by wsuchic1

I begin my senior practicum in an ICU in a few days and was wanting some advice from all of the experienced (or even new) ICU nurses.

Do you all have any advice based on positive and negative experiences you've had when precepting students?

What additional reading do you think will be helpful for me?

I've been reviewing labs and comparing that to physical changes that may occur in the patient. I've also just completed a 3 day course on Critical Care Nursing where we reviewed EKGs and Hemodynamics.

I'd appreciate any advice you have to offer!

Re: Advice for Senior Practicum student in the ICU?

The first thing you should do is find out what is the patient population like. Is this a gereneral cardiac care unit and intensive care unit? Do they only have heart patients, pt's post cardiac cath? Is it a medical unit with COPD's on vents, CHF's etc? Is it surgical with open heart's, neurosugery, open abdomins, etc? Is it a trauma center with pt's with gunshots, stabbings, de-glovings etc?

Find out what sort of conditions you will be seeing and concentrate on those. Learn the type of medications you will be using and types of plan of cares used for those conditions.

Re: Advice for Senior Practicum student in the ICU?

Originally Posted by ukstudent

The first thing you should do is find out what is the patient population like. Is this a gereneral cardiac care unit and intensive care unit? Do they only have heart patients, pt's post cardiac cath? Is it a medical unit with COPD's on vents, CHF's etc? Is it surgical with open heart's, neurosugery, open abdomins, etc? Is it a trauma center with pt's with gunshots, stabbings, de-glovings etc?

Find out what sort of conditions you will be seeing and concentrate on those. Learn the type of medications you will be using and types of plan of cares used for those conditions.

I'll be on a MICU...I'm not sure what meds are commonly used in a MICU but I'll be sure to find out. I'll also focus on common conditions and care plans.

Thanks for the helpful advice!

Re: Advice for Senior Practicum student in the ICU?

I did my practicum in the ICU and now workin the same ICU. I would know what pressors are used (neo, dopamine, levophed)...doctors asked me this a lot and sometimes I would be racking my brain to remember what the names were. Know your sedation drugs for vented patients (versed, diprivan) and paralytics (we use nimbex). You will come across these drugs a lot and are pretty basic info you need to know! You might ask if there are a set of "Routine ICU" orders and get a copy to look over.

Re: Advice for Senior Practicum student in the ICU?

Something that is hard to grasp as a new nurse is the big picture. Cliche' as it may be it really is an area that can take some time to develop. Something that may help is to take a step back every once in a while with your patient and ask "what's our main goal with our pt and how are we going to accomplish it?" The details are important, but rather than getting hung up in the details try to discuss big picture ideas with your preceptor as much as possible."

For instance: try to identify some main goals when you come on shift (such as becoming ambulatory by Saturday, achieve ideal lung function by ambulating/IS/C&DB/etc, extubate by shift end, etc) and then identify very specific things you can do on your shift to push that patient closer to their goals. Thinking this way, rather than just doing tasks all day, will really help your patient out and help you get a feel for how all the little tasks fit together to achieve an outcome.

You have a huge effect on whether or not your patient progresses a little in your shift or a lot. Especially in the ICU. This isn't as much the case on the floor, but in the ICU you get a significant amount of autonomy and it's up to you to put it to good use.