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Fast Track to the ICU

*Original post released 4/22/23

No matter where you are in your nursing journey, if you’re interested in pursuing critical care, there are plenty of things you can be doing to boost your chances of getting into that department! You can be a nursing student, new grad nurse, or even an experienced nurse…anyone can start in a critical care area if determined enough. My own critical care journey began in nursing school when I was able to take an internship during my final semester in the ICU followed by accepting a new grad nurse position in a different ICU. In this article, we’ll discuss things you can be doing at each of these stages to increase your likelihood of nabbing a coveted position in a critical care unit…so if you’re already out of school, stick around to the end!

First, let’s begin with discussing what you can do while in nursing school to set yourself up for success and enhance your chances of getting a critical care new grad nurse position offered to you! Although this seems like a no-brainer, while enrolled, make sure to keep your grades and overall GPA up as high as possible. While your potential job interviewers may not be looking at individual grades, they will likely examine your overall GPA and nursing-specific GPA. Moreover, a higher GPA increases your chances of making the Dean’s list and/or being offered entry into nursing honor societies which will definitely look great on your resume. Doing well in your nursing classes may also aid you in developing good relationships with clinical and didactic instructors who may, at a later time, be willing to provide letters of reference and/or serve as a mentor after graduation. Grades are incredibly important, as you can see!

Also, in terms of bolstering up your nursing student resume, consider getting involved in your program’s student nurse organization or any local nursing organizations. Many organizations, even nation-wide organizations, offer student memberships for little or no cost and they can most definitely be listed on your resume. Often times, nursing programs and organizations offer volunteer opportunities which can look really great on a resume, especially if you’re unable to provide recent work experience due to school or other circumstances. Here’s the kicker though, make sure you attend meetings and/or events fairly routinely if you plan to include it on your resume; anything you put on your resume, you should be able to answer to, explain, and expound upon. HINT: you can reference the volunteer and organization experience in regards to how it allows you to get involved and stay connected with the local community and enhances your awareness of current issues of importance to them.

If you’re one of the lucky students who has to or can work during their program, consider getting a job in the medical field or as a certified nurse’s aide (CNA) or patient care tech (PCT). If possible, apply for those positions on a critical care unit or a long-term care facility where you’ll gather experience in caring for patients who are “total care.” The benefit of understanding how to care for these patients is that the majority of critical care patients are “total care” patients, which can give you a leg up and be a speaking point during an interview later on. If you do land a critical care CNA or PCT position during your program, try to make sure you network with the nurses, management, and other healthcare professionals. Doing so can increase your chances for transitioning to a new grad nurse position on that unit upon graduation and these people may also serve as references when applying for such positions.

During your clinicals, always try your best to work hard, step up and take initiative, and again, network with the nurses, management, and healthcare professionals you interact with… no matter the unit you’re rotating through at the time. Excelling and being professional during clinicals can make it easier to obtain a preceptorship where you want during that final semester if your program allows for internship placement. Be sure to get names and contact information from anyone who may be willing to be a reference for you in that final semester when applying to new grad nurse positions. You’ll want their name, title, email, place of work, and phone number if possible.

In your final semester as a nursing student, begin applying for new grad critical care nurse positions as early on as possible. And yes, this is my recommendation even though you haven’t graduated or obtained your grad nurse temporary work permit. Employers will verify that you’ve met these requirements prior to your start date anyway, so they matter very little in the grand scheme of things at this point in time. My final semester was in the spring, so before the holidays, I reached out to potential references to see if I could gather their contact information and have their permission to put it on my resume and applications. After the holiday break, I searched for and applied to multiple critical care positions for new grads throughout my area. Meanwhile, other students were focusing on the last semester and relaxing because it was more clinical based than didactic in nature. By the time mid semester came, I had already accepted a job offer in the ICU and had very little competition for the position at that time. This was not the case for my peers who waited until after graduation or until after obtaining their new grad nurse permits. I had the remainder of the semester to focus on my internship, graduation, and studying for the NCLEX (which I took immediately upon graduation and passed with the minimum number of questions).

For nursing students, new grad nurses, and experienced nurses, practicing emotional intelligence based interview questions can be an incredible way to boost your chances for placement into a critical care nurse position! Emotional intelligence interview questions are those that typically start with, “Tell me about a time when…” or “Give me an example of when…” These questions require you to speak to your life and work experiences and provide scenarios in which you demonstrated the qualities they’re looking for in a job applicant. Typically, you’ll want to construct your response using the STAR method where you speak briefly about the situation, the task or problem involved, the actions you took, and the results or outcome of the situation. The more concise you can be, the better. Again, like with your resume, anything you speak about is fair game for the interviewer to discuss with you, so being concise is absolutely necessary.

Now let’s segway into the realm of new grad and experienced nurses seeking positions in critical care. Many hospitals have new grad nurse positions for nearly any unit, however they can be competitive and limited in quantity. Experienced nurses may find it difficult to obtain opportunities to transition into a different unit at times based on the needs of their facility and job availability in their area. The good news is that there are multiple things either of these types of nurses can be doing to improve their chances of getting that critical care position!

Firstly, always take initiative, learn the ropes of the unit you are working on, and ask for more difficult patients once you feel comfortable taking those cases. Try to get an entry position in a unit that has an easier time transitioning to critical care such as telemetry, progressive care, intermediate care, and PACU units. Once you’ve met the minimum experience required, consider taking a float or as needed (PRN) position for critical care and/or step down areas. You could also speak with the critical care director for your facility to see if they are willing to cross train you to pick up shifts when their needs are greater than available staff nurses. Doing these things can make it easier, not only to obtain a critical care job but also to transition to the demands of the job intellectually and physically.

As with nursing students who are in clinicals, I suggest working closely with other nurses, management, and HCPs. Get to know them better on a professional and personal level so that when the time comes, you can more confidently approach them about possibly being a character and professional reference on your behalf. If your references routinely work in the critical care unit to which you applied, their attestation to your character, work ethic, and knowledge can provide quite a bit of sway in the interview and hiring process.

Alternatively, once you have at least a year of nursing experience under your belt, you could consider travel nursing as an option to move into progressive and critical care units. Many cities and facilities have unmet needs in these areas! While it will likely consist of heavy assignments and a lot of hard work, these facilities may be willing to be supportive of your critical care endeavors if you are willing to fill in and fulfill some of their needs. Nursing is a highly transactional profession, meaning you often have to offer up something in return for your own pursuits. When interviewing for travel positions, be sure to highlight the most critical experience you do have as well as reiterate your willingness to work hard to meet their expectations, needs, and standards.

Finally, while waiting for that critical care position, consider obtaining certifications in the area you are able to work in. If you’re working on a stepdown unit of some sort, the progressive care certified nurse (PCCN) certification is one you can pursue. Getting this certification can look good on your resume if pursuing the ICU or CVICU and will definitely help you later on if attempting to obtain your critical care RN (CCRN) certification. Once you’re in a critical care position and have met the minimum requirements, you can consider pursuing subspecialty certifications in cardiac medicine or surgery (CMC and CSC certifications). There’s also a trauma care course certification open to anyone willing to learn about taking care of trauma patients. This can be a beneficial certification to pursue if you’re interested in emergency nursing. It may also help you later on in your emergency nursing career should you attempt to obtain your certified emergency nurse (CEN) certification.

As you can see, there are so many things you can be doing to help boost your chances of getting into a critical care nurse position no matter which stage you’re at in your nursing career. Of course, the earlier you start doing any of these things, the better for your end goals. But better late than never! It’s also not the end of the world to start in a unit other than ICU or ER or another critical care area. Take that time as an opportunity to learn about nursing, expand your skills, and gradually take on harder patients. However, I’m also here to advocate and be the first one to tell you that if critical care is your goal as a nurse, don’t let anyone tell you that you have to start in med surg first. You can ABSOLUTELY start as a new grad nurse in the ICU, ER, NICU, or PICU and excel! Now go out and get that critical care internship or job! Don’t let anyone get in your way or make you doubt that path. Until next time, happy studying!

Andra Alyse

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