What can I do to get into the ICU I feel like I've trapped myself into med-surg

Eiano · Sep 5, 2009

Do you have/Can you take ACLS certification? Your hospital will more than likely pay for it. Also, there are some "Critical Care Pharm" and general CC courses that hospitals offer.. that may make you more competitive.

highlandlass1592, BSN, RN · Sep 5, 2009

I am frusterated right now and some advice would be wonderful. I graduated from nursing school in May of 2008 and have been working on a med-surg/tele floor since June of that year. I decided to start off there because I felt I would get solid skills to help me transition into my passion which is critical care. The floor I work on has a high acuity for a med-surg floor and although I myself am still learning everyday I am starting to feel confident in myself and my managers must trust me as well because they have been using me as charge and have me orienting new grads. My issue is I feel stagnant in my work and feel that I am ready to give ICU a try at a well known hospital near by which is a level 1 trauma facility and a wonderful teaching hospital. However when I put in applications for the ICU and IMCU I was told that I did not have the skill set that they were currently looking for:cry:. I could understand that they may not hire me for the ICU because they do get the worst of the worst there but the IMCU is the same unit they offered me a position on as a new grad ( I had already accepted the position I am currently in). So now I feel that I have shot myself in the foot by not starting in a specialty as a new grad. If you all have tips on what I can do in my current position to become a more appealing candidate for an ICU position it would be very appreciated. Also why is it that hospitals hire new grads in these positions but not nurses with some experience???

Well, my first step would be to contact the manager who stated you didn't have skill set they were looking for and find out what they were looking for that you don't have. You can obtain courses in areas that they may want experience in. ACLS as someone mentioned, a critical care course, EKG class..all may help. But I'd try to zero in on what they specifically were looking for and cater your education to their needs as that seems to be where you want to work.

On a side note, I'd also have someone review your resume/CV. Sometimes when we're looking for jobs, we shoot ourselves in the foot by having a sub par resume. Make sure you are presenting yourself in the best light to show them why you're the ideal candidate for the job.

Another area that might help you is if you can work thru an agency to pick up time in an ICU..it would help beef up your resume with current ICU experience. Don't know if it's possible for you, just floating a thought.

Some hospitals are more likely to hire new grads for ICU's because they feel they can train them from the beginning, they way they want their nurses to function without having to untrain them from any bad habits. Not all hospitals are like that, I just know some are like that. Don't give up...if it's your passion to work there, it'll happen. Just may take some time.

stressgal, RN · Sep 5, 2009

Can you transfer to the ICU at your current facility? Maybe some time spent there would give you the "skill set" they are looking for and beef up you resume. I agree you should also get yor ACLS. Any futher experience/certifications added will enhance your resume and should make you more marketable

Rook · Sep 5, 2009

If you really want to get into that hospital, reapply for the IMC and work your way up. There are other options though. At the hosp I work at if you have a BSN you could go straight into CICU or the ICU units as a new grad so maybe try a different hospital or apply for the ICU at your current hospital, they know you are good at what you do and would want to keep you.

Remember you've only been working for a year now, you defo aren't trapped in anything.

jjjeep4 · Sep 5, 2009

Be encouraged, it is not hopeless....but it does require an investment in time and effort....Unless you are coming to a level one as an experienced icu nurse, it is highly unlikely that you could go directly into the icu, however many offer critical care intern/entry programs for nurses who have spent at least 2-3 years on an intermediate care unit...if it is not available, then you still have a couple options. Work your way up in the hospital where you are by completeing ekg/acls/critical care self study (you could get at least a working academic command of critical concepts -ie. pharmacology/lab interpretations)..Just show yourself consistently interested/motivated while making it clear in writing to the icu where you are that you desire that track....or apply to medsurg at the facility that you desire and work up the grid there.

Unfortunately, 18 months post graduation is considered very early for entry to icu....just be diligent...icu managers are always looking for potential nurses to track in, but it simply takes time and experience.....Even after beginning in icu from step down, it takes a good 2 years to truly develop critical thinking skills at that level...and even after 20 plus years, I daily learn something new ....Good critical thinking is developed with time, reptition and comittment.....

Best of luck to you!

Sirapples · Sep 5, 2009

Ive been a nurse for 5 years, done cardiac float, agency work, and started on a floor similiar to yours and Ill be honest, I wouldnt feel comfortable without some serious training to work on a level 1 trauma icu. My advice is learn all you can from your floor. As others have said get your acls, and just gain experience. You have not shot yourself in the foot starting on a med/surg tele floor. You get exposed to everything on a floor like that.

My advice is to on top of that accept any floating to any floor that you can. Accept any chance to float to the icu at your hospital. Also try some agency work. Work with favorite staffing or another agency and one day a week work for them on vented rehab floors and so forth. Doing those 2 things will really show a lot of flexability on your resume, and increase your clinical skills.

After doing that for about 6 months apply to your icu. Get involved with them, talk to the manager first of the icu and explain to them what youve been doing for the past 2 years and how you are seeking greater challenges and learning experiences. Then apply to that icu. See how you like icu level work, then after a year of that apply to the level 1 trauma icu that you want.

Thats how I would do it. Of course after 6 months of agency and accepting any float to any floor, you could just head over the the level 1 trauma icu manager and ask them what they are looking for and talk to her. But I am really big on preparing and learning clinically before you start a major specialty like that.

meandragonbrett · Sep 5, 2009

ACLS, become certified in your current specialty. Contact the managers of various ICUs and see what they are looking for. Some managers hire with no experience and others won't even think about it. Is this ICU that you applied at the ICU that takes trauma patients?

RNperdiem, RN · Sep 5, 2009

It is not your fault. When you were in nursing school, ICU's probably were taking more new grads, and a couple of years ago, a transfer would not have been so difficult.

A step-down unit might be a good place to try next. The skills you learn there are very transferable.

SummerGarden, BSN, MSN, RN · Sep 5, 2009

i i could understand that they may not hire me for the icu because they do get the worst of the worst there but the imcu is the same unit they offered me a position on as a new grad ( i had already accepted the position i am currently in). so now i feel that i have shot myself in the foot by not starting in a specialty as a new grad. if you all have tips on what i can do in my current position to become a more appealing candidate for an icu position it would be very appreciated. also why is it that hospitals hire new grads in these positions but not nurses with some experience???

definitely take the advice from the above posters and do not give up! i completely know how you feel, btw. my career goal in nursing is to be an expert in emergency and trauma nursing. so i worked hard in nursing school and did everything one could do to be considered a great candidate for the ed when i graduated. however, i was not given a job. so i ended up in a similar boat. more then six months post full-time medical surgical nursing experience in very high acuity units, i was asked about specialty experience during my interviews. i too felt as if i had shot myself in the foot starting in medical surgical nursing because it is not considered relevant to employers (at least not in this economy)! later i realized that medical surgical nursing is only a trap if i continued to play by the rules, so i stopped playing by the rules!

in this economy employers can make up any and all rules they wish to legitimately turn down applicants. therefore, you may end up spending years if not a decade getting all these misc. certifications and trainings and still not be any closer to working in an icu full-time. thus, i suggest that you stop playing by the rules and make friends (network). try joining the local icu or critical care association even if the local chapter is at the state level and network your butt off! if that does not work, try local ana chapters and/or try mentoring with an icu nurse. anything and everything you can do to make friends, do it and do it now (i joined the ena, ana, and have an ed mentor)! by the way, i recently landed a job in an ed because of who i know ... gl! :up:

-er nurse working in med-surg for a few more weeks!

diane227, LPN, RN · Sep 7, 2009

Get your ACLS and take a course on basic and advanced EKG interpretation. Also, get with the managers of those units and ask specifically what skill sets they are looking for. If you can find a course in critical care, take it. Do everything you can to work toward going to ICU. If they get trauma patients in the ICU, take the TNCC course. If they see that you are working toward that goal they are more likely to hire you. I assume that you have a good track record where you are now, no disciplinary problems and your file is clean. If not, clean it up then apply for a transfer. Talk to your manager before you apply for a transfer.