Advice for "seasoned" nurse moving to ICU

Specialties CCU

Published

Making the transition...finally! I have Med/Surg floor experience and am leaving a Tele charge nurse/unit educator position for an ICU staff nurse position. We do open hearts and eventually I would like to be skilled enough to care for them. Scheduled to be precepted by two great nurses. I have been at my hospital for 10 years and I know a lot of the staff and doctors.

I am nervous but extremely excited about all the new things I will be learning. Any advice?

Specializes in MS, LTC, Post Op.

I enjoy reading your updates, I am hoping to get a place in my hospitals ICU Fellowship in the next month or so, your post makes me excited!

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Specializes in CVICU.
So sad because she is so very sick. I feel guilty because I was excited to get so much experience from one patient.

Don't feel bad that's a good thing IMO. I do the exact same thing when someone tells me, "Hey your patients getting a balloon pump they arent doing so well." My eyes probably light up and a slight smile grows across my face. Its not that I enjoy other people's misery, but it's why you work in ICU. The fun and excitement always dies for me when I see the family though, that one always reminds me of the true sadness of the situation.

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I watched someone balloon up too with subQ emphysema from a trach. It was scary. Down her chest and into her face. And when I finally got the doc in, he tried to reposition it, at the bedside, blindly! She got transferred to a bigger hospital :(. Scary!

((And my eyes kinda light up too when something interesting comes in! Kinda weird to say, eh? lol))

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hello, well i am walking your shoes completely!

i started on ccu 2 months ago and came from a med-serge, telemetry unit with 3 years of experience, doing charge and presepting there. we are sooooo brave to go to icu. i feel as a new grad, but is it fun. however, our icu nurses have a bad reputation and i found that is true. they are not nice, they are judging people around them and criticize them. a lot of politics. i don't like this. i came from very friendly environment. one of my goals is not to become "one of them" and to try to change the working environment around me. i am very cheerful person and like to receive the respect that i am giving too. well, not on my new floor. i am overstressed with the politics around me. otherwise, my preceptors are ok, they are surprised of my performance. i was born overseas and have an accident. a coworker told me that the people in icu does not give me enough credit for my performance but tend to judge me first due to my accent.

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Specializes in floor to ICU.

Wow, pulipam, sorry you are dealing with a negative environment. Why some act like this, I don't understand!

I am "officially" off orientation and had my first solo shift last Thur. I am desperate for OT so I picked up that day after already working Mon, Tue and Wed. Stupid because I was so busy and ended up exhausted by the time I got home.

My shift in a nutshell:

#1 pt: 600lbs ARF, A fib w/ RVR and resp failure. We had to get a bigboy bed. Unfortunately, it did not rotate or have a "turn assist" feature. :crying2: She had skin issues (of course). She was on cardizem gtt @ 7.5mg/hr but HR still in 130s. SBP low 90s. Hesitant to increase dose because of BP but charge nurse suggested that if I up the dose and the HR went down then perhaps the chambers would have more time to fill and the BP would go up. Loving learning all this stuff! BTW, it didn't work. Allergic to Amiodarone. I was thinking maybe Dig would be nice but cardiologist never ordered it. We extubated on my shift. Nervous because it was a traumatic intubation in ER-took many attempts. Thankfully, she flew after the tube was out!

#2 pt: pneumonia, vent/trach, CVA, craniotomy, MDRO and unresponsive (but fullcode). Cdiff w/ flexiseal that was leaking :uhoh3:. Had Amiodarone and Levophed infusing. Tube feeding. Day before had lots of ectopy w/ runs of Vtach. Trying to wean Levo but bp kept dropping. Trying to wean from vent but didn't tolerate. Ended up transfusing PRBCs.

Between documenting vs every 15 minutes on both patients and gowning up in plastic, trying to find another "dirty" nurse to assist me in cleaning pt ( unit tries to keep "dirty" and "clean" nurses separate!) I was exhausted!

We are supposed to go computerized (old promise- not sure when) in the future. It seems a waste of time to have to graph the vitals off the computer. Especially, every 15 minute vitals. Wish we could just print off the computer!

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My hospital made the change from paper to comp charting. Now the vitals import straight from the monitors to computer charting. Its AMAZING.

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Specializes in floor to ICU.
My hospital made the change from paper to comp charting. Now the vitals import straight from the monitors to computer charting. Its AMAZING.

OMG! That would make our lives soooooo much easier! You can understand how much more time you actually have to spend w/ the patient!

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Specializes in Cardiac/Med Surg.

So glad to hear you are doing well, I am very excited too. I have gotten a position in Jax at baptist heart hospital CVICU. I am leaving a SFL hospital where i have worked for almost 30 years, only 3 as RN in a cardiac stepdown unit.

I am also swithching it up and working days which i have never done as an RN..learning on the fly..hopefully maturity will help..I am one of those late in life RN's!

Keep us posted on how its going!

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Specializes in floor to ICU.
So glad to hear you are doing well, I am very excited too. I have gotten a position in Jax at baptist heart hospital CVICU. I am leaving a SFL hospital where i have worked for almost 30 years, only 3 as RN in a cardiac stepdown unit.

I am also swithching it up and working days which i have never done as an RN..learning on the fly..hopefully maturity will help..I am one of those late in life RN's!

Keep us posted on how its going!

Wow, what a leap! Awesome that you are trying new things. I am sure you will do fine. Love to hear back form you how you are progressing.

Good Luck!

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