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yes or no

Posted

I know this question has been asked a thousand times, should new graduate nurses go straight into any ICU?

Depends on:

Prior work experience

Stress tolerance

Good orientation program on the unit

Your own intelligence (if you did poor in patho it's a tough adjustment to not just being a pill pusher but actually using your brain)

Some other stuff I'm probably forgetting but those are biggies.

tewdles, RN

Specializes in PICU, NICU, L&D, Public Health, Hospice. Has 31 years experience.

What do you think? What qualities do you think that a good ICU nurse has vs. a med surg nurse. Are you considering going directly into ICU from school? What skills do you possess that will help you to be successful in that endeavor?

Whether or not nurses can go straight to ICU from school is mostly determined by the management of that unit. They must be willing to provide that level of support to the newest members of their staff...because graduate nurses require a different level of supervision and support than do experienced nurses who are new to ICU. There must be in place an ICU team that is receptive to having inexperienced nurses join them...their ability to coach and support that person is essential to their success. So...if you think you can and want to do that...find an ICU that is willing to take the stroll with you...Good luck.

1) It depends on the new grad

2) Prior work experience in the hospital outside of clinical?

3) It greatly depends on the particular ICU and the culture of that unit. Is everybody so sick in that unit that nobody has time to help you or answer questions? Or is it a good mix of sick and slightly sick patients?

4) The orientation process and a supportive management team that will grow the new grad into a critical care nurse.

for me its not a yes or no, its a maybe. I am finishing up a critical care orientation to an icu and it is hard. There are a few new grads so its possible but its a little harder for them since they are trying to figure out how to be a nurse and all the craziness that comes from being new. That being said, it is very possible and many people in my unit started out as new grads.

Thanks for posting you guys...

Ok about me Ive been a nurses aide and a tech, currently im a unit clerk because that was the only part time position they had during school so I took it. Critical thinking, im not to confident in that area, and i work well under stress. I want to work on the Burn ICU or SICU (trauma) but I dont want to bite of more than I can chew.

Nccity2002, MSN, RN

Specializes in Trauma/Critical Care. Has 10 years experience.

Jnw8606,

I think one of the main requirements to become a good ICU nurse is common sense. From reading your posts, I have a good feeling about you...Go for it!!:nurse:

PMFB-RN, BSN, RN

Specializes in burn ICU, SICU, ER, Traum Rapid Response. Has 16 years experience.

Of course. Get them while they are new and before they have learned lots of bad habits working the floor. Assuming of course your hospital has a good training program for new grads.

carolina4

Specializes in Surgical Trauma Burn ICU, Oncology.

Thanks for posting you guys...

Ok about me Ive been a nurses aide and a tech, currently im a unit clerk because that was the only part time position they had during school so I took it. Critical thinking, im not to confident in that area, and i work well under stress. I want to work on the Burn ICU or SICU (trauma) but I dont want to bite of more than I can chew.

I'm a new grad in the surgical trauma burn icu and i don't think i bit off more than i can chew...it's awesome. that being said, i definitely take advantage of my preceptors every single day while i'm still on orientation b/c they are SO smart, it's unreal. if you want to constantly learn and like putting pieces of the puzzle together, you'll be fine (probably).

ps. i have 1.5 months of orientation left of 6, so i guess i'm on one of those units highly receptive to new grads (:

Rabid Response

Specializes in ICU/CCU. Has 5 years experience.

It depends on the nurse and also on the unit and the hospital's training program. I don't think my hospital's critical care training program was any great shakes, but my unit was friendly and supportive, and I've always been a quick learner.

Now that I have more contact with the med-surg nurses in my hospital, I'm not so sure that a year of med-surg would have helped me all that much. Those nurses are so BUSY that there isn't much time to delve into the condition of any one of their many patients. From what I see, they are forced to run from task to task to task. I used to wish that I'd done a year of med-surg first, but now I'm happy that I did not. The first year was much harder for me than for those who did have med-surg experience, but now I feel just as competent as any of the ex-med-surg nurses who were hired into ICU at the same time as I was.

nursetam1

Specializes in Psychiatry, Med/Surg, Critical Care. Has 16 years experience.

I think new grads need some experience first, I worked in several different capacities as a nurse over the span of 10 years. Only then did I consider critical care as an option (after much prodding from colleagues) Not many new grads survive going straight into critical care. At least from my experience. :)

TemperStripe

Specializes in ICU. Has 5 years experience.

I'm a new grad (December, '08) in an ICU. I just finished 6 months of orientation and have been on my own for about 3 weeks. Two nights ago, I had the shift from hell and was fairly certain that I, nor any other new grad, should ever work in an ICU. I was ready to throw in the towel, call my boss and quit, then find a new career. After talking to my (wonderfully supportive) co-workers about this situation, it sounds like it's fairly typical, especially for us 'nubes. So, following that, here's my thoughts:

1. New grads must be willing to fail. Miserably. It's a hazard of being in the ICU from the start; we are task-oriented and just not experienced enough to see "the big picture" in a lot of cases. There will be many humbling experieinces. Check your ego at the door. Being on orientation is a walk in the park compared to the "real thing," even on the days when you're given a long leash by your preceptor.

2. Stress management and care of YOURSELF. The ICU has changed me in many ways. I am still learning to adapt my life to the new person that my job has made me. It might mean making some changes outside of work. It's a traumatic environment for nurses, too...I've started seeing life differently.

3. Asking questions. It's a given, I know, but after my super-bad day, I realized I hadn't been asking ENOUGH questions. Ask stupid questions. Ask smart questions. Think of something to ask another nurse at least once an hour. Just ask them. If you're on a unit that doesn't support this process, I would suggest running away as fast as your little legs can carry you.

It is a very, very steep learning curve, and I almost feel like I'm starting from scratch now that I'm off orientation. I was very antsty (by the end) to be "free" and while I'm still glad to be on my own (finally,) it is more stressful and difficult than I could have ever imagined. I've been fortunate enough to have been blessed with the genes and the work ethic to excel at most things I set my mind to...the ICU is whole different animal. There is no flying under the radar when people's lives are on the line.

Best of luck to you!

WindwardOahuRN, RN

Specializes in Critical Care.

You want the quick and dirty or you want the neat and nice?

Quick and dirty? NO. Just...no.

Neat and nice? NO. Just....no.

Yes, YEARS later, new grads "have done well" in ICU. But honestly, no holds barred? They are a massive burden to experienced nurses who feel obligated to save them and, not incidentally, their patients.

Those of us who have any conscience at all can not look the other way while these very-well-meaning newbies screw up left and right. It's tremendously draining but dammit, we do it, time and time again.

No offense meant to the new grads who mean well and are trying their very hardest to do right. But you have to start with the basics and ICU is NOT the basics.

You simply have no idea what you do NOT know. Trust me on this one. I was there once, with years of med-surg and other experience behind me. I was humbled and humiliated, appropriately so. Absolutely no sense of entitlement, no cockiness. Scared poopless. Those who had knowledge vastly superior to mine took me under their wings and taught me. Had I shown the very faintest bit of cockiness they would have shot me on sight. Gotta love the NY county hospital ICU environment, LOL.

Get your basics down pat and then venture into critical care. Lives depend on it. Truth be told? I don't want you taking care of me or anyone I love. I've seen way too many mistakes made to trust a newbie with my loved ones.

Yes, once again I suppose the folks who went into critical care as new grads will declare that they did amazingly well yada yada yada.

And once again we will see a dearth of posts from experienced nurses who beg to differ.

So sorry if I failed to contribute to the usual support group atmosphere.

PMFB-RN, BSN, RN

Specializes in burn ICU, SICU, ER, Traum Rapid Response. Has 16 years experience.

You simply have no idea what you do NOT know. Trust me on this one. I was there once, with years of med-surg and other experience behind me. I was humbled and humiliated, appropriately so. Absolutely no sense of entitlement, no cockiness. Scared poopless. .

*** Our hospital has a 7 month long nurse residency program for new grads going into the ICU. It includes two months of three 12 hour shifts a week on one of the med-surg floors with a preceptor to gain time management and prioritization skills before they come up to start their clinicals in the ICU. I regularly serve as a preceptor to these new grads and they are great. I much prefer them to the stream of experienced med surg nurses I used to train. I find them easier to train, less "ya I already know that" attitude. In my view the biggest hindrance some of the med surg nurses have is their instinct to call a doctor or somebody else with an emergent problem rather that heading strait to the bedside to intervene RIGHT NOW. Usually our patients don't have time to wait while a doctor calls you back. We have protocols and standing order for nurses to interviene immediately without first seeking medical direction. It can be a big leap for some of them.

We stopped recruiting med-surg nurses. They are still considered on a case by case basis if they seek us out and apply.

thanks again for posting.....Ive taken everyone opinions into consideration and I decided to apply for the Burn/trauma stepdown unit. As long as I am working with burns I am okay.