Working in critical care as a new RN

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I applied for a bunch of med/surg positions over the weekend and yesterday since I recently got my license. I haven't gotten any calls yet. I have been staying away from critical care nursing because to be truthful the ICU setting scares me because the patients are very sick. I went ahead and applied for an ED position just so I would have some more applications out and maybe someone would call me. My question is should new RN's apply for ICU/critical care positions or start off with med/surg? I have never worked in the hospital, not even as a tech or volunteer, the only experience I have had is my nursing school clinicals. The emergency department sounds exciting to me and I am not afraid of blood and guts or any other gross stuff, but I am just afraid of the critical care part of it. I don't feel that I know enough or can act quickly enough to work in the ED. I am even afraid to start working on a med/surg floor because I feel that I am not ready. Any advice would be appreciated.

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Specializes in ICU.

If you feel you aren't ready, I'd say stay away from critical care/emergency. I have landed my first job in a MICU (can't wait to start!), but I feel good about it because I did my preceptorship in one and logged over 200 hours of direct patient care there. I know I don't know everything, but I feel like I got a pretty good foundation since by the end of the rotation my preceptor was very hands off and letting me do 90%+ of the patient care on all of her patients. I don't know what your preceptorship was like, but if you still feel uncomfortable in the role of a new nurse try to start on the type of unit where you did your preceptorship. You will have the most familiarity and knowledge with that area, which may make your transition a little easier.

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It would really depend on your readiness.

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Specializes in SICU.

You feel like you're not ready because you're not ready. How could you be? You haven't been oriented.

Basically it's like this: If you excelled at your in clinicals, and were pretty much in the front of your class during nursing school, then you'll probably survive in the ICU after an extensive orientation. Otherwise, try med/surg or stepdown first.

And by survive I mean exactly that. I don't mean thrive or master. You don't even begin to do that until you've been nursing for many years. There is much to learn.

You're only afraid because you haven't started yet. Sitting around thinking about it just builds up fear. Once you begin orientation and start remembering how to do things, the fear will go away. I prayed all the way to work every day for my first year of nursing. You probably will too, even if you don't believe in God LOL.

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I have been applying for med/surg jobs since I graduated and have re-applied since getting my license and they all either turn me down or I don't ever hear anything. So I thought I should just apply for anything and see who calls. I wouldn't say I excelled in my clinicals because I never felt very comfortable. However, during my preceptorship I started to feel comfortable after a few days. This was on an orthopedic/telemetry floor. My preceptor gave me 2-3 patients at first and slowly gave me more by the end of my preceptorship. She let me go on my own after watching her and how she did things for the first day, I did my own assessments and charted them and gave medications, gave report on my patients during shift changes. She was available if I needed assistance with anything. I learned a lot and felt more better during my preceptorship than during all those clinicals. I worry about a lot of things, mostly because of the unknown and the unknown scares me. I know there's a lot to learn when starting a nursing career and it takes time, but it drives me crazy that I don't know everything and my worst fear is being in a situation where I don't know what to do. I prayed before some interviews and before some clinicals and it did calm my nerves, I have feeling I will be praying a lot whenever I finally get a job. Thanks everyone for the advice.

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You're saying you feel afraid to work med-surg because you're not ready as a new grad? I would stop applying to ED, ICU, and ICU step down environments.

Look for med-surg new grad RN residencies. Good luck to you!

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calivianya - 200 hours in the ICU....200/36 (about the standard length of a work week, 36 hours,) = 16. 16 shifts as a student and you feel that confident?? Perhaps my view point is skewed, because I work in a level 1 trauma/academic medical center. Our ICU's take patients who are thisclose to death. If I was a new grad, I know I would not be able to handle CRRT, high alert drips, and distraught family members (for just one of your two patients). If you have done all this, props to you. Please, ask for help and ask often. I say these things with care in mind - I have a couple of colleagues who were not able to finish an ICU new-grad internship.
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Look for med-surg new grad RN residencies. Good luck to you!

I have applied for RN residencies and was turned down. I have applied to numerous med/surg positions with no luck. I have only had one interview for a med/surg position and didn't get the job, I didn't have my license then but I don't think that was the only reason they didn't hire me. The person they hired was probably an experienced nurse and I know hiring a new grad costs the hospital a lot of money. I applied for a physician's office position through a local hospital's HR department and they said they forwarded my application to the physician's office. Hopefully I'll hear from them about an interview. I haven't been applying for any critical care positions until now because I know that a highly experienced nurse should work there, but I am losing hope with finding a job. A girl I went to high school with had a scholorship with the local hospital so she could attend nursing school and she had to work for them for over a year, when she graduated they placed her in the ICU. I have always thought that a new grad should work med/surg before they move into critical care positions, but most hospitals around here want at least one year's experience.

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Obviously you know what you're comfortable with. I can't speak for ICU but ER is not the monster everyone makes it out to be. You're not going to get thrown into a full arrest your first week on the job and be expected to just wing it. ER is actually a lot of nonsense patients and following protocols (i.e. stroke, chest pain, etc).

My biggest piece of advise to you is don't just take the first job that comes along bc you'll be miserable (trust me, I've done the leg work!). I worked in ER in nursing school and there isn't a day that goes by that I don't regret not staying there as an RN. You are a REGISTERED NURSE!! Even with limited experience you're a hotter commodity than you think. Also, just to throw it out there--unless you'll be eating a soup kitchen don't EVER take a job with the primary motivation being money--you'll regret it. Best of luck!!!

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The only critical care area that I have an interest in is the ED. Working on a med/surg floor is where I need to be to in order to get comfortable with my nursing skills and critical thinking. I have only had my license for a little over a week, and my applications haven't been out for long, I just need to give it time. I didn't think finding a nursing job would be this hard, I guess I thought wrong.

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I'm a few weeks from the end of my ICU residency, and as a new nurse I think it was a great decision for me. I did my senior preceptorship in the ICU and really enjoyed it, and was thrilled when I got this job offer as a new nurse. However, if you are going to go this route, find a hospital with a well developed residency program. I had education classes almost every week on top of my shifts working with an orienting nurse. If you love an aspect of nursing, don't be afraid to go for it as a new nurse, if the hospital has a program in place to support new nurses.

I'll be honest, I am nervous about being on my own, but I know that the nurses on my unit are always willing to answer questions, or jump in to help if my patient starts going south. Also, I know that I don't know everything. Always be aware of your limitations.

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