Calling all new grads/new to the ICU starting Feb. 2013!!!! - page 9

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  SherluckyRN profile page
    0
    I was recently offered a position for step down icu unit but known as SCU (special care unit) for this hospital located in upstate NY. I am a new grad RN BSN May 2012. It is hard finding a job in NyC as a new grad
  2. Visit  LadyFree28 profile page
    0
    Welcome Jean and Sherlucky!!!
  3. Visit  keepnpositive profile page
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    Hello
    So far my experience is going well. Working on time management and the "little things," that really aren't so little, like remembering to check labs. The ICU I work in is not state of the art or particularly organized so I spend a lot of time making 3 steps in situations that should take 1. As an agency nurse who has been all around my area stated " they work harder not smarter here." That has been a challenge to work through. Anyone else working in a semi disorganized ICU?
  4. Visit  FlorenceNtheMachine profile page
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    I wouldn't say our place is "disorganized" so much, as not streamlined. There are too many checklists and failsafes we have to put in place. Such as all ports must be capped, lines and pumps labelled for 1. Identity and 2. Expiration, chart here and there. It's getting better, and I understand the point in all of it, but it's a lot of little things to forget.

    I have three more weeks and then I'm getting kicked out the nest!
  5. Visit  luckylotusRN2B profile page
    0
    Hello nurses!

    Well, I've had two shifts with my preceptor so far. I feel incredibly lucky to be paired with a really sweet, experienced, smart and patient preceptor.

    Looking back on my nursing school experience, i got too much busy work and not enough repetitive skills practice. The whole art of taking/giving report in an efficient manner, without bumbling over my own tongue, is new to me. Having my thoughts on my patient's status organized in my head, so that when a physician inquires, i have a worthwhile answer......is completely foreign at the moment. I know it takes time to develop a methodical way of thinking on the floor, and right now i just have tons of info coming in with no set drawers in my head to file it in. Does this make sense?

    If anyone has some experience/suggestions on what works for you as far as handling the massive amounts of information as it comes at you.....I'd love to hear it!

    Also, any report brains, or other documents that you use regularly.....please share!

    Meanwhile I'm going to enjoy Easter weekend off!! Thank you Jesus :-)
  6. Visit  etymed profile page
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    luckylotus:

    Yep, that makes complete sense. I am in the same position as you right now.


    In that in-between stage of confident doing most of the normal routine stuff (as long as there's a preceptor to catch you when you fall or to fill in what you missed) but not at that point where you've done everything enough times where you know what needs done after what. Honestly, I think there's so much information both general to nursing and disease processes as well as the specifics that come with each patient that we'll be hard-pressed for it to all really 'click' until we just have the experiences under our belt.

    I guess take the same advice I need: Keep on keepin on!
  7. Visit  LVegasRN profile page
    0
    Hi everybody!

    New grad here new to All Nurses and found this thread to be my starting place on this site. I just landed a job in a Progressive Care Unit/Intermediate Care. I know this thread is dedicated to ICU nursing but hoping to find some help/clarification between the floors. I understand for the most part the PCU/IMC is a step down. I see that a lot of people here have posted links to resources on this thread and wanted to know if it will be appropriate to study these to get ready for the PCU/IMC floor. I have 4 weeks before my start date so I really want to prepare as much as I can. What would be the best way to prepare for the PCU/IMC?? Would studying the resource links such as ICUFAQS be helpful??? Any advice would be very much appreciated!! Congrats New Grads!!
  8. Visit  FlorenceNtheMachine profile page
    1
    Quote from LVegasRN
    Hi everybody!

    New grad here new to All Nurses and found this thread to be my starting place on this site. I just landed a job in a Progressive Care Unit/Intermediate Care. I know this thread is dedicated to ICU nursing but hoping to find some help/clarification between the floors. I understand for the most part the PCU/IMC is a step down. I see that a lot of people here have posted links to resources on this thread and wanted to know if it will be appropriate to study these to get ready for the PCU/IMC floor. I have 4 weeks before my start date so I really want to prepare as much as I can. What would be the best way to prepare for the PCU/IMC?? Would studying the resource links such as ICUFAQS be helpful??? Any advice would be very much appreciated!! Congrats New Grads!!
    Welcome! ICUFAQs would be a great resource and so would kathy whites fast facts for critical care. I would think the PCU would still be critical care. Just a little more stable, or maybe not! You may have some ICU holds/overflow time to time.

    My advice in these four weeks, learn meds that you will be giving like the back of your hand now! Day 1, they expect you to know the common drugs and dosing, or at least my unit did.
    LVegasRN likes this.
  9. Visit  LVegasRN profile page
    0
    Thank you for your reply!!

    Any advice on specific medications?

    Also during the interview, it was noted that new grads tend to have a problem with time management. What is the manager referring to specifically when it comes to Time Management and what are some strategies I could use to help me along the way? The manager described her unit as a higher acuity unit that specializes in everything...I'm still trying to wrap my head around it =/

    Happy Easter by the way =)
  10. Visit  FlorenceNtheMachine profile page
    1
    Quote from LVegasRN
    Thank you for your reply!!

    Any advice on specific medications?

    Also during the interview, it was noted that new grads tend to have a problem with time management. What is the manager referring to specifically when it comes to Time Management and what are some strategies I could use to help me along the way? The manager described her unit as a higher acuity unit that specializes in everything...I'm still trying to wrap my head around it =/

    Happy Easter by the way =)
    Happy Easter! I would take the top 100 meds prescribed (usually a list floating on the internet, google it) and know at least common dosages and indications. Then, depending on your unit, you may be titrating/handling drips, like nitro, amiodarone, insulin.

    Time management, I think that's just grouping your day together. If you have a med due at 8 and another due at 9, if it's okay to do so, group the admin together to save time. And don't forget when drawing blood, always think do I also need a CBG? Also, prioritize your time, don't get so stuck with one inane task and ignore a more pressing matter, like a patient who is desatting. It's obvious I know, but you'd be surprised how much the need to accomplish a task you started can throw you off of where you really need to be.


    I found this PDF, good summary of expectations of a PCU. http://www.aacn.org/WD/Practice/Docs...eFactSheet.pdf
    LVegasRN likes this.
  11. Visit  LVegasRN profile page
    1
    Quote from FlorenceNtheMachine
    Happy Easter! I would take the top 100 meds prescribed (usually a list floating on the internet, google it) and know at least common dosages and indications. Then, depending on your unit, you may be titrating/handling drips, like nitro, amiodarone, insulin.

    Time management, I think that's just grouping your day together. If you have a med due at 8 and another due at 9, if it's okay to do so, group the admin together to save time. And don't forget when drawing blood, always think do I also need a CBG? Also, prioritize your time, don't get so stuck with one inane task and ignore a more pressing matter, like a patient who is desatting. It's obvious I know, but you'd be surprised how much the need to accomplish a task you started can throw you off of where you really need to be.


    I found this PDF, good summary of expectations of a PCU. http://www.aacn.org/WD/Practice/Docs...eFactSheet.pdf

    Your awesome! Thank you again
    FlorenceNtheMachine likes this.
  12. Visit  srandall1492 profile page
    0
    Hello nurses! I have enjoyed reading all about your successes in the ICU field. Congratulations to you all! It is apparent you all were exactly what the ICU was looking for, and I'm hoping to be in the same position as you very soon. I am very appreciative of all of the links you all have provided, I was just wondering if any of you could provide a sample resume for ICU??? I am insecure with my resume at this point, and I don't want it to be what holds me back. Thank you so much in advance. Keep up the good work nurses!
  13. Visit  ktliz profile page
    4
    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.
    etymed, LVegasRN, srandall1492, and 1 other like this.

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