#14 - Can I work in the ICU right out of nursing school?

Austin writes, I really want to work in the ICU but I’ve heard it’s best to start on a med-surg floor. Is it ok to start in a specialty unit right after graduation?

Well Austin, yes it is. And for reasons you may not expect. Let me tell you a story…

My student Rebecca began her first nursing position after graduation on a med-surg floor, because like you, she heard it was best to begin here as a new nurse. Eventually she hoped to work with surgery patients in the PACU.

She had heard that a med-surg floor is a great place to practice and refine nursing skills, learn time management and how to manage a larger patient load. In her first year, Rebecca found these to be true, but also noted that there were some challenges she did not expect to encounter.

For example, in a med-surg unit, patients were admitted with a wide variety of diagnoses, which meant ever-changing plans of care. Though a great learning experience, she found it difficult to be efficient. In addition, the nurse/patient ratios quickly became difficult to manage with frequent admissions and discharges on the unit and staff call outs. She often left work feeling like at least one of her patients did not get the attention from her they needed.

For Rebecca, it affected her job satisfaction and made her doubt her choice to become a nurse.

After 2 years on the med-surg floor, she applied and got a position in the PACU. Almost immediately her love and passion for nursing returned. Why?

In the PACU, she was serving a “population” of patients fresh out of surgery. She found ways to be systematic and efficient with her care, honing in on the unique needs of surgery patients. Because nurse patient ratios are lower in speciality areas, Rebecca was able to spend ample time caring for each patient, without being stretched thin. In addition when call outs occurred, her unit quickly received help and support.

In the end what Rebecca liked most about her new unit, was that she was in an environment where she could give great care and be a great nurse.

Austin, some nurses will suggest that you start on a med-surg floor where you can practice a variety of skills. This is good advice. However, I would suggest that you consider not only Rebecca’s story but also your own passions. If you want to work in the ICU after graduation, do it. Work where you can be your best self and do your best work.

I hope this story was helpful, and as always, if you have a question about nursing school or life, Nursing School Masterclass can help!