much appreciated.

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I say go for it. I will never understand people who say you should spend time on the floor first, it’s a completely different set of skills and If the ICU is where you want to be, go there ASAP.

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Hi! I'm finishing my first year as an RN and went directly to ICU. I have no regrets, and some days I'm so thankful for going directly to ICU because I know it's where I want to be. I think I would have been fairly miserable in med surg, just waiting to transition to ICU. The transition into nursing is difficult/intimidating any route you take. So my opinion is that if you know you love ICU go for it. PS Tulane Medical Center hires new grads into critical care if you complete the STARRN

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Specializes in ICU.

I went directly into ICU. It was overwhelming at times, but boy did I learn. Any kind of nursing should be a little bit scary, I feel we should never be over confident. So, if the opportunity presents itself and you feel like you can handle it, give it a try. Fortunately the ICU I started in had us shadow a nurse for half a day to see if we were a good fit before the job is even offered. That cut down on a lot of new grad/ nurses who wouldn’t hack it. Then 4 or more months orientation depending on abilities, and you’re on your own.

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