New Grad Headed to the ICU!

ThatBigGuy · May 29, 2015

The best advice I can give you is to study on your days off. Learn about hemodynamics (cardiac output, ejection fraction, stroke volume, Frank-Starling's Law), vasoactive drugs (Levophed, vasopressin, neosynephrine), arrhythmias, sedation (fentanyl and versed, propofol), and get familiar with ABG's. You can find fantastic videos about all this on youtube, via nursing schools and also medical schools.

Your facility will have policies on drug titration, so memorize these per your facility. Figure out who is the best reader of rhythm strips (this may even be an EKG tech, or a particularly friendly MD) and pick their brain every now and then. I'd also take notes on a notepad of things you learned each day, then go home and type them up, print it out, and put it on a three ring binder. Keep this binder in your bag, and you'll eventually have a nice fat binder of information that you can refer to when your brain needs a refresher.

You can challenge the CCRN after about a year of full time work, so go ahead and grab a CCRN study book after about 6 months of working. You'll find that much of it is over your head now, but you'll start getting "ah-HA" moments every time you crack the book. I also kept my Med-Surg and Pharmacology textbooks from nursing school, and will open those from time to time to refresh my memory on different things. There are tons of other books you can purchase, such as "Rapid Interpretation of EKG's" by Dale Dubin, MD. Don't be afraid to spend $100 a month on books and other learning materials.

Most facilities also offer some sort of continuing education classes, so sign up for as many of these as you can. You should be getting some good printed materials that you can add to your binder as well.

I was hired to ICU as a new grad. This is how I've managed to keep my head above water for the first few months until I've reach a point where I feel I'm minimally competent on the floor. I continue to try read or watch youtube videos every day I'm off. It doesn't have to be hours everyday, just a ten minute video about a particular disease process I ran across on a previous shift is enough to keep my mind working.

scheeh73 · May 30, 2015

Thank you so much for your tips! I will put them into practice when I start working!

Here.I.Stand, BSN, RN · May 31, 2015

Drat. .. I was nearing the end of a long post, and my WiFi disconnected itself. .. and my post went the way of the tan M&M.

I'll try to redo it in the next few days.

Congratulations on your graduation and new position!

scheeh73 · Jun 1, 2015

Oh no! That is so frustrating, but thank you! I appreciate any advice

Mavrick, BSN, RN · Jun 2, 2015

Drat. .. I was nearing the end of a long post, and my WiFi disconnected itself. .. and my post went the way of the tan M&M.
I'll try to redo it in the next few days.
Congratulations on your graduation and new position!

Don't you just be teasing us now.

Hmmmmm all of a sudden I'm jonesing for some M&Ms.

SICU_RN09 · Jun 2, 2015

There are tons of other books you can purchase, such as "Rapid Interpretation of EKG's" by Dale Dubin, MD.

:up: Definitely recommend this book. I had to take a skills test in reading EKGs in order to qualify for an interview in the ICU and reading this book beforehand was immensely helpful. I too just graduated in May with my BSN and just started in the SICU. Best of luck!

Pheebz777, BSN, RN · Jun 4, 2015

Over the years, I've seen new grads come and go. In my honest opinion, it's 50/50 split with how I see new nurses.Some do exceptionally well and some get too overwhelmed or patient outcomes have suffered due to their inexperience in anticipating patient critical needs. I have always been a firm believer that new nurses should get at least 1yr med/telemetry experience and learn all the basic skills before tackling on critical care skills.

Annath · Jun 10, 2015

Over the years, I've seen new grads come and go. In my honest opinion, it's 50/50 split with how I see new nurses.Some do exceptionally well and some get too overwhelmed or patient outcomes have suffered due to their inexperience in anticipating patient critical needs. I have always been a firm believer that new nurses should get at least 1yr med/telemetry experience and learn all the basic skills before tackling on critical care skills.

This is part of the reason why I applied for jobs on stepdown/progressive care units instead of trying to jump straight into the ICU (where I want to end up). It definitely seems like the best way to get acclimated to the critical care mindset, without having the same pressure as you'd find in an ICU.

That said, one of the facilities I applied at offered a dedicated New Grad Residency. 12 months long, divided between working the floor and training dedicated to transitioning from Nursing School to working as a Nurse. The facility accepted new grads onto its ICUs, and the training you'd receive was tailored to the position you accepted. This was the only place I applied for an ICU position, because of the extra support I'd have as a new grad.

In the end however, I got a fantastic offer in a different facility, on a Progressive Care Unit, so that is what I chose. The residency would have been great, but that facility is very slow with moving through applications, and I got an offer elsewhere before they even interviewed me.

thevez · Jun 11, 2015

I'm so excited for you. í ½í¸„