Unrealistic goal to get job as new grad in ICU?

tanaynicole · May 20, 2005

I think you should start where you have the most interest. I'm not sure where you are located, but where I live ( Cali) Many, if not all hospitals have " New Grad" programs. These are designed to give those with less than 6months experience in a particular field the extra orientation, training, mentoring, and help they need. Most are taking applications now. It might help to look into one of those.

Go for what you want!

Good Luck,

AKav8trix · May 22, 2005

Thank you everyone for your honest feedback, encouragement, and helpful tips (and for taking the time to read my really long post). :) I'm hoping this week to start hearing back one way or another from all the places I've applied to, two of which are ICU internships, so we'll see what happens.

A few of you mentioned how it sets your mind at ease to have your patients on tele, and that's so true. It's so nice to be able to glance at the monitor once in a while and see that the rhythm hasn't changed to anything nasty and if it does, it gives me a chance to address it right away instead of not knowing about it until the patient is almost dead.

Whatever happens I know I'll end up where I'm supposed to be, even if it isn't my first choice. It's just hard to not know yet what I'll be doing this summer and this next year. I'll keep you all posted.

Take care :)

BabyRN2Be · May 22, 2005

I graduate tomorrow and a majority of my class are starting in ICUs. PICU, NICU, CSICU, MRICU, STICU, NVICU....
I think hospitals prefer new grads sometimes because they get to mold you.

I highly agree with this statement as well. I know of many students who went to work immediately in CCU, SICU, and NICU. Go for what you want. Hope you do well in whatever you chose!

rach_nc_03 · May 24, 2005

I agree with most of the other posters- go for what you want to do. I'll be starting in the PICU in june as a new grad at a large teaching hospital, and the NM said she has no issue with new grads, as long as they've shown some interest and/or effort, in the past, to expose themselves to critical care (EMT, working as a tech in an ICU, etc.)...which you did. Working in an icu over this past year as a CNA, I asked each nurse whether they started in ICU as a new grad, and how they felt about it. *All* of the nurses who did ICU straight out of school felt they made the best decision. There were a handful of step-down and floor nurses who floated to our icu from time to time, and they gave me the lectures about the year of experience in med-surg. I've floated to these areas before, and the nurses, for the most part, are burnt out and miserable. In past careers, I've had jobs in toxic environments, and they take a huge toll on you, both emotionally and physically.

Before I accepted the picu position, I shadowed for a day and talked to most of the nurses, the majority of whom had started in icu's as new grads; they all said it was the best decision they'd ever made. Sure, if you were somewhere with a shaky orientation program, that would be scary and unsafe. But, from what you've said, this hospital takes the time and effort to train new grads.

Go for it!

bluesky, BSN, RN · May 24, 2005

I am currently finishing my first year as a nurse AND as a SICU nurse in a big urban teaching hospital. It hasn't been easy but I have been floated a couple of times and I can't think of anywhere else I'd rather be! If your heart and your gut tell you that you belong in NVICU, then girlfriend listen to that voice and run with it. I mean examine if you will the worst case scenarios ... would you rather struggle and burn out in Med/Surg for a year or give ICU your best shot and come back a little later if it is too overwhelming? I know that if you felt confident and comfortable in your senior elective, you are going to fly! I did my elective in ER so I was a little deer in headlights for a couple of weeks but I think I'm doing OK now (or so the boss says).

annarborGUYRN · Feb 28, 2006

GO FOR IT! I was a new Grad in a neuro ICU. Neuro ICU is a good place for a new RN interested in ICU. You get the ICU skills (swans, vents...etc) and these patients are usually sick from the head up. Rarely do they do into renal failure, ARDS..etc. These patients will also teach you to really assess patients thoroughly. Assessment is a HUGE component of Neuro ICU nursing! There are some even EXPERIENCED RN's who do not belong in an ICU. Even though you have no "RN" experience you may find that you are well prepared for the ICU!!! Good luck!:)

leaflet · Mar 2, 2006

Only you can make the decision, but it sounds like you have had a lot of experience and that you know what you want to do. I am in the middle of ICU clinicals and I ask every nurse if they started there, what they like about ICU and such. I actually have been encouraged by my clinical teacher that I could start in the ICU and be a well rounded and grounded nurse. She usually does not recommend new grads, but there are exceptions and it sounds like you could handle it with your goals and background. I have talked to the clinical managers in our ICU and they want me to do my senior capstone there and then decide for sure, but they all say that I could do it. I want to get a masters in Acute Care NP and need the ICU experience not to mention that I love the ICU. I have had two years experience as a PCT/CNA in the hospital and know that ICU would be a good fit for me. So good luck to you and talk to the actual managers of potential ICU's or clinical instructors who are familiar with your abilities and goals.

Nutmeg5575 · Mar 5, 2006

I'm so glad I found this post. I was wondering the same thing and these responses are great!

ArizonaICU · Mar 9, 2006

I went into nursing specifically to become a CRNA. I started out in a SICU in a level one trauma center. I never looked back. I will warn you though, that socialization into critical care is VERY HARD on both new grads and experienced nurses who are transitioning. Your preceptor can make or break you. DO NOT tolerate any abuse or hazing from your preceptor!!!!! If you do, you're setting yourself up to be the unit's doormat.

I applaud your decision to become a critical care nurse. That being said, I must dispense some very important advice:

1. Critical Care requires ongoing educational commitment- reading journals, going to conferences, etc.

2. ICU is not always a happy place. It is intense, challenging, and sometimes frustrating, but always worthwhile.

3. Get your CCRN after you have 1750 hours in the unit.

4. ICU nurses are one of the hottest commodities on the planet! Don't settle for a crap ICU that won't invest serious money in your training and development. I currently am a full time registry employee, so I decide my own schedule, get paid $50-$75 an hour plus benefits (more $ than some docs) and they pay me to go to conferences. I'm working on a BSN and hopefully go to CRNA school in about 3 years.

Just imagine if I had listened to the medsurg nurses who said it was unrealistic to go to ICU. theyre still in med-surg, and I have nothing to prove to them.

So, do it! and stick to your guns!!

NYTramaRN, RN · Mar 9, 2006

I went into nursing specifically to become a CRNA. I started out in a SICU in a level one trauma center. I never looked back. I will warn you though, that socialization into critical care is VERY HARD on both new grads and experienced nurses who are transitioning. Your preceptor can make or break you. DO NOT tolerate any abuse or hazing from your preceptor!!!!! If you do, you're setting yourself up to be the unit's doormat.
SNIP....
So, do it! and stick to your guns!!

Absolutely the best advice so far. I've pretty much worked everywhere(except OR) both prehospital and hospital settings. More depends on your drive and ability to adapt then other issues. Read, study, observe, do..and you'll be OK.

Paul

postmortRNhere · Mar 9, 2006

Hi, I think Pebbles and Pricklypear are giving good advice. Here in Los Angeles many Hospitals will hire new grads right into ICU. They have very long specialized programs to train you and make sure you are ready. I would also work med-surg first then step up to ICU. As a new grad however confident you may feel, there is soooo much more to practice and learn. When I graduated and was hired for my first job I was given a 6 week class to train me, despite this I still felt like the dumbest one there....I felt I took on more than I could handle.

oldnurse newnurse · Mar 13, 2006

Help! Am I being unrealistic trying to get into the ICU as a new grad?
Ever since I started nursing school I have had a desire to work in critical care. Actually it was the encouraging words I heard from critical care and ED nurses two years ago that helped me to decide to get my nursing degree first instead of the paramedic degree I was headed towards. My long-term goal is to be a flight nurse because pre-hospital is where I truly love to be and I knew that I would probably have to work >5 years in a Level 1 Trauma ED and ICU before I had a chance to get in the air. The thought of getting stuck on med-surg has always been, well, awful to me.
Now I am about to graduate from nursing school and have found during my senior preceptorship in a Level 1 Trauma/Neuro ICU, that many of the nurses on that unit think that a new grad will never make it in ICU and should start out in the neuro stepdown med/surg unit. However, other nurses who were new grads in the ICU and ED (at the same hospital) encourage me to not settle for anything less than what I truly want, and to go for it. "There's no sense in making yourself miserable in med/surg," I've been told.
Now that I've had a taste of taking care of patients in the ICU for the past two months, I really, REALLY don't want to start on med/surg. The thought of being stuck there for at least one year just isn't pleasant. I love it in the ICU. (Also, the particular neuro stepdown unit is poorly staffed and I just see myself getting burnt out with nursing if I have to work there for a year.) However, I don't want to be so bullheaded about starting in the ICU that I miss the opportunity to get my foot in the door by starting on a stepdown unit to eventually get into the ICU, if that's the only way to do it.
The hospital I am doing my senior practicum in is projecting that they will have a critical care internship this October (but they do not have any openings right now). It is the place where I would really like to be. I've been told by someone in the employment office that I don't have a chance because of all the internal applicants that want to move from med/surg. I did apply at the other large hospital in the area for their critical care internship this summer, but am unlikely to get in because I did not do my senior practicum there (although I did do more than a year of clinical time on their med/surg units.) I do have additional patient care experience as an EMT for three years on a rural transporting 911 ambulance, a CNA for a year in med/surg, and a unit secretary in med/surg and telemetry for more than two years.
My other consideration is that I do have a guaranteed med/surg position at the hospital I currently work at as a US/CNA, if I want it. I do really love working there, but it is a small hospital with mostly routine stuff and I don't know that I would get the experience I need to get into the specialty area I want (Level 1 Trauma). I also know that if I started there I would likely be moving on in a year, if I could, to a bigger hospital, and would feel bad for leaving after they spent all that money on me for orientation. They've been so good to me over the years that it just doesn't seem right to take the job and leave after a year.
So that is my dilemma...turn down the med/surg position and take my chances on getting into the critical care internship later this fall, or do the time in med/surg and try again in a year to get to where I really want to be. Help!

Hey I am just like you and go figure I was hired at one hospital for med/surg and just felt like I'd be making a mistake if I had started there so guess what? I went to another hospital and started on the Neuro ICU. I will not make it seem like a peice of pie but it was and still is tolerable and if you want it, you can do it I too am a new grad but I refuse to be miserable working on a med/surg unit. The Neuro ICU is challenging and leaves me guessing everyday but guess what I like it and will stay. The one thing I don't like are the other nurses not all but some but they don't matter I am there to work and that's what I will do. I say go for it you'll be fine;)