Nurses switching to ICU have no structured preparation path

“Hi everyone I started my career in inpatient for 3 years took a break and did outpatient for 1.5 years and now I’m back in inpatient. I honestly feel like I’m brand new!! The hospital I work in now is much higher acuity it feels like all my patients are the most complicated patients I would have at my first job and I’m just a little overwhelmed!! I want to know has anyone had the same experience as me? How long did it take to feel comfortable at your new position? I just feel like there’s so muc”

“Hey guys, i recently switched over from NICU to PICU and hate it. i’m not sure i want to go back to bedside and have been thinking of trying out the Cath lab. what do you guys think of it? Anyone who’s worked cath lab what advice do you have and how is it on your mental and physical health? submitted by /u/Confident_Strain_788 [link] [comments]”

“Hey all - currently looking for some advice on education for my unit. I work in a smaller hospital where our ICU pretty much handles everything except for surgical patients. I personally am newer to the ICU setting but came from higher acuity stepdowns prior to this job. I traveled for about 6 years so it has been awhile since I’ve been staff and that’s why I need some ideas from you all! I personally know I have a lot of things to learn working in the ICU compared to my previous role. It’s a bi”

“So I'm a new grad, about 4 months in as an RN, only a month off orientation. I got hired to a cardiac stepdown unit, which I actually like. 3 patients, sick enough that I'm learning a lot, and my long term goal is ICU (ideally CVICU). Problem is things at my hospital are getting rough. I keep getting floated to a med surg tele floor with 5 patients, which I've never been oriented to. Our contract literally says nurses with under a year of experience won't be required to float in”

“Hi everyone! I’d love some advice from experienced nurses, as I’m feeling a bit nervous about my decision. My placements include 3 weeks in general medicine and 13 weeks in a surgical ward (vascular, gastro and urology), all in the same ward. Originally, I planned to choose surgical for my new grad year, as I already had experience there. However, I decided to take a chance and chose a small rural ED with around 5–6 beds for the full 12 months, with no rotation. The problem is that I’ve never do”

“hi! thanks for all the feedback!! i’m just really nervous it’s going to be mostly like transports to and from and not critical care if that makes sense? [re: Fixed Wing Flight RN]”

“The only ones who think this are most likely CVICU. [re: why do some nurses think that neuro icu isn’t critical care?]”

“Hey guys, Just recently had my interview at Stanford. Does anyone here work in the ICU? Do you guys have a lot of overtime? Just wondering 😂 submitted by /u/Glass-Force217 [link] [comments]”

“I did it! I loved it! Definitely need good support from your team and higherups. You need solid skills which you likely have from ICU. I did it after ICU and ER experience and I felt comfortable. Loved the thrill, the change of pace, autonomy, acuity...it was my dream. [re: Fixed Wing Flight RN]”

“Literally never heard this take. You’re doing hourly neuro checks, dealing with EVDs and doing NIHSS at every handoff. Of course it’s real critical care. We had way more codes in the Neuro ICU than in the CVICU when I worked critical care. [re: why do some nurses think that neuro icu isn’t critical care?]”

“This is something I’ve genuinely never understood. Why do some nurses act like Neuro ICU isn’t “real” critical care compared to SICU, CVICU, or MICU? When I first accepted my Neuro ICU position as a new grad, I literally had a nurse tell me I was going into “long-term care ICU.” Like WHAT??? I’m sorry, but since when did Neuro ICU become long-term care? I started my nursing career in Neuro ICU, and I can confidently say it was one of the most stressful experiences I’ve ever had. Not because I di”

“Hey everyone! I’ll be starting on a high acuity med cardiac unit in December. Coming from a low acuity med surg unit I don’t often deal with many cardiac issues and would love to have a good book to have at work that breaks down EKGs, what certain rhythms mean, common treatments, etc so that I can come into this job a little more prepared. Thank you! submitted by /u/Cynicallys [link] [comments]”

“Third shift this week. I'm six months off orientation, med-surg trained, and last night they floated me to ICU with a 1:4 assignment. One was on a levo drip I had never titrated before. Charge was in the code of another nurse's patient for six hours. Resource nurse? 'Called in, not coming.' I asked the house supervisor for help with an art line I couldn't get to zero and she said 'you're ICU now, figure it out.' I stayed three hours late charting. Nobody died. I d”

“Oh interesting. I think the hopsital nearest me is like this on one half. One side of the hospital is new and all of those floors have big doors that you have to badge in to, but a lot of the med surg type floors leave the doors open. The ICU floors in that section keep them closed and visitors have to buzz in. The older half of the building doesn't have the big doors separating the lobby from the floor. [re: Feel defeated]”

“Wow I’ve been in the profession over 20 years but we definitely got longer than that in my NICU orientation. I think it was almost 5-6 months. No way it’s safe as a new grad after a few months in icu. We also had a mentor assigned once we were on our own. Currently our health system has a program where nurses can transfer from other units and train in new departments and that program is at least 4 months. Mind you these are nurses who are already practicing not new grads. [re: ICU orientation]”

“Does anyone else think 12 weeks (basically 10, 1st week onboarding, another week of classes) is NOT enough for NEW GRAD orientation in the ICU? submitted by /u/No-Dot-4564 [link] [comments]”

“As an experienced ICU and ER RN my last ER job was a 6 week orientation. My current GI job gives people a 5 week orientation. Your orientation is assuming is 3 shifts a week so 4 weeks? That's not enough as a new grad. My new grad ICU orientation as 6 months but I think I was on my own around month 4. [re: I made a huge med error and now I’m cooked]”

“Just wanting to hear how it is to be a nurse in the ICUs here. Is the culture good? Etc submitted by /u/Tall_Visual_3605 [link] [comments]”

“hi everyone I start on the neuro/stepdown unit next week and i want to get as much advice as I can to be prepared and helpful to my future coworkers. a lot of what I’ve seen so far doesn’t make the neuro floor look good haha but I’m determined to make this job work and last for a good amount of time. any advice/prep helps! thanks!!! submitted by /u/Old-Restaurant-6024 [link] [comments]”

“I currently work in a level 2 trauma center in the ER. Have been an ER nurse for 4 years now and I love our hospital, love the unit, love the chaos, love the ER. I’m feeling disheartened because there seems to be no growth. Everyone stays here for decades so no new “spots” open up for anyone to get any training. I work in a trauma center and have my TNCC but I cant work in “trauma” because the trauma director doesnt think it necessary to train more staff. All the old timers are trauma trained. I”

“Hi y’all I currently work at a PCU in one of the big hospitals in San Diego. I’ve been here for almost 3 years and want to leave so bad. I’m really interested in the OR. What’s the best route to take to transition? I know Scripps has a transition program, but I heard they prefer their own. I was even opening to moving out of state, so if there’s any state/hospitals/programs you recommend….lmk submitted by /u/acaciagorteau [link] [comments]”

“I’m currently a cardiac PCU new grad RN coming up on my first year of experience and thus eligible to transfer. I have some exposure to both the ICU and ED as my unit cross trains into CCC/CICU (Cardiac critical care/cardiac icu) and we get a lot of patients who are barely stable enough to get downgraded, and I’ve been floated into the ED numerous times as well as doing my senior practicum in the ED. I honestly love both as I love the pace and quickness in the ED but also the complexity and asse”

“hi all! i just recently changed jobs due to relocating and decided to go from adult medsurg to PICU. for my background; i tech’ed in a level 1 Peds ER and absolutely loved it and then moved to adult med surg for a sign on bonus. Adult med surg was better than I thought, but I also really enjoyed my coworkers and that really made it easy for me to work and learn. Even though med surg made me enjoy adult care more than I had throughout nursing school, I missed working with kids so when moved, I kn”

“I have worked in the ICU at a critical access hospital for almost 10 years. We are a mixed unit, so we can take ICU level, and also PCU step down type pts, even MedSurg. I absolutely love having ICU patients. Of course being critical access limits what we can handle, but I can monitor an intubated pt on multiple pressors, understand how it works, and keep them alive (usually). I have had my CCRN for years and try to stay updated on critical care with online classes. Recently I have been looking”

“Hello, this is PGY1 who's doing her first inpatient block .. I have 8 pts (CAP) who continously/almost daily changing cz they get discharged superfast and I have difficulty knowing these pts in details in one day making it difficult to cover all things that are important when discussing case with attendings, almost always gaps in all the care I provide .. they said its ok, its normal, its take practice, one told me I'm seeking perfection, I am not cz I'm not even at the lowest accept”

“Heavily considering learning and taking on NICU but I love adult critical care and currently cover a 20 bed ICU. For people who went from practicing with adults to babies, how was the transition? Were you still able to keep your adult skill set while managing both? Advice appreciated! submitted by /u/luvingdoggy [link] [comments]”

“Hey Y'all I am seeking advice on how I can be a competitive and strong ADN applicant against BSN applicants that will help me get into an ICU residency in Texas. I'm finishing up my last prerequisite class this fall semester. I'll be applying for the ADN program this spring and hopefully get in next fall. My grades are excellent and I plan to keep it that way. I currently volunteer at Texas Health Resources which is actually where I want to do the residency program. JPS is another ho”

“I had a similar interview last year when I transitioned from med-surg to ICU, and they definitely asked about vent settings and ABG interpretation, definitely brush up on those. [re: CTICU interview]”

“Hi all, im a medsurg nurse interviewing for an icu position at my hospital. What can i expect. Will they ask me actual icu questions such as about abgs, vents, etc? Or will it be more personality based. Idk im rly nervous bc i want this job. Any advice is appreciated. submitted by /u/gummychode [link] [comments]”

“So I’ve been on my current unit almost a couple years now. I’ve been trying to be more involved in it a few months back and try to be helpful. Initially I was trying to leave however didn’t really see anything that caught my eye so I left it alone. However there was a job posting I saw about a week ago and thought to apply just to see my chances. I got word back from outpatient facility from the nurse manager a few days later to set up an interview. Again I know I’m overthinking it as I do not h”

“I just quit icu after a year . I came from med surg. I hated every second of the bullying , personalities , and Pas and Drs. PA screamed at me in front of the entire unit , yup that was it for me . I left and I’m much happier [re: ICU just not for me or is it the culture?]”

“Hey everyone! Feeling discouraged and need some advice. My background is mainly ER. Loved the emergency room. Loved the teamwork, loved my docs. Could count on one hand during my ER time where I had a bad interaction with a coworker. Decided to move to the icu because while I loved the ER, flight nursing has always been the goal. I’m in a mixed CVICU/MSICU. Enjoy it to some degree because I can definitely tell my strengths as a critical care nurse have improved. However, and I don’t know if it’s”

“Hi! Wondering if anyone made the transition from level 3 NICU to peds ED - hoping to broaden my skill set and knowledge. Would you recommend a peds med surg unit to bridge the transition or just go for it? Thanks! submitted by /u/No-Nebula-653 [link] [comments]”

“I understand that, because I know that critical care experience is a pre requisite for CRNA school. My point is more geared toward your number of years of experience, not the individual patient care experience that you have. I'm not knocking you for wanting to go back to grad school, I'm literally in a graduate program myself. I just think people should strive for a minimum of 5 years of experience before going back. That time as an RN is very valuable. [re: Seeking career advice.]”

“I intentionally put myself into an ICU job for CRNA school as a new grad. And actually I do have a lot of experience. CRRT, Swans, charge experience, RRT nurse at my last job. [re: Seeking career advice.]”

“My hospital is restructuring and I am in the unique position of getting to choose to transfer to the MICU or OR. I have two years of med surge experience. I was hoping for some advice on which to choose, I know that they are way different. I value predictability, which the MICU has less of than the OR. I have had to become more extroverted in med surge, and patients and families seem to love me, but its exhausting masking all the time. However, I value the complexity of the MICU and truly unders”

“Has anyone transitioned from an LTACH (Select Medical) to a traditional ICU? I’m RN with about 7 months of caring for critically ill patients with trachs, vents, multiple comorbidities, and critical drips. We also respond to rapid responses. For ICU nurses or whoever may have input about this, would you consider LTACH experience valuable when hiring for an ICU? submitted by /u/Full-Ad-2709 [link] [comments]”

“I am just starting out in the surgical ICU and im struggling with learning the nuances of surgery and taking care of the postop ICU patient population. I did most of my ICU experience in a medical ICU and I find it’s a very different thought process compared to the typical patient presentations for the SICU. Are there any specific resources out there specific to the SICU?? I’m very familiar with Marino’s and IBCC but I’m looking for something that would give more context for the surgeries as wel”

“It’s an 18-bed unit! Staffing is definitely one of my biggest concerns, but the 16-week orientation and experience with higher-acuity patients are appealing. I appreciate the insight! [re: New grad RN: High-risk OB vs PCU?]”

“As a hiring manager in an ICU who also still works bedside, absolutely share about the med error. We are looking are for an experience that forced you to learn and grow. If you can't think of another decent mistake that you made, it can look disingenuous. The goal of the question is to learn how you respond when mistakes are made, nobody's perfect. [re: Would you mention a med error during an interview?]”

“I have been an LPN for 7 years. RN since January. My experience includes: LPN: - SNF: 1 year - Acute Care Float Pool: 1 year - Hospice: 5 years RN: - Hospice case manager since January I have won awards at my hospice job and was a preceptor. My goal is to go to the ICU, but I realize it’s competitive, what floor would you suggest that I apply to make my application better suited to move to the ICU. I will still apply to the ICU, but just want to broaden my horizons in case I can’t get in. I also”

“I’ve been an IMC/ICU nurse my entire career. My very first day ever being floated to med surg. My first day ever working med surg! I had 8 patients and they dump two nursing students on me at once. Like I’m just trying to not drown and pass meds on time. That day sucked. [re: It's the third time this week. Made a meme to let it out.]”

“Just start in med surg and then do an internal transfer to ICU [re: Discouraged about job opportunities]”

“Hi, I’ve officially been a nurse for a year. I started as anew grad in the ICU but the unit was not supportive, I did 5 months of orientation in the ICU and then transitioned to IMC/PCU/Step down in the same hospital. I want to get back into the ICU, should I include those 5 months in the ICU or just mention step down. I think going to step down was the best decision because I got to develop my clinical nursing judgment at a a good pace and I learned time management really well. Would it be bene”

“Looking for some insight for the best hospital work environment and patient in the twin cities area! Anywhere around the twin cities and possibly down to Rochester (Mayo) area. Plan on moving to the area and transferring from ER to the ICU setting. Thanks in advance! submitted by /u/Responsible_Tower453 [link] [comments]”

“I’m also hoping to hear from any nurses currently working on the Burn Unit or with the Critical Care Resource Team. As a new grad, I’d love to learn more about your experience on these units, the patient acuity, what a typical shift is like, and how supportive the transition is for a new grad. Also, if anyone has gone through the interview process for the program, I’d really appreciate any insight into what the interview is like and whether it’s online or in person, as I’m trying to prepare as m”

“Been in Med-Surg/Ortho for about 9 years. Besides a shadow shift, what are some factors to choose between going to ICU or ER? I like the ER due to being able to see a lot of different things. I like the ICU because it seems more structured. Thoughts? submitted by /u/Suspicious-Buddy4513 [link] [comments]”

“Hello, As the title states, I just recently got a job as a Rapid Response Nurse. My experience primarily lies in Cardiac Critical Care so I’m curious to see if anyone has advice or recommendations for someone new entering this role. Thanks! submitted by /u/Ok-Version-7297 [link] [comments]”

“Hi everyone, I'm a new grad RN considering the CTICU at Yale New Haven Hospital. I'd love to hear from anyone who has worked there or gone through their ICU internship program. A few questions: 1. How is the preceptorship structured? Do you start by shadowing and gradually take on your own patients, or is it more of a full shadowing experience throughout? How long is the internship period and what does the progression toward independent practice look like? Do nurses in the CTICU get floa”

“Hi everyone, I’ve been a nurse for a little over a year now and currently work in ICU on nights at a level 1 trauma center. I started there as a new grad in their ICU nurse residency under their 2 year contract and rotated through a few of their ICUs before picking one. As of lately my pre shift anxiety has gotten significantly worse, even on my days off I find myself feeling anxious for my upcoming shifts. I have no energy or motivation to do anything on my days off. I thought my anxiety would”

“I work for Piedmont Neuro icu. It’s a time. You learn a ton. It’s a lot and their are challenges but I love it”

“I recently transferred to L&D from a med surg floor. I am a newish nurse with 2 years of experience. I was hesitant joining this floor even though it’s my passion because I’ve been a patient on it and most of the nurses were very unpleasant. I also heard from various sources that it’s a toxic environment. Despite all of this I decided it was time to chase my passion. I applied and I got the job, I have found that some of the nurses are angels on earth while the majority are straight from hel”

“i can help you out if you still need someone. i worked in med-surg for few years before moving to icu, now doing crna things since 4 years back. the questions you have are probably basic ones right”

“Hey guys. Does anyone working or applying in the float pool have successfully gotten a job offer after their interview? Can someone share their experience and tips to ace the interview pls? submitted by /u/Glass-Force217 [link] [comments]”

“I left the ICU for PACU and honestly I left the PACU. The PACU was so easy and little to no stress. Honestly, I got bored a lot and that was not the issue. The issue I had was getting my hours cut by a couple hours 2 out of three shifts a week and I just didn’t like the idea of losing money even though the job was easy and not stressful. I decided to return to the ICU and I don’t really have regrets. I will say it’s just personal preference. I care a lot about putting money into my retirement an”

“Starting in neuro ICU. I have been away from bedside for couple of years so I feel like m starting from scratch. Can someone advice me how to prepare for it? I have icu background of ten years in the UK but I feel like idk anything ! What books or resources should i use ? Any advice is helpful please. Thank you . submitted by /u/No_Farm2984 [link] [comments]”

“hi everyone! i got a job at an ICU end of April 2025 and didn’t get to finish orientation because critical care is just not for me. i’m currently an RN in an elective orthopedics/trauma unit and i’ve been off orientation since end of November 2025. but i want to get away from bedside, mainly because i don’t want to have the burden of everything being your fault or at least, the feeling of everything being your fault. if a doctor doesn’t come or doesn’t do something, the pt/family puts the nurse”

“can somebody help me/give me mom nurse advice… i have been an ICU nurse 3 years now. Grew up here as a baby nurse & now frequent as charge nurse. I have started to notice some burn out & lack of drive. Our unit is constantly changing, going through managers like NOBODIES business, hiring probably the most incompetent RNs I have seen. I have been training nurses for almost a whole year now, never have a shift to myself (the shifts I do I get floated, have a 3 pt team, or in charge) &”

“Hello! I’m looking for a sanity check here. I’ve been on a neuro/trauma ICU at a decently sized level 1 in a US metro area for a few years now, for context. Been a nurse for a little over a decade. Have critical care experience in other specialties. How long does neurosurg/stroke/trauma at your shop keep orders for q1 comp neuro checks on bleeds, post-TNK, and the like? I feel like we’ve got this truly doo-doo culture in our shop where they’ll keep hourlies ordered way past the acute/evolving ph”