Calling all new grads/new to the ICU starting Feb. 2013!!!! - page 10

Hello everyone! I'm starting this topic for any new grads or new to the ICU. I think it will be good to come here to compare notes, encourage, vent and support each other. I am extremely nervous... Read More

  1. Visit  ktliz profile page
    1
    Oh, and my vent for the day.... I work night shift. Why on earth do I fall asleep at 10pm and wake up at 5am on my nights off?!?!
    srandall1492 likes this.
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  3. Visit  LVegasRN profile page
    0
    Quote from ktliz
    My time management tips:

    You WILL be slow at first. It's the nature of the beast. Don't feel bad about taking a long time to do things. You should be going slow at first because you need to really think about what you are doing. Plus, the fiddly skills-type things just take practice. It used to take me 10 minutes to do oral care that now takes 3 minutes, 30 minutes to give meds that now take 5. Half an hour to do an assessment that now takes less than 5 minutes. Developing a routine and figuring out what works for you will come eventually. What I would focus on now is making sure you are simply aware of how you are using your time. Try to set goals, like, "I will have A, B & C done by X time." For example, I try to have both my patients assessed, meds given, charting on one done and working on charting on the other by 8:30. Of course this doesn't always happen... things come up or you might just have a particularly complicated patient. If you don't meet your goals that's fine, as long as you are thinking about the time as you go along.

    The big tip you will hear from everyone is to stay organized. Take time at the beginning of your shift to write out your med administration schedule, along with any additional timed tasks like labs.

    Make a to-do list. I include my daily shift duties on my to-do list, like changing suction cannisters, 24 hour chart checks, etc. I also like to put little boxes next to everything so I can physically check them off. Seeing an unchecked box is a visual cue for me that "I have to do this!" I also keep a post-it of things my patient needs that either need to be addressed by me, addressed by the physician or passed on to the next shift. I can then stick this post-it directly onto my patient's kardex (our report sheet) when I make a copy for the next nurse.

    Think ahead. Take inventory when you first walk into your patient's room. What will you need to provide their care for the shift? Do you need dressing supplies, skin care supplies, extra gloves or flushes? Lab draw supplies? Make a trip to the supply room and grab EVERYTHING you need. I also grab new linens so whenever there is a tech available, we can dive right in and get my patient bathed without having to grab this and that. We have drawers in our patient rooms that are stocked with lots of stuff, but if you get whatever you need from the supply room, your drawer will stay stocked in case you forget something. Plus, you won't have to stock it for the next shift.

    We have computers in every room and they can be sllooooow, so I try to never stand at a computer doing nothing. I walk into the room, log onto the computer, then do my assessment as the system boots up. Little stuff like that.

    I know, I wrote a novel. I just drank an energy drink and am procrastinating cleaning my apartment. Hope this helps! Time management was my #1 concern throughout orientation but it has really fallen into place.
    Thanks for the advice! It will be interesting to see how I do during orientation. Along with time management, mastering assessment and nursing skills, being comfortable with medication administration (actually knowing why we are giving it and common dosages), interventions, charting as an actual RN (oppose to a student nurse), communicating with all health team members, and adapting to the culture of the floor (getting along with coworkers)...I think it will be a very exciting process. I have tons of questions!!! But I feel they will be answered during orientation. Like how the actual floor functions. Is that a stupid question to ask here?? Sorry its late
  4. Visit  LVegasRN profile page
    0
    Quote from ktliz
    Oh, and my vent for the day.... I work night shift. Why on earth do I fall asleep at 10pm and wake up at 5am on my nights off?!?!
    That sucks! Do you want to start having the same sleep time on your days off? If your getting enough sleep on your days off, doesn't sound like to much of bad thing. You still get to enjoy the daylight when everything is open!
  5. Visit  grayRN profile page
    0
    Hey everyone, it's great to hear such positive feedback on starting in the ICU. I'm curious where y'all are working (cities/metro areas)?
  6. Visit  dressagerdr profile page
    1
    In reply to the above poster, I'm in a "city" of about 80,000 people, but our hospital covers a large area outside of the city as well, so we get lots of transfers via flight and such. I'm in a rather more remote location, with my hospital being the largest/most advanced for hundreds of miles around.

    Update on orienting to ICU... I'm about 8 weeks along now, just switched to day shifts about a week or so ago. So far my biggest challenge is that my ICU covers so many different pathologies, whereas my entire background has just been in neuro. My hospital has a CICU and the general ICU that I work in. So, I can see anything from severe head traumas, to GI bleeds, to respiratory failure, to drug overdose, to multisystem trauma, etc and it encompasses both peds and adults. It's impossible to see everything in 10-12 weeks of orientation, so I'm nervous for when I do see a patient with a diagnosis I haven't dealt with since nursing school. Not to mention, I never had a peds rotation so I've never worked with them ever!

    That being said, I can see a huge improvement in just the 8 weeks I've been there. Just yesterday I was taking a student nurse under my wing and showing him how to take care of our trauma patient. Never could've done that 8 weeks ago! It looks like I'll be getting off the orientation bandwagon in 3 weeks or so. I feel ready to spread my wings, but I'm scared crap will hit the fan afterwards. I've never had a patient code on me (or even seen a code), or had a patient totally dump on me either- although we've had some close calls. I'm hoping it happens before I cut the cord so I can see how that all goes down.

    My advice to other people starting is to definitely do some research in advance! Look up common ICU meds, vent settings, labs (especially ABGs, chemistries, cbcs). Don't be afraid to ask questions of others, and let your coworkers know that you're wanting to learn about anything interesting going down on the unit. Lots of my learning has been done by going and seeing other patients on the unit, even if they're not assigned to me at the time.
    FlorenceNtheMachine likes this.
  7. Visit  FlorenceNtheMachine profile page
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    I don't love nights! I feel sick to my stomach a lot, normal?
  8. Visit  Rose2013 profile page
    0
    Hi i'm new here I am currently licensed as an LPN and will be getting my RN license this summer after I graduate next month. I just got a volunteer LPN position in the step down ICU and i'm very excited. We are in Hawaii and getting a paid job as a new grad nurse here is next to impossible. I start on the 30th so I am trying to read up on as much information as I can before then. My critical care rotation as a student nurse ends next week so I will at least have some base. Is there a list of the most common meds used in ICU/PCU anywhere?
  9. Visit  CrazyGoonRN profile page
    0
    Quote from Rose2013
    Hi i'm new here I am currently licensed as an LPN and will be getting my RN license this summer after I graduate next month. I just got a volunteer LPN position in the step down ICU and i'm very excited. We are in Hawaii and getting a paid job as a new grad nurse here is next to impossible. I start on the 30th so I am trying to read up on as much information as I can before then. My critical care rotation as a student nurse ends next week so I will at least have some base. Is there a list of the most common meds used in ICU/PCU anywhere?
    Just curious. How do you get a volunteer position in a step down ICU? I am an LPN and graduate with my BSN in December so I'm interested. Thanks! :-)
  10. Visit  RNnur profile page
    0
    As we are all new to ICU...I am curious to how everyone's orientation is setup? How is your progress being measured/evaluated? Have you worked with several different preceptors or basically just one? Are you establishing goals each week? Are you working right along side your preceptor or does he/she just let you off to figure things out? Basically what has the structure of your orientation been like and do you feel prepared to be on your own (if your near the end of your preceptorship)?
  11. Visit  monkey2008 profile page
    0
    Hi everyone! Ahhhhhh. I love work so much . There are times that it's overwhelming and I feel completely clueless, but there are so many times I can see how I'm progressing. We don't get goals, but I always ask for feedback from preceptors and ask how I can improve. I've had several preceptors and all of them have been fantastic. We just started the aacn essentials of critical care program, so it's honestly like we are back in school...but the concepts all make so much more sense now that I'm applying what I learn every day at work.

    Hope everyone else is doing well
  12. Visit  ktliz profile page
    1
    RNnur... my orientation was 6 months. We had class and computer time built into our schedule, 1 or 2 days a week. Toward the beginning those days were mostly class/workshops/SIM and toward the end it was mostly online at home through AACN's ECCO course. We were assigned a new preceptor each month. There were some guidelines for our preceptorship, e.g. start giving meds in week x, start taking 2 patients in week y. We oriented on days and only switched to nights for the last month. The last 2 weeks we had "mentorship" which meant our preceptor had his our her own assignment. Around month 4 I felt like i would never be ready, but when the time came, it was a seamless transition. I've been on my own for 2 months now and Iook forward to going to work everyday. This job is everything I dreamed it would be.
    rntob2013 likes this.
  13. Visit  ktliz profile page
    0
    As far as goals, I kept a private journal in the beginning. I wrote down things that went well that day, things I learned, things I wanted to look up, and of course, goals for the next shift! Our preceptors were supposed to fill out forms at least weekly on our progress, but that was often forgotten. They were all great about giving us verbal feedback. The forms were mostly for the unit educator's benefit and for our file.
  14. Visit  Rose2013 profile page
    0
    Quote from CrazyGoonLPN
    Just curious. How do you get a volunteer position in a step down ICU? I am an LPN and graduate with my BSN in December so I'm interested. Thanks! :-)
    I am completing my BSN right now so I did a rotation there and the Red Cross accepts nurse volunteers as staff nurses. There is a huge hiring freeze because I will be working at a military hospital so there are no paid positions right now but the hope is to move into a paid position in the future I'm extremely excited to start. I just completed the 4 day orientation to the hospital yesterday. If you are looking to volunteer as a nurse to get your foot in the door the Red Cross is definitely the way to go IMO. I am also in the process of signing up for the disaster response team to respond to disasters on island and in the Continental US


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