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

[guest1076655]

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]

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]

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]

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

[JBMmom, MSN, NP]

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]

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]

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

[guest1076655]

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]

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]

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]

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. 

[Kooky Korky, BSN, RN]

So what do you think you will do, guest?

Best wishes, whichever choice you make.