Too many newbies?

Aymese · Nov 15, 2009

I think if your classmates have the ambition to work in critical care right out of school they will do just fine. They will learn early on to develop strong critical thinking skills, all the while developing their nursing organizational skills at the same time. You can handle the learning curve if you are self-motivated enough to put in the time/effort required to learn critical care skills (ACLS, drips, hemodynamics, EKG interpretations, etc). The unit wouldn't hire more new grad RN's than they felt was appropriate for patient safety.

New grads often flourish in the night-shift ICU environment. It's a good time to get a handle on all the new things you are doing without the fast-paced dayshift (although you sometimes get to see more on dayshift, ie procedures, etc). You can actually have time to breath and stop and think about why you're doing something. During those slow nights was actually when I learned my IABP waveforms and timing, haha! I don't think it's true about not understanding teamwork just because one may be a "young folk" with their first ICU nursing job. The crew I first worked with out of school in CCU was awesome! We were always their to offer our assitance if one of us had a tough assignment or a patient was really sick. I've always valued the experience I gained starting in critical care...i don't know... i found that it just suited me very well.

I really think you're putting too much worry into it. If ICU is what you want to do, you should go for it! Ask around while you're at clinical how they orient new grads? Do you get a 3 month orientation? Does the hospital have a new grad nurse fellowship? These are great programs that are being newly implemented at many hospitals. It gives nurses a year of floating around to different areas of the hospital and provides a great basis of support amongst the new nurses ( so I hear). Does the hospital offer a 2-3 week long critical care course prior to starting on the unit?

Good luck!

Ruby Vee, BSN · Nov 16, 2009

so i am doing my last part of nursing school all in the icu. this icu i find, has no problem hiring totally green gns. wondering from the highly experienced out there... (not so much the new grad icu nurses right now). how does this sit with you? i look around, and wonder. it seems i see more baby faces than those with experience. i would feel more comfortable if there were a higher percentage of nurses at this site with yoda-type experience.
wondering if accepting employment in a place such as this without very seasoned mentors might jeopardize my newbie learning pace, as well as my license? seems many in my class (the younger students) think that its great that they could get in an icu so fast. sometimes i wonder if they just are thinking of patient ratio and not at the extreme learning curve. some young folks know not what teamwork is either, as this is their first real job, and it's icu?! i had been thinking of transitioning off a cardiac unit or the like. another icu i spent some time with requires a few years under the belt, preferably cardiac.
am i totally off base? or is this tbe as the norm for most facilities.
as always:bowingpur

you are quite astute. as you've noted, too many newbies and too few seasoned nurses is indeed a recipe if not for disaster, certainly for things to get overlooked or missed. and the sad thing is, too many newbies won't recognize that things were missed. nurses with relatively little experience (less than 5 years or so) won't recognize when things were missed, either, if they started out in an icu that was staffed mostly by relative newbies . . . . and the cycle perpetuates.

i know that new grads who want to start in the icu can rationalize that doing so is just fine, they'll learn critical thinking skills, they'll get a fabulous orientation, etc. etc. but the truth of the matter is that they miss basic skills, may not learn teamwork and may not develop a good work ethic, especially if their mentors are relative newbies and/or lacked adequate mentoring themselves.

you are absolutely right. get yourself some experience first. learn the basics of nursing, develop your knowledge base and skillset carefully. learn critical thinking skills, organization, communication and teamwork. then when you move into the icu you'll already have a solid framework of good basics to build upon. then even if there are a lot of newbies orienting in icu at the same time as you, you'll have a solid skillset to build upon and you won't eventually become one of those "mentors" that is unable to pass along that which you haven't learned.

and now i'll read the other response, which, likely, will have the opposite viewpoint.

RN1982 · Nov 16, 2009

I am going to agree with Ruby. I am only of a handful of nurses on my unit that are considered "seasoned". I only have almost two years of SICU experience. I had worked in step-down for 2 years prior. I don't recommend new grads going to straight to ICU. There is just way too much to learn especially if you haven't got the basics down..such as assessment and organization. Everyone wants to run to ICU after graduation, I thought I did too but I'm glad that I didn't.

PostOpPrincess, BSN, RN · Nov 16, 2009

I find that the stress of ICU is tripled for those of us who precept new nurses.

It is one of the reasons I left the ICU. I work with an area now where 17 years is still considered a baby (no, not really, but one of our nurses has 30 years plus of experience.).

jessiern, BSN, RN · Nov 16, 2009

I shudder to think about what kind of nurse I would be without all the "old dogs" to show me the ropes. I can not even start to tell you how value their leadership, advice, guidance, ect has been over the years. I'm still learning from them!

elkpark · Nov 16, 2009

The unit wouldn't hire more new grad RN's than they felt was appropriate for patient safety.

That's certainly not something you can count on -- I've seen plenty of facilities at which "patient safety" was pretty far down the list of priorities. If you haven't encountered that yet in your career, you've been fortunate and I hope that continues for you! :)

nurturing_angel · Nov 16, 2009

There are times when our ICU is staffed only with agency nurses and a few newbies. I do not know what is going on down there but they do not seem to be able to keep dedicated, experienced ICU nurses. It was kinda scary being a patient down there overnight before being transferred to the big cardiac hospital in the city last year.

:paw: