Views on New Grads Entering Critical Care

schwalmys8862 · Feb 7, 2007

Soren Drakes story is great... however this has not been my experience. In our CCU we definetely eat our young. They don't stand a chance. New grads will go to night shift. They never go to days. They work crazy schedules and extra weekends. Their orientation will get cut short because we are " short staffed" and they will be expected to take patients and do so independ. Good luck if this is what you choose. Do so very carefully.

I hope my coworkers eat ME if I ever turn into that kind of holier than thou ccu nurse.

Brad_RN_Student_PA · Feb 22, 2007

The attitude that you seem to convey through your post is exactly what I encountered. Stereotypically, CCU nurses are known as mean ( i can think of another word) and there were days when i wanted to leave this job. But, I have been here under a year and I find this attitude has made me more determined to prove these ahem "mature" nurses wrong- to show them that it didn't take me ten years to get to CCU and I am fantastic at what I do. I go home and read my textbooks, I listen and ask articulate questions on teaching rounds and attend teaching sessions whenever I can. So that one day perhaps the tables will be turned and these young eating nurses will know how it feels to have someone try and take your confidence away

I must disagree. I have worked in PCU/ICU for two years as a CNA, and I plan on working there as a new grad. (Graduate in May, YAY!) I have had SO much better luck and have learned so many more things from these "mean" nurses as you call them, than the ones on med-surg-ortho. The older nurses on these medical/surgical floors, I feel anyways, are very burnt out. These are the ones who either chose not to or could not enter into a speciality. However, the nurses in critical care tend to be semi-territorial and very demanding, and if you don't have that kind of "get it done now, get it done perfectly" attitude, then yes, they probably do seem like mean people, but in reality, they are very knowledgeable, and care very deeply for his/her assigned patients. It is more "intimate" in critical care, for the most part. Don't get me wrong, I have absolutely no qualms with medsurg nurses, but what you described is more in line with what i've dealt with on med-surg floors. Perhaps a difference in personalities, hence why the people who are working where they are, stay where they are!

BSN_DEC_2006 · Mar 6, 2007

okay, so i'm currently a GN in the ICU, and i just now got home from a night shift; i'm scheduled to take the nclex in about 2 weeks....

well, i'm almost finished with my 4th week of orientation, and i have to say, i've had my ups and downs these past 4 weeks... i just started caring for 2 patients this week on my own... previously i've just been responsible for 1, and would help out my preceptor with hers, when i had the time...

with me.... i've just been having difficulty managing my time appropriately... it's relatively easy for me to do all the charting/asmts/interventions/and so on, for one pt... but as soon as i started getting 2 patients this week, my nights have been a lot more difficult... i start to make silly mistakes, like not auditing my chart/MARS correctly, or forgetting to label the tubings, and even forgetting to change the tubings.... i've been behind on all my charting for the past week, and end up staying pretty late afterwards to finish up...

also, since i've been taking on 2 patients, my report to the oncoming nurses in the morning has really sucked! like this morning, i just barely finished my bed baths @ 0600, and then tried to quickly finish up my charting, and didn't even know what the AM labs were when the oncoming nurse and docs asked...

what really gets to me is that i have trouble sleeping because i'll remember some things when i get into bed that i forgot to tell the nurse during report, like change the tubing or give potassium replacements because the AM K+ was low...

well... like i said, i'm in my 4th week of orientation, and i don't think i'm where i should be... a classmate of mine who i graduated with and started with in the ICU just quit last week, and that wasn't encouraging... i'm hoping things will get better for me, because this is where i want to be.... wondering how long it took other new GNs in the ICU to adjust to the working environment?

fsutallyrn · Mar 7, 2007

We have new grads coming into our ICU all the time. Some of them do well and some don't. I think it all depends on the person. I tend to see that those with some prior experience tend to have a less difficult time however. I think I sometimes have problems with the new nurses who come to the ICU to make their resume look better, or to "challenge" themselves. And some only come to our hospital because they can get ICU experience as a new grad, and as soon as they get it they leave and go work somewhere else. We are taking the focus of why we are in the profession to begin with. The people we take care of. Having ICU experience should open the doors for new nurses to work in other critical care environments if they choose to do so, but hopefully not because they want to challenge themselves or because they think it makes their resume look better, but because they enjoy the atmosphere and environment of the ICU's, and what they do and how they feel as a nurse providing care to people in those environments.

esokane · Mar 13, 2007

I bypassed Med/Surg and went right to a critical care step down. I have been there for 1 year this January and wouldn't change a thing. I had 6 months of precepting....unheard of at most facilities, the norm seems to be 3 months. I was also the only new grad on the floor with a staff that had a minimum of 3 years on the floor. Every one of them took me under their wing and always made time to answer my questions or show me how to do a procedure (especially the med/surg ones I didn't have experience in). I have learned something from every nurse on my floor. I have also taken on projects on my floor to increase my skill level, like being in charge of the teaching materials. This project has helped me learn as well as benefiting my patients. I continue to ask questions on things I am uncertain of and realize I have learned a lot in a year, but there is so much more for me to learn and I appreciate the time and my co-workers have spent with me. In short it can be done, but I beleive the staff, facility and traing programs that are offered have the greatest influence on the success of the new grad. Choose wisely grasshopper!!!

traumalover, RN · Mar 18, 2007

Started in the ICU as new grad. Very very hard, as ours is 20 bed ICU that takes all-renal-sugrical-trauma-cardiac, etc. Lots to learn. I always do wonder if I would have been more comfortable the first year if I'd done Med Surg or tele....but I love what I do....Am good at it....Am on days.....Get great evals....so I guess it worked out okay!

I think it depends on the nurse, the preceptor, and the caliber of other nurses around. Some of our new grads work out some don't. Some of our new nurses from or/tele/ms work out some don't...in fact I'd hazard the percentage is quite close.

heartrn4duke · Mar 18, 2007

Some new grads do well some don't. I come from the school of thought that you should work on a floor or step down unit for a year. With the shortage though new grads will be taken into the units. I feel one should be able to look at a patient and know when bad is coming before coming to a icu and having machines tell you that. I have been a CCU nurse 8 years and worked a year and half on a step down unit before going to icu. I felt it helped me learn to be a nurse first. :nurse:

clarkheart · Mar 25, 2007

I worked my first two years in med/surg and for me it was the right move. I've worked in ICU or CVICU the rest of my nursing career. The basic nursing skills I honed while in med/surg can't be underestimated. I saw new grads in critical care grabble with routine tasks such as dressing changes, foleys,ng, when they should have been concentrating on more clinical matters. But I've seen some new grads handle this pressure and I've seen others fail. It's just up to the individual I guess. I think the time you would spend in med/surg will only help you-never hurt you. The demand for critical care nurses is so great that there will always be positions avaliable.

ella1972 · Mar 25, 2007

I worked as an assistant in a hyperbaric chamber unit prior to starting nursing school. The nurses who worked there were all ICU nurses. They were wonderful people and encouraged me from the beginning to go into critical care immediately post-grad. I've oscillated on the issue and finally said, Okay I'll try tele or ms first. I've had my resumes out and gone into almost every nurse recuiter/hospital in my area.....you know who finally called me? The nurse manager from an ICU who had happened to read my cover letter and resume. I went in and met with her and she hired me that day, I start my training in 2 weeks. All of my encounters with ICU/CCU nurses have been great, much better than any interactions that occurred on the ms units. Bottom line however, there are great nurses with wisdom and knowledge and experience to share in any unit as well as those who will revel in seeing the new grad fail. As someone said above, the new grad plays a significant role but the unit, the nurses, the educators and the support that flows freely or is reigned in figures into the success formula too.