Fresh out of nursing school, many nurses go to work in a hospital setting, most often on the medical/surgical unit. These floors are a great place to get your feet wet in the "real world" because of the variety of patients and medical diagnoses. Should you consider moving into a specialty, such as critical care, once you have gained some experience? Or perhaps you should seek direct entry into a critical care nursing job?
What is Critical Care Nursing?Critical care refers to care for the most acute and unstable patients in the hospital population. For example, the intensive care unit (ICU) and coronary care unit (CCU) are examples of critical care nursing. While all types of nurses work in medical/surgical units, working in critical care requires specialized experience or additional preceptor training due to the complex care provided, and many nurses obtain an AACN certification to document their advanced skills and knowledge.
What to ExpectWhile other hospital units may utilize LPNs, you'll need to be an RN to work in critical care settings. Also, you should expect 12 hour shifts exclusively to reduce caregiver changes with such unstable patients. The care is far more complex with this group of patients, but you'll find much lower ratios here than on a typical medical/surgical unit where nurses may care for anywhere from four to eight patients at a time. Meanwhile, an ICU nurse usually carries a patient load of one to three, depending on the patient acuity. While this may sound easier, note that even one patient can keep you hopping around for the entirety of your shift.
Be in DemandIf you choose critical nursing as a specialty, additional doors open in your career. Because critical care is a specialty, those nurses experienced and certified in this area are generally in even greater demand. This translates to more bargaining power for better wages and flexible working conditions.
Where Do I Sign Up?If all this sounds good to you, consider a couple of different career paths. Most nurses enter critical care after spending a minimum of a year or two on a medical/surgical floor, and sometimes they work in a cardiac telemetry unit as a stepping stone before going into a critical care setting. However, another possible option to consider is finding a hospital that offers a special new graduate training program, as many do now. Because of the need for critical care nurses, some hospitals offer an extended training and preceptorship to route new nurses directly into ICU, CCU or the ER. Critical care nursing offers a desirable niche in your job search as well as lower nurse to patient ratios, which many nurses prefer. If you haven't considered this specialty before, you may not know what you're missing.