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Trying to get into the ICU but no luck as a new grad

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guest1076655 guest1076655 (Member)

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Hello, I recently graduated and my goal at the moment is to land a job in the ICU. I have two job offers both from a nurse residency program. One being surgical PCU or Med-Surg. But if I accept the surgical PCU position I have a 2-year commitment and no commitment to Med-Surg. I am uneasy about the 2-year commitment. I have applied to ICU jobs but have not gotten any response. Any advice on what should I do or what steps should I take to get into the ICU?

Emergent, RN

Specializes in ER. Has 28 years experience.

If you can't get a job immediately into an ICU, your way into an ICU is to accept one of these two jobs and prove your worth, then eventually transfer into the ICU.

gere7404, BSN, RN, EMT-B

Specializes in Emergency Services, Cardiac Step-Down. Has 5 years experience.

PCU is probably a better pathway to ICU. More exposure to drips and LDAs and sicker pts than a regular med surg floor.

my ED wouldn’t even look at my application until I had a year and a half of experience. Likely, your hospital’s ICU won’t hire you until you’ve got some time under your belt.

Been there,done that, ASN, RN

Has 33 years experience.

It would take one or two years of experience to function in ICU. Be grateful for the offer for PCU.

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

Either one could work out fine for you. The 2 year commitment might sound like a long time, but you're just starting your career and PCU would be a great stepping stone to the ICU. A med-surg position will also get you a solid skill set which could transition to ICU but depending on where you are and the current ICU demand, you're still going to be expected to have at least one year of experience before you could apply. You have two great offers, try to focus on that and not be disappointed that ICU didn't work straight off graduation. While there are many people that have been successful in going straight to ICU after school, I think the skills you will gain in med-surg or PCU will pay off in the end. Good luck!

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

I'm kind of in agreement with most, if not all, of the above. Given your goal of ICU, you'll probably get a better overall experience and have a slightly less horrible learning curve if you start from the PCU. Sure, a 2 year commitment seems like a long time, but you'll likely get a solid base from which to move forward from. Starting from Med-Surg is also going to be a good start but I think going from that to ICU would be a bigger leap. 

In any event, after you're done with your time in the PCU, if you want something less complex, a Tele slot should be relatively easy and jumping to ICU, ED, or other relatively more intensive care unit/floor won't have as large of a learning curve as you'll already have knowledge and skills that you can fall back on.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 19 years experience.

To quote my dad "If something isn’t going the way you want it just means it's not the time for that." If you open your eyes and look past your disappointment you will be better able to focus on the offers at hand. PCU will proably take you to ICU but M/S will give you a solid skill set for whatever you want to do. 2 years is nothing in the grand scheme of things.

Hppy

Thanks for the great advice. I have not seen the unit I interview for because of covid. I’m afraid I would lock myself into a 2 year commitment and it’s not something I would like. I just prefer to look at all my options and make a decision that is beneficial to me. I want to take excellent care of my patients and learn as much as I can especially in the start of my career. Yes, I am a little bummed I didn’t get ICU straight out of nursing school we all would if we was set on a specific area and got jobs for something else not saying it’s horrible because it’s not. I am happy I got an offer for pcu and med Surg with no nursing experience. I’m thankful they are interested in me and giving me a chance to prove myself. I just want to make the right decision in the end.

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

I just consider myself very lucky in that I was able to eventually get an ED RN job as a new grad. It took me about 10 months. Part of what got me into the ED was the fact that I'm also a Paramedic so I didn't have to learn to deal with the unknown that comes through the doors and that most of what I've learned procedurally carries directly over. The one big downside is that outside of the school environment, I've never done med/surg or tele work, so I'm definitely NOT an expert with that stuff, though I can do it. In becoming an ED RN, I also had to learn some m/s nursing concurrently and that is not an easy task. Had I started on a floor (m/s, tele, PCU, etc) I probably would have had an easier time transitioning to the ED, like perhaps doing an orientation in Tele then doing an orientation in the ED would have been better in my case. ICU as a new grad is doable, a couple classmates of mine did that, but they also were at facilities that have excellent new grad programs that appropriately people to the ICU over a longer period of time than someone coming from a m/s or tele background. 

EDNURSE20, BSN

Specializes in ED, med-surg, peri op. Has 4 years experience.

I agree with everyone else. 

and for the 2 year contract, I wouldn’t worry about it. It’s becoming more and more common for new grads, employers want a return on there investment. So many new grads move on once they have the one year of experience. 

DowntheRiver

Specializes in Urgent Care, Oncology. Has 7 years experience.

2 year commitment to just the floor or to the hospital? I've seen nurses with these agreements switch units after a year/year and a half for more advanced units. 

So what do you think you will do, guest?

Best wishes, whichever choice you make.

Edited by Kooky Korky

What is your end goal? Why do you need to get in an ICU immediately after obtaining licensure sans experience? 

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

I wouldn't want to be in the ICU right now = ( Some of the posts from new grads dealing with covid in ICUs are pretty sad and scary. Not to say Med/Surg and PCU aren't exploding with covid too, just that in ICU there are so many deaths and also painful, futile treatments that are hard to be a part of, plus dealing with families who are separated from their loved ones while they die. Maybe you are super strong but to me it sounds like an extra hard time to be a new grad in ICU (or an experienced nurse too...). But I may be grumpy coming off ten months in covid PCU with floating to ICU under team nursing LOL so take it with a grain of salt. Congrats on 2 job offers!! Good luck with whichever you decide.

lcc0101, BSN, MSN, CNA

Specializes in 5 years ICU, 5 Behavioral Health, 15 Float Pool. Has 26 years experience.

If youe like my friend who was a CNA last year who now works with me in the ICU you’ll have no problem, make sure your mom is the infection control nurse, your aunt is in charge  of the ER and your dad’s best friend is one of the ICU doctors 😂

 

Robmoo, ADN, BSN, RN

Specializes in RN, ADN, BSN, CVRN-BC. Has 25 years experience.

On 12/25/2020 at 6:45 PM, guest1076655 said:

best-way-get-into-icu-pcu-med-surg.jpg.5c0ec1460113012e0d7832b12dff7aed.jpg

Hello, I recently graduated and my goal at the moment is to land a job in the ICU. I have two job offers both from a nurse residency program. One being surgical PCU or Med-Surg. But if I accept the surgical PCU position I have a 2-year commitment and no commitment to Med-Surg. I am uneasy about the 2-year commitment. I have applied to ICU jobs but have not gotten any response. Any advice on what should I do or what steps should I take to get into the ICU?

If you can't get into the ICU straight away which is not unusual then Telemetry is the best way to go.  Skill with cardiac patients is a valuable step up into ICU.  Since you don't have that choice PCU is best.  MedSurg skills don't translate as well into the ICU unless it is a surgical ICU.  Even then you will be behind the curve when it come to cardiac medication including potent drips and EKG interpretation.  In the higher acuity PCU you will be gaining more skills that will give you a step up in the ICU.  Two years may seem like a lot, but when you leave less time might make you seem like a potential job hopper.  If your only misgiving about PCU is the two year commitment then go PCU.  They are going to make a substantial invest in training you.  I don't think that 2 years is unreasonable.  Good luck in whichever you choose!

sns5200, BSN, MSN, CRNA

Specializes in Anesthesia. Has 7 years experience.

I graduated from nursing school in 2014 with hopes to get straight into ICU in order to get into anesthesia faster. I finished CRNA school this past fall and have been at it for three months. I was extremely lucky to be able to get straight into the ICU as a new grad. I think a big part of me being able to do so is the fact that I had done a Summer externship that previous Summer so the ICU knew my face and name. Despite this, I would be lying if I said it was an easy transition from nursing student to ICU nurse. There were many tears shed during the orientation process and several times I wanted to give up and thought I wasn’t going to make it (this was a level one trauma center so I was getting the sickest of the sick). It wouldn’t be a bad idea starting in PCU or med surge because of how difficult it is going to ICU right off the bat. I spent four years in that ICU before going to anesthesia school and I’m extremely grateful for my experience. Good luck with whatever path you take! 

NinjaNabiRN, BSN

Has 14 years experience.

When I was a new nurse with 3 years experience in an LTACH, I was told I didn't have enough experience for a new grad level ICU training job. It took me 10 more years to be able to get into ICU. I wish I had the option to lock in for 2 years. It would've saved me time.