Searching for new grad ICU jobs? Is it even possible for a new nurse to work in the intensive care unit (ICU)? The short answer to this question is that new grad ICU nurse jobs are 100% attainable. However, getting a job as a registered nurse in an ICU and succeeding in that environment are two different things. Let’s dig into the specifics of new grads in the intensive care unit.
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Definitions: ICU Nurse vs. Critical Care Nurse
Critical care can be provided to patients in many hospital areas (PACU, ED, transport, stepdown); however, ICU nurses provide only critical care in a unit dedicated specifically to these very sick patients.
When people refer to an “ICU Nurse,” they are referring to a critical care nurse who works specifically in the adult Intensive Care Unit (ICU). Intensive care units for children and infants are called something different (PICU and NICU, respectively), which is why when people use the terms “ICU” or “ICU nurse,” they often refer to the adult patient.
An ICU nurse could work in a specialty ICU, like a neuro ICU, cardiac ICU, trauma ICU, transplant ICU, etc. They could be referred to as an “ICU nurse,” “neuro ICU nurse,” “critical care nurse,” or “neurocritical care nurse,” and all would be correct.
New Grad ICU Nurse Jobs: What Does an ICU Nurse Do?
For a very detailed explanation of what ICU nurses do during a normal shift (plus a video!), check out this blog post of mine.
As you can imagine from the title, this job is very intense! Naturally, the more nursing experience you have going into it, the better the transition can be. I was a cardiac med-surg/step-down nurse for two years before becoming a neuro ICU nurse. My previous experience was invaluable, but it did not prepare me to the point where I could merely be shown around the unit and was able to function independently quickly. I had weeks of orientation before I was able to fly solo.
New Grad ICU Nurse Jobs – Old School Perspective
If you were to ask this question to the 2010 version of me, who was graduating from nursing school, I would have said, “Absolutely not.”
Back then, the culture of nursing was to spend 2+ years working on a med-surg or similar type of acute care unit before applying to ICU positions. Many ICUs would not even consider hiring new graduate nurses. In fact, the neuro ICU I was hired into in 2012 would not hire new nurses.
At that time, hospitals could afford to be more selective about who they hired into which units. While this depends on the specific markets, getting into a good intensive care unit was challenging, and you needed the experience to land an interview.
Also, the general tone of the profession was that nurses needed to get their feet wet and acclimated to the field before increasing the level of complexity. There was a general attitude that even if you wanted to specialize at all (NICU, ICU, PICU, labor and delivery, emergency department, PACU, etc.), you had to spend 1-2 years in a med-surg unit providing direct patient care before you could get hired in your desired specialty.
New Grad ICU Nurse Jobs – New School Perspective
The demand for new grad ICU nurse jobs has significantly increased due to the growing needs of healthcare facilities. With more remote nursing job options and people aging out of the workforce, there are not as many applicants for inpatient jobs. Hospitals can no longer afford to be as picky as they once were with their new hires in critical care areas.
Furthermore, successful new graduates of the past have paved the way for new grad ICU nurse jobs. When units can successfully train newly licensed nurses, it makes them more open to continuing to do so and gives others a chance to excel in this challenging yet rewarding role.
Many hospitals now openly welcome newly licensed nurses into their general and specialized intensive care units to provide direct patient care. In my personal experience, I have observed new graduates thrive in critical care. However, it is important to note that these new nurses were more of an exception than the rule.
My Hot 🔥 Take on New Grad ICU Nurse Jobs
Hot take ➡️ I do not believe the average nursing school graduate is equipped for the challenges of ICU.
Reflecting on my nursing development, I know that I would not have survived working in that environment as a new-grad nurse. I observed many newly licensed nurses start in the intensive care unit only to find jobs elsewhere during orientation because it wasn’t a good fit.
The pace was too fast, the information was too complex, the expectations from patients and the medical team were too intense, and/or the social-emotional skills required to support patients and loved ones were not there.
There is no shame in recognizing when a job isn’t a great fit. There is a bit of an unspoken nursing hierarchy that the nurses caring for the sickest patients are the most skilled or the best and highest on the totem pole of respect. However, as I have grown in my career, I’ve seen that facade for what it truly is: the illusion of prestige.
I’ve seen skilled ICU nurses who felt like they were better than other nurses who lived pretty miserable lives with rough bedside manners and gave pretty cold nursing care. I’ve also seen med-surg and observation nurses who were wonderful people and excellent nurses who had very happy and fulfilling lives and whose patients were so grateful for their care and expertise.
Just because someone works in a seemingly “better” unit doesn’t mean they are a better nurse or person.
Characteristics of Successful New Grad ICU Nurses
I can think of a few nurses who excelled in their new-grad ICU nurse jobs. Here are some of the common characteristics I observed.
- They knew this was going to be extremely difficult. They were not surprised or deterred when they needed to try things 3, 4, 5+ times before getting it right.
- They took constructive criticism like a pro.
- They looked up things they didn’t understand at home and were subsequently more prepared for the next shift.
- They did not gossip or get distracted. They were focused. When the experienced nurses chatted at the nurse’s station, they were catching up on charting, double-checking something, or reviewing their plans.
- They knew where to focus and what questions mattered.
- They adapted well to technology.
- They had an instinct to know when to stop asking questions and hop in and help.
- They were not above giving bed baths, changing patients, walking them around the unit, or feeding someone.
- They tried to get to know and build trust with the intensivists and other physicians they regularly worked with.
- Done was better than perfect, and they were okay with the messy process of becoming competent.
Now, please keep in mind that just because these were exceptional new graduates does not mean that they had an easy path. There were a lot of challenges, frustrating shifts, mistakes, missteps, and lessons learned the hard way.
Not-So-Great Aspects of New Grad ICU Nurse Jobs
High-performing nursing students tend to want to lean into the most challenging job after graduation, which is often a position in an ICU. It does feel pretty cool to call yourself an ICU nurse, but just because you’re an ICU nurse does not mean that you know everything about nursing or acute care. This is a bit of a mind-blowing 🤯 realization that took time to sink in for me because the care I was providing in the ICU felt so important and all-encompassing because it was so detailed.
ICU Isn’t the Only Place That Matters
With my med-surg experience, neuro ICU experience, and master’s in nursing education, I felt like I developed an understanding of holistic nursing care and realized how narrow my perspective was in the critical care setting. It is very easy to develop a “But did you die!?” calloused mentality that neglects the patient’s needs after receiving ICU care.
The downside of entering directly into an ICU right out of school is that you do not yet have the experience and understanding of the care provided outside of your unit. You will soon become engrossed in becoming a phenomenal ICU nurse, and nothing will be more important to you than getting really good at your job. Because you must be very focused on becoming competent in your current role, you will not understand what patients will experience after their ICU stay is complete.
The new grad ICU nurses I knew personally did not fully understand what nursing care looked like beyond the walls of their ICU. However, it was common to assume the challenges patients faced after the ICU were not nearly as important as the ones they helped the patients navigate during their ICU stay. For example, they did not fully appreciate the long-term implications of extended deep sedation and restraints. They didn’t have to deal with post-ICU delirium because they transferred the patient to the med-surg unit right after extubation.
The new ICU nurses who had a few years in med-surg on a similar unit could enter the ICU with a more holistic understanding of patient needs from admission to discharge across different departments. They were able to anticipate barriers or needs, prepare the patient for transfer, and communicate with the medical team and receiving unit with more confidence and tact.
My advice for people looking at new grad ICU nurse jobs ➡️ See if, during orientation, you can shadow a med-surg nurse. It would be ideal if this unit is the one you will be transferring patients to most often so that you can see and understand what it looks like on the receiving end. This will help you give a better nurse-to-nurse report and prepare your patient for a smoother transfer.
Slower 🐢 Progress and Increased 🗜️ Pressure
If you and a few classmates start your new ICU nurse jobs simultaneously as others who start in lower acuity areas, you may notice that it’s taking you much longer to feel comfortable coming to work. Because the med-surg patient population is overall more stable, those new nurses are not learning things that are nearly as time-sensitive or critical. Lower acuity patients tend to have a plan of care that is more straightforward to implement. Also, med-surg nurses have a little more mental space to process what the heck is happening and adjust accordingly.
It takes longer for new ICU nurses to feel comfortable clocking in, and ICU nurses receive longer orientations. Med-Surg is definitely still a challenge for new grad nurses. However, the pressure of picking up on assessment changes and promptly intervening in critically ill patients isn’t there.
Your colleagues who started in other areas might be taking on leadership roles earlier as well (charge nurse, preceptor, for example), but don’t let that phase you! The foundation you need to build to function autonomously takes more time to solidify.
New Grad ICU Nurse Jobs: The Deep End of the Pool 🏊
I like to compare learning how to become a nurse to learning how to swim.
First, you start in nursing school, which is the kiddie pool. It’s safe, and you have lots of support. It’s not a problem if you fall over because the water isn’t deep. You’re just getting used to floating and simply being in the water.
I feel like med-surg is comparable to the 3-foot area of the pool. It’s a lot more challenging because you’re dealing with much more water, but it’s manageable. Patients are typically stable, and while it is challenging, you can still put your feet on the floor and touch the ground.
You’re learning how to swim while trying not to drown. For some, they can pull it together and learn how to tread and keep their head above water. But for most (myself included), they need some time in the shallow end before heading out into deeper water.
Benefits To Consider in the ICU
If you would like to work as a registered nurse in an ICU, your position should come with the following common benefits:
- Health insurance
- Vision insurance
- An employee assistance program (EAP) – these often provide free counseling and discounts to things like local gyms
- Professional practice support – like reimbursement for professional development activities, certification reimbursement, educational programs, tuition reimbursement, and more
You may also want to inquire about how the schedule will work. Many ICU’s function with 12-hour shifts (day shift and night shift) but they may also offer supplement schedule options (like coming in as “helping hands” during busy times, or picking up a partial shift). Inquiring about what a standard shift looks like for this unit is advisable.
Understanding how far in advance the schedule is put out is helpful. It might be a weekly schedule or block schedules that are done every 4-8 weeks. If it is a unique ICU, they may schedule 8-hour shifts and you work the exact same shifts every time.
How to Land New Grad ICU Nurse Jobs
After reading all of this, do you still want to go for ICU as your first job as a registered nurse? If so, that’s awesome! It will be exhausting and challenging and push you to your limit.
Here are a few tips that will help you get that ICU nurse job:
- Set up job alerts for your area and desired positions – Don’t forget about LinkedIn for networking!
- Nail the interview – I have a guide just for you. It explains how to ace the interview and what will set you apart from the competition. (If you want my full course on landing the job, click here).
- Bring 🌟 glowing 🌟 references – While in school, make connections with ICU nurses, CNA’s, physicians, and even nurse managers. Ask for a reference or email them your LinkedIn profile and ask them to recommend you!
- Familiarize yourself with all things ICU – I have many blog posts, videos, and podcasts about ICU nursing care that will help prepare you to speak confidently and tactfully during the interview process. (I also have a full ICU prep course too!) The benefit to this doesn’t end with landing the job; it helps refine your professional practice as a registered nurse as well!
Once you land the job, get ready! Life will be quite hectic and centered around acclimating to providing quality patient care in your new role. You’ll need to study at home about disease processes, meds, labs, equipment, diagnostics, and more so that while you’re at the bedside you’re focused on practical preparedness.
Chat with your loved ones about your orientation time, as it will be very draining both mentally and physically. You will need support and grace from your loved ones as you navigate this new challenge. If possible, find a mentor who is also a critical care nurse. They can provide valuable perspective and support that you preceptor (even if they’re awesome!) won’t be able to do while training you.
What Should You Do If the ICU Isn’t For You?
This happens. A new nurse is excited and works really hard and gets the job in the ICU. But after a while, he or she discovers this isn’t the right job for him or her. When I was working in critical care, for every 10 that started, only about 3-4 made it through orientation and stayed long-term.
If you go home and realize it is draining you too much and you don’t think you can be your best in the ICU, then tell someone. It’s admirable to ask to be reassigned to a different unit or floor rather than suddenly quit. Maybe someday in the future, you can try ICU again, or maybe you learned that the ICU just isn’t the place for you.
It’s better to know your limits and find a job that uses your strengths than to keep working in a place that is either over your head or so difficult that you don’t have enough to give. Management doesn’t want you miserable.
There is a place for everyone and a job for you. It’s ok to realize that maybe you have some more areas to grow in, or perhaps this is not a place you enjoy working. You’ll be a better and stronger nurse when you work in a department within a nursing specialty that utilizes your strengths the most.
More Resources on New Grad ICU Nurse Jobs
- Tips for New Grads in the ICU Show Notes– FreshRN Podcast Show Notes
- What Do ICU Nurses Do?– FreshRN Blog Post
- The Real ICU Nurse Job Description– The Nerdy Nurse Blog
- Perfecting Your Craft – Week 2, ICU Time Management Tips– FreshRN Blog Post
Trying to build your confidence as a new ICU nurse?
Breakthrough ICU from FreshRN is a 6-week, online course specifically crafted for brand new ICU nurses who want to get ahead of the game. So that instead of merely surviving orientation, they’re confidently thriving all the way through. With Breakthrough ICU, it’s like we took all of the highlighted info from the nursing textbooks, mixed in our own experience, wisdom, and expertise, and packaged it in a way that it’s tangible, easy to digest and understand, and can be applied to your very next shift. You can start your ICU journey with your head held high (but not too high!) and your heart calm.
Can a new grad nurse work in ICU?
Yes, a new graduate nurse can work in the ICU. However, it could require additional training, potentially a longer orientation, and support to manage the complexities and demands of critical care nursing.
Can you work in the ICU right out of nursing school?
Yes, you can work in the ICU right out of nursing school, although it typically involves a thorough orientation process and mentorship to navigate the challenging critical care environment.
How to get into ICU as a new grad?
To get into the ICU as a new grad, focus on building a strong foundation in nursing fundamentals, seek ICU-focused clinical rotations, demonstrate an eagerness to learn, and apply for ICU positions or residency programs that offer specialized training and mentorship for new graduates in critical care.
Is ICU the hardest nursing specialty?
Whether the ICU is the hardest nursing specialty can vary depending on individual skills and interests. It is certainly one of the most challenging due to the complexity of patient care, the need for advanced technical skills, and the high-stress environment. Still, the difficulty is subjective and depends on each nurse’s capabilities and preferences.
Can you work in ICU with ADN (associate nursing degree)?
Yes, you can work in the ICU with an ADN (Associate Degree in Nursing). Many hospitals hire ADN-prepared nurses for ICU positions, although they may require additional on-the-job training and encourage further education, such as pursuing a BSN (Bachelor of Science in Nursing).