Experienced nurse - new to MSICU

[NurseyB]

I have 3 years of progressive care experience, with the last year and a half on a very high acuity cardiac step down unit at a large teaching hospital in a fairly large metro area. I will be transferring to the MSICU in a few weeks, and I'm wondering what I can do to prepare. I am PCCN-CMC certified, so I have a (very) basic working knowledge of vents, iabp, swans, etc., and a pretty darn good understanding of the heart and its impact on other systems. I am planning on making an orientation binder for my reference with pharmacology, equipment, and protocols (If you can't tel yet, I am a little compulsive). I feel as though I am at a good starting place, but it's going to be hard to go from being preceptor to being preceptee.

So,

Any things you wish you would have known as a newbie?

Anyone have any insight on what it's like to go from being a resource person to being a deer in headlights?

[VANurse2010]

The best thing you can do when orienting to an ICU is keep your head down and make them think they know everything and you're totally their sponge. It can be very demeaning but it's the best way to make sure you don't become the bait in a shark tank.

[Larry3373]

I'm in a similar situation right now. I've started working in a 24 bed SICU that takes fresh hearts. My experience was in a smaller hospital in the ICU that doesn't take hearts (1 year), and two years of telemetry and med surg prior to that. I also worked PRN in PCU for a while so I am familiar with hearts and cath lab patients. My advice is to ask questions and to show humility. That is what has worked for me. I try to avoid saying "this is how we do it at my other job" because I know I wouldn't want to hear that if I was precepting someone.

As far as resources, check out the following youtube.com: medcramvideos, Eric's medical lectures, hemodynamicmonitor1, Dr Gallagher's neighborhood. IUcritical care, and gotresuscitation. I have found numerous helpful videos on those channels including ventilator management, pressors, shock, ACLS, DKA, hemodynamics, etc. A book that came highly recommended to me is A Manual of Perioperative in Adult Cardiac Surgery by Robert M Bojar. So far it has been very helpful in understanding the management of heart surgery patients.