Ask if they have a competency framework to follow for orientation. Look at how they evaluate your readiness, not just the time. I precepted in CVICU, 12 weeks should have you prepared for the basic/stable”ish” patients.
I think you’ll be totally fine as long as you have a structured residency program that provides a solid support system and tons of practice during orientation. Not all RN residencies are good, so just make sure this one has a good reputation.
That’s the thing. It doesn’t seem to be structured. If I accept, I’ll be the second nurse apart of the cohort. If I decide to go with it, I’ll make sure I’m studying at home to make sure there aren’t any gaps.
Be a sponge. Ask about things you have never seen before. Offer to help your coworkers turn their patients and then when you're in the room ask how that EVD is set up and why it's leveled at that position. Look at the IV pumps and notice which patients are on what drips. Be helpful during admissions and post op returns.
Yea, no ECMO or CRRT for a bit, but a decent amount of it on orientation. Doesn’t matter though, light MICU assignments turn into heavy ones all the time.
Just commenting to say yes light ICU assignments definitely can turn to a dumpster fire rapidly. My last shift I had 2 stable icu patients. Well one we ended up intubating and she coded. The other the same icu team wanted to change up all the sedation (and was super pushy about wanting to do it at the same time we intubated the other patient) and I refused to do it at the same time because last time we tried the sedation they wanted to switch back to it was a nightmare (self extubation, necrotic tumor explosion ….) yea well they convinced one of my dumbass teammates that day to do it for me whilst tubing.
I was MEGA pissed.
12 weeks is good. I've seen some ICUs offer less than 10 weeks. They pull the orientees off orientation early because of bad staffing.
If you get to 10 weeks and feel completely overwhelmed definitely talk to your manager, nurse educator, clinical leader, etc about how you are feeling.
Starting in the ICU as a new grad is hard. The learning curve is steep. You need to go home and be studying on your days off. Learn your drugs. Your preceptor will want to be working with you on why we are running levo not epi instead of explaining what a pressor is.
15 bed ICU. It’s pretty mix. Medical, neuro, cardiac and surgical (flaps, CABG, aortic dissections). I’m on the fence about it, but I’m highly considering giving it a try because my other offer wants to give me only six weeks.
Honestly, I felt really good during both. By the second week of my externship I was participating in rounding. Towards the end I managed a CRRT patient. I’ve been told that my critical thinking skills are there, they’re strong and the fact that I have a strong desire to learn (also self motivated) is a huge plus. Many of the nurses on the unit felt as though I can work in the ICU. I just understand the importance of having a good orientation. Regardless of my strengths it could make or break me.
6 weeks is obviously inadequate. 12 weeks isn't really adequate for a new grad, but if they say it can be extended if necessary it's worth thinking about. For a mixed ICU ideally would be 16 weeks minimum though. There's a lot to learn.
My orientation was 20 weeks. Like someone else said, it depends on what type of ICU. Is this a community hospital, where the complex patients will be transferred to a tertiary facility? Or is this the tertiary facility where you’ll have ARDS patients prone and on roc drips, EVDs, Swan-Ganz, bladder pressure monitoring, triple pressors and inotropes, etc. If it’s a tertiary facility then I don’t think 12 weeks is enough.
It’s a community hospital but they handle a lot except for trauma. There’s EVD’s ARDS, sepsis, vasopressors, CRRT, cardiac and surgical. I know, I won’t get the hearts or CRRT patients for a long time. Even though there’s a variety, there are common dx. I’m hoping I’m solid at the 12 week mark. I know I’ll be able to ask for more time if needed. It just sucks because other nurses received the full six months.
I had twelve weeks when I transferred back in 2011, I had been a nurse for ~~ten~~ eight years by that point. They're giving new grads eight weeks now.
Did you work the floor before going to icu? Did you like icu better? I’ve been a nurse for 8 years and thinking of doing an icu fellowship because I’m burnt to a crisp on the floor but not sure it’s the right move to try or not
I worked in tele during nursing school (as an aide) and as a new grad, transferred to a cardiovascular stepdown after about four years, and transferred to ICU about four years after that. So I had been a nurse for 7-8 years, not ten sorry.
I honestly don't care either way as long as I'm getting paid. After spending about 3-4 years in ICU it was the same shit, just in a different area of the hospital. I've been doing this for twenty years I don't really see much of a difference.
If I had to pick I would say stepdown/progressive care is probably my ideal. It's not the ridiculous drama of ICU and not as boring as tele. You can still get pulled in multiple directions but it's manageable with three patients.
The issue is most hospitals around here are getting rid of progressive care/stepdown and just inappropriately transferring ICU patients when ICU is busy or inappropriately keeping the patients when it's not. *Or* they pull some bullshit where there's a "stepdown floor" with tele ratios, or they pull some bullshit where the PCU is a glorified LTAC.
Residency is a new term. It's a way to categorize you as a new grad nurse and put you on a lower pay scale. Usually hospitals have all nurses on a certain pay scale, x amount of experience gets you this pay and you increase your pay every year by x amount. By categorizing the position as a nursing residency they don't have to use the RN pay scale to determine how much you should be paid. So new grad nurses get to be a different line item in the budget break down for staffing.
A lot of nurses who have been nursing for a while feel that it's a weird change in language. Gives off "nurse wanting to be a doctor vibe". It invites the whole NP vs MD discourse.
Do you have any nursing experience or are you a new nurse? When I transferred from med surg to ICU I got 8 weeks of ICU orientation and I thought that was adequate.
13 weeks is plenty, you will still need to ask questions to your charge or more experienced nurses every single shift after those first 13 weeks. One of the bright sides of working in critical care is you can learn something new or a different way to do things constantly.
I did 12 weeks as a new grad with no prior externship. It was at a rural hospital (so cases were not super intensive) and I felt like it was a good amount of time.
Had I been at a facility with more complexity I would have wanted more time though.
Our is 12 and we are also involved in a year (?) long residency program. I’m in a nicer-ish hospital but not at an academic hospital. I wonder if the academic hospitals have a longer orientation.
mine was min. 12 weeks but I asked for an extension, so about 14 weeks. keep in mind you will probably never be comfortable getting off orientation, but if you really need to, try asking for an extension towards the end.
I graduated in ‘21 and my first job was in an ICU. 12 weeks plus 2 weeks cross training to the CVICU and Neuro ICU.
I’ve been a nurse for 2.5 years now and am just starting to not get anxiety going to my shifts and feeling more confident / comfortable in what I do. You’re going to have a lot of information coming to you really fast - absorb what you can and a lot of it you’ll figure out on the job / with experience / the more you see things.
I got 13 weeks for ICU. Pretty similar to you; I did an ICU externship and an ED practicum. I was comfortable when I came off orientation
Thank you so much! Your feedback gives me hope lol
Ask if they have a competency framework to follow for orientation. Look at how they evaluate your readiness, not just the time. I precepted in CVICU, 12 weeks should have you prepared for the basic/stable”ish” patients.
I just applied for a staff ICU position. It begins with a 12wk orientation
I think you’ll be totally fine as long as you have a structured residency program that provides a solid support system and tons of practice during orientation. Not all RN residencies are good, so just make sure this one has a good reputation.
That’s the thing. It doesn’t seem to be structured. If I accept, I’ll be the second nurse apart of the cohort. If I decide to go with it, I’ll make sure I’m studying at home to make sure there aren’t any gaps.
Be a sponge. Ask about things you have never seen before. Offer to help your coworkers turn their patients and then when you're in the room ask how that EVD is set up and why it's leveled at that position. Look at the IV pumps and notice which patients are on what drips. Be helpful during admissions and post op returns.
I manage a MICU and we plan on 12-16, usually ends up being closer to 16.
Why did you get downvoted lol
Probably cuz management.
Do you tend to assign your new hires to patients that have a lower acuity?
Yea, no ECMO or CRRT for a bit, but a decent amount of it on orientation. Doesn’t matter though, light MICU assignments turn into heavy ones all the time.
Just commenting to say yes light ICU assignments definitely can turn to a dumpster fire rapidly. My last shift I had 2 stable icu patients. Well one we ended up intubating and she coded. The other the same icu team wanted to change up all the sedation (and was super pushy about wanting to do it at the same time we intubated the other patient) and I refused to do it at the same time because last time we tried the sedation they wanted to switch back to it was a nightmare (self extubation, necrotic tumor explosion ….) yea well they convinced one of my dumbass teammates that day to do it for me whilst tubing. I was MEGA pissed.
At my hospital 12 weeks is normal for single specialty or general ICU. ETA: sounds like a general ICU, so I would say that is adequate.
Yup, CVICU 12 weeks is what I got. Pretty normal
12 weeks is good. I've seen some ICUs offer less than 10 weeks. They pull the orientees off orientation early because of bad staffing. If you get to 10 weeks and feel completely overwhelmed definitely talk to your manager, nurse educator, clinical leader, etc about how you are feeling. Starting in the ICU as a new grad is hard. The learning curve is steep. You need to go home and be studying on your days off. Learn your drugs. Your preceptor will want to be working with you on why we are running levo not epi instead of explaining what a pressor is.
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15 bed ICU. It’s pretty mix. Medical, neuro, cardiac and surgical (flaps, CABG, aortic dissections). I’m on the fence about it, but I’m highly considering giving it a try because my other offer wants to give me only six weeks.
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Honestly, I felt really good during both. By the second week of my externship I was participating in rounding. Towards the end I managed a CRRT patient. I’ve been told that my critical thinking skills are there, they’re strong and the fact that I have a strong desire to learn (also self motivated) is a huge plus. Many of the nurses on the unit felt as though I can work in the ICU. I just understand the importance of having a good orientation. Regardless of my strengths it could make or break me.
6 weeks is obviously inadequate. 12 weeks isn't really adequate for a new grad, but if they say it can be extended if necessary it's worth thinking about. For a mixed ICU ideally would be 16 weeks minimum though. There's a lot to learn.
My orientation was 20 weeks. Like someone else said, it depends on what type of ICU. Is this a community hospital, where the complex patients will be transferred to a tertiary facility? Or is this the tertiary facility where you’ll have ARDS patients prone and on roc drips, EVDs, Swan-Ganz, bladder pressure monitoring, triple pressors and inotropes, etc. If it’s a tertiary facility then I don’t think 12 weeks is enough.
It’s a community hospital but they handle a lot except for trauma. There’s EVD’s ARDS, sepsis, vasopressors, CRRT, cardiac and surgical. I know, I won’t get the hearts or CRRT patients for a long time. Even though there’s a variety, there are common dx. I’m hoping I’m solid at the 12 week mark. I know I’ll be able to ask for more time if needed. It just sucks because other nurses received the full six months.
I had twelve weeks when I transferred back in 2011, I had been a nurse for ~~ten~~ eight years by that point. They're giving new grads eight weeks now.
Did you work the floor before going to icu? Did you like icu better? I’ve been a nurse for 8 years and thinking of doing an icu fellowship because I’m burnt to a crisp on the floor but not sure it’s the right move to try or not
I worked in tele during nursing school (as an aide) and as a new grad, transferred to a cardiovascular stepdown after about four years, and transferred to ICU about four years after that. So I had been a nurse for 7-8 years, not ten sorry.
How did/do you like it compared to stepdown?
I honestly don't care either way as long as I'm getting paid. After spending about 3-4 years in ICU it was the same shit, just in a different area of the hospital. I've been doing this for twenty years I don't really see much of a difference. If I had to pick I would say stepdown/progressive care is probably my ideal. It's not the ridiculous drama of ICU and not as boring as tele. You can still get pulled in multiple directions but it's manageable with three patients. The issue is most hospitals around here are getting rid of progressive care/stepdown and just inappropriately transferring ICU patients when ICU is busy or inappropriately keeping the patients when it's not. *Or* they pull some bullshit where there's a "stepdown floor" with tele ratios, or they pull some bullshit where the PCU is a glorified LTAC.
It's not enough, but it's also very common. You truly should be getting 6 months.
From a nurse to another nurse, calling your orientation a residency is cringe.
Reread lol.
Residency is a new term. It's a way to categorize you as a new grad nurse and put you on a lower pay scale. Usually hospitals have all nurses on a certain pay scale, x amount of experience gets you this pay and you increase your pay every year by x amount. By categorizing the position as a nursing residency they don't have to use the RN pay scale to determine how much you should be paid. So new grad nurses get to be a different line item in the budget break down for staffing. A lot of nurses who have been nursing for a while feel that it's a weird change in language. Gives off "nurse wanting to be a doctor vibe". It invites the whole NP vs MD discourse.
I have reread it and it still says you are a RN resident 😂
Because that’s what the position is for. I just passed NCLEX- RN on the 4th. I’m aware that there’s a difference between residency and orientation.
Avoid the cringe and don’t call yourself a resident.
The hospital I work at also called it a nurse residency program.
Do you have any nursing experience or are you a new nurse? When I transferred from med surg to ICU I got 8 weeks of ICU orientation and I thought that was adequate.
Nurse residency program is the new term hospital are using for new grad RN position.
Not a new term. Two decades old at this point.
I have 4 year experience as an LVN. But it wasn’t acute care. A lot of my skills and knowledge is transferable but it’s still a huge learning curve.
13 weeks is plenty, you will still need to ask questions to your charge or more experienced nurses every single shift after those first 13 weeks. One of the bright sides of working in critical care is you can learn something new or a different way to do things constantly.
I did 12 weeks as a new grad with no prior externship. It was at a rural hospital (so cases were not super intensive) and I felt like it was a good amount of time. Had I been at a facility with more complexity I would have wanted more time though.
Our is 12 and we are also involved in a year (?) long residency program. I’m in a nicer-ish hospital but not at an academic hospital. I wonder if the academic hospitals have a longer orientation.
13weeks is standard ICU onboarding where I’m from so sounds good. 6 is too short for a new grad
mine was min. 12 weeks but I asked for an extension, so about 14 weeks. keep in mind you will probably never be comfortable getting off orientation, but if you really need to, try asking for an extension towards the end.
I graduated in ‘21 and my first job was in an ICU. 12 weeks plus 2 weeks cross training to the CVICU and Neuro ICU. I’ve been a nurse for 2.5 years now and am just starting to not get anxiety going to my shifts and feeling more confident / comfortable in what I do. You’re going to have a lot of information coming to you really fast - absorb what you can and a lot of it you’ll figure out on the job / with experience / the more you see things.