New grad hired into Trauma ICU in a Level 1 Trauma hospital

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    I just got hired this week at a trauma ICU as an RN in a level 1 trauma center. My training with a preceptor is only 6-8 weeks. Can anyone provide me with any tips? I have already bought AACN Essentials of ICU Nursing, and have started reading the files on icufaq.org.
    Last edit by rnfeb2011 on Jun 17, '11
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    Other than the usual stuff I would start brushing up on in depth neuro assessments especially in the summer time as all the motorcycle accidents are starting to come in with the warmer weather.
    Zookeeper3 likes this.
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    6-8 weeks seems short for a new grad. Does anybody else think this? Are they willing to extend it longer if you need it?

    I know 6-8 weeks is typical if you are floor nursing, but trauma ICU seems like it would take a lot longer to get familiar with everything you would come across. Am I wrong? I oriented for 10 weeks in the ER as a new grad. I have heard of people orienting 3-4 months in a large, busy ICU, and most of that is because of all the classes they want you to take on equipment and such.

    I know it doesn't answer any questions that you have, but I just want you to be safe and comfortable knowing you should ask for more time if you need it. You worked too hard for those letters after your name!
    TomGuy, msn10, Zookeeper3, and 2 others like this.
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    Boy, I would think 3-4 months as well. Level 1 trauma ICU? Sickest of the sick? Mangled of the mangled?

    I just applied for a similar job, no word yet, but I think I could make it in 6 weeks, but I have 12 years ICU experience!
    chelseyrn, Zookeeper3, and A&OxNone like this.
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    Glad somebody else agrees!

    OP, Good luck to you, and please, PLEASE do not go off orientation unless you feel ready. You will never feel 100% comfortable in orientation, but at least wait till you feel safe to take care of those sick people.
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    I too just got a job, but I am in the ER of our only trauma center, level II. I am starting my third semester of nursing in August, so I am just a level 2 patient care tech in the ER. I am so excited to not only start working and learning, but my dream job is RN with my BSN in ICU/critical care, but when the recruiter called me and started asking questions....I don't want the same thing every day, want to be challenged every day, and really get bored with the same-ole, same-ole, so she said I sounded like the adrenalin junkies in the ER, that it was very competitive, but RN manager wanted to talk to me. I got the job and have my orientation soon. I wanted critical care and trauma, but I thought I'd end up in ICU, as this hospital is very hard to get into and we have the helicopter transport, so it's the best place for me, in my opinion, cause it's where we get the stabbings and gunshot wounds, and so on! I would love any advice of anyone working in trauma and/or ICU; they seem to be close because they are both critical care, but the assessments and prioritizing seem more fast paced than ICU, but I have no experience at all yet, just what patients I ended up with in clinical that did go south and I loved doing VS q. 15, O2, etc., seemed way more exciting than passing meds all day--no offense to anyone, just have never pictured myself as a floor nurse, never.

    As an elective for my BSN I am going to do the emergency/critical care certificate, but I had planned (before applying for this job) on getting my CCRN eventually. It looks like I do not need clinical hours for the EMC or CC advanced technical certificate, and I believe you need tons of hours for the CCRN, but what is the major difference between the credential; CCRN showing you have way more experience? Is it considered another certificate or is it a separate license? I have not researched ER opportunities or credentials until today, and I just want every credential/class so I can learn this and be the best of the best. I know these are going to sound like silly questions to most, but I want to know what the difference is between the above credentials and any advice on the ER/trauma/critical care assessments, prioritizing, that kind of thing. I won't get to do too much as a PCT, but I should get enough experience and extra skills the hospitals teach to have my ACLS by the time I graduate, so I am so happy that I have been blessed with this opportunity, and human resources told me congratulations, that it really is unheard of to get in like this and that I could even get into ER as an RN on graduation, which is rare, she said, however possible. I believe I can do this and just can't express in words how darn happy I am LOL.

    Advice on critical care/what to watch for (other than airway, O2 sat, obvious signs)....and please let me know what the difference is between the 2 credentials; it looks like one is more classes and then CCRN is the exam and license or cert?

    I know I just ramble when I get going, but I could not have asked for a better offer! I don't mean to hijack the thread either, would love the same answers OP is looking for.

    Thanks for any input!
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    I work in a level one trauma ICU and I love it.
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    WOW! 6-8 weeks seems very short! I started in a Level II Trauma ICU (that serves a pretty huge catchment area) about 6 months ago and had a 13 week orientation period. This is one of the reasons I chose it, it seemed like a pretty generous training period compared to current standards! I have been working as an EMT in various positions for 6 years, but know others that were hired w/ no experience at all.... I agree w/ other posters here, if you don't feel ready after orientation, LET SOMEONE KNOW! honestly - i still ask SO many questions of more experienced RN's that i probably drive them, and myself, crazy. *BUT* they ALL say that it's a good thing... the scary nurses are the ones that are afraid to ask questions and just go for it - ASK!!! find a preceptor, experienced RN that you click w/, or someone, that you can use as a major reference (and buy them a beer from time to time!) and pick their brain. don't be afraid to ask for a different assignment if you feel like you are in over your head - remember, you are in w/ the most critically ill and things can go south in a second. you *will* make mistakes, and you second guess everything for a while, and that's just part of it... you obviously like a challenge, or you wouldn't be where you are now! be humble, be a sponge, and DON"T be afraid to ask questions!! GOOD LUCK and CONGRATS!!!
    WhiffOfGas and Freedomsong like this.
  11. 2
    In my previous role as clinical educator for the ICU and ED my suggestions would be:
    1. Knowing the pathophysiology of disease processes will save you every time and help you to stay ahead of the power curve when caring for your patient and anticipating what could go wrong.
    2. Know what the policies and procedures for the unit are, your not going to be able to memorize them but at least you know they exist and where to find them.
    3. I discourage asking other staff members policy or procedural stuff until you have first reviewed the information, then you can refer to that information during your discussion and take responsibility for the professional decision you make. I found that most staff members did not or were not keeping up to date with policy changes and they honestly thought they were giving accurate information to others, remember that game "telephone".
    Because when the "poop" hits the fan and it will you will be judged by "what does the policy say". I find this is where very little time is spent during the orientation process because it is viewed as boring, wrong...
    4. Give yourself time to get experience under your belt, because that is where the problem lies for the new grad no experience to draw from when making decisions.
    5. Ask questions don't wing it..
    Hopefully, this will not overwhelm you but these are tried and true methods that work. Remember the studying has just begun for your new assignment.
    You to can be a success story......
    tofu-tofu and diosadelsol like this.
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    Dang, 6-8 weeks?? I will start my new grad orientation in 2 weeks, and it will be 16 weeks minimum. I have also been working as a level 3 Nurse Extern in my trauma surgical unit for 6 months now. I could not imagine only having 6-8 weeks of orientation.


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