New grad RN into ICU

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    Hey everyone! So, I am looking for some advice...I just graduated in December and took my NCLEX three days ago and passed . I was then given a "highly possible" offer to go straight into ICU. I precepted as Nursing supervisor, ER nurse and ICU nurse (she was quite the amazing RN). My preceptor asked me if I'd be interested in this job and of course, I said yes. While I am completely ecstatic at this opportunity, I am insanely nervous! My preceptor will be the one who is orienting me so I am well aware that I would be in good hands in the beginning but I would love to hear from others who have went straight into ICU from school. Give me the good and the bad....NO SUGARCOATING Any advice, tips, things to read/study, etc would be greatly appreciated as well!
  2. 10 Comments so far...

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    I Think that's amazing! I really wish this will happen to me too! I doubt it will though ;(. This is a great opportunity I think you should go for it! Don't worry too much, they will train you. Its been done before youre not the first new grad to enter ICU, its doable you will be fine.
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    I went straight into ICU after graduating. The facility I work for put us through 2 weeks of advanced/intense critical care classes and orientation on the unit is 16weeks, more if needed. We started with one patient and moved up to two. We had a huge packet of procedures and such that had to be checked off by the end. All the nurses were very helpful and willing yo help out. I have Kathy Whites fast facts learning binder I take with me to work every shift. I also use critical care drugs book can't remember the exact name and on my ipad I have icufaqs which is awesome. You'll be fine. No question is stupid just ask always ask! They expect you to be nervous and not know everything. It's the non nervous completely comfortable new grads that are scary. Lol
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    I was one of the fortunate new grads that got into ICU straight out of nursing school. It was there that I learned I definitely did not learn everything in nursing school. I was in the new grad program for 6 months with a preceptor at my side. I was then on my own , but you are never on your own. There are always coworkers to ask questions if you need to. Do not be afraid to ask questions it's the questions you don't ask that might hurt a patient. I still ask questions when I do not remember something or have not done a certain nursing procedure in awhile. My new grad experience in the Icu was the best hands on education for my nursing career. I still work in the Icu and continue to love what I do. Good luck to you! I wanted to quit several times in the first year,but i stayed
    and it got better.
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    As an ICU preceptor, let me just mention that you will be expected to study on your own time. A lot of new nurses are unprepared for that expectation, or unwilling, and it shows.

    You will get critical care classes and hands on time with your preceptor on the unit. Be sure to ask questions when you're uncertain of something. One of the first questions you should ask would be "How do I find the procedure for doing this?" Once you know how to look up procedures at your new job, you'll always have a handy reference when you're faced with a new skill. Also find out where to locate the policies. Unfortunately, some of your preceptors won't be up to date on the latest changes, and you'll save yourself some grief if you know where to look. When your patient travels to CT, who travels with him. A nurse? Nurse and RT? Nurse and provider? Can a patient on a dopamine drip transfer to the stepdown? Your charge nurse will know the answer to that, but when the charge nurse asks at 0800 what's preventing your patient from transferring out, it would be nice to be able to say "that dopamine drip."

    Good luck. The first year of nursing is miserable, and I'm confident that yours will be miserable at times as well. But with perserverence and a good attitude, you'll get through it and you'll have learned an awful lot in the process!
    HGTVrn33 and ICULINDA like this.
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    I'm coming up on 8 months in the CVICU. Fresh of my ADN program. I precepts on the same unit before graduating and had an amazing experience there. I got offered a job and I have learned so much!!! I have been taking fresh CABG from day one, with an awesome preceptor, and independently for the past 2 months or so. I must say that I have been fortunate. We have a small work family and we all work well together. No bickering among us, no constant complaining, and a sincere willingness to continue to learn/teach. I look forward to work most days actually.


    Some things that have helped and are helping are EBP articles surprisingly. We look them up frequently on the unit if we have a chance to. The 2 people who oriented me to the unit when I was hired are critical thinking junkies! They will ask you to look at ECG strip X and compare it to strip Y and try to identify differences. They pushed me to make me think through the patho or pharmacology of various issues. They help me become an independent thinking nurse, and reinforced the need to have a plan when you call a MD or NP. If you find someone who is willing to help push to make you better, half the battle is won! I agree that studying up on various things while off is helpful to. Being in school for your RN to BSN (and having goals for grad school eventually) helps as well, at least for me.


    I also read "The ICU Book" it's pretty good, but there is another that I really like, but the title slips my mind now, Critical and Emergency Nursing care something...... Anyway I'll post the name of it when I get the book in my hands (it's at the mini unit regency library at work).

    I've had an awesome time thus far in my first year as a RN, I have moments that I learned better ways to do things, and learned not to do other things, but I can honestly say that I wouldn't trade my job with anyone.


    We are called the "Cadillac Unit" bc other units think we never have stressful days, but we most certainly do!!! Lol! We just know how handle most things early and without panicking!


    I think that learning how to be an adaptable and independent thinking nurse , while also remaining a functional team member is key in becoming a well rounded RN. Just my opinion from my experiences thus far.


    I wish you the best!



    Sent from my iPhone using allnurses.com
    Last edit by PatMac10,RN on Jan 27
    nandosport and KariZayBSN like this.
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    thank you all so much! I really appreciate all the comments, suggestions, and advice! I found out last week that I did indeed get the job! I go through all the paperwork this week and then I begin next week! I am lucky enough to have my AMAZING preceptor in school as my trainer in ICU so I know I am in good hands! I am a true nerd at heart so the studying outside of work is actually enjoyable to me (Weird, I know). My biggest fear is that I am going to look like an embarrassment so I pray that everyone else is patient with me. I'm a super quick learner but I'm not sure what they expect from me straight out of school. Thanks for the encouragement! I can definitely tell you are all great nurses
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    Are you in school? If so, I highly recommend making an effort to make it known your desire to be in ICU. My professor knew how much I enjoyed the unit and so she made sure I had an ICU preceptor. I was extremely lucky that my preceptor was so incredibly amazing. I made it a point to meet as many people as I could while I was there, if nothing more than for someone to recognize my name/face when I was applying. I stayed in touch with my preceptor throughout studying for my boards. Once I passed my boards, I immediately received my ACLS certification and NIH stroke scale certification as I knew those were required to be in any critical care unit. I then contacted my preceptor to tell her that I was officially an RN and they were quite impressed when I told them that I had also received my certs. They offered me the job right then and there. Just show them that you want it and are willing to work hard for it! It is clearly possible GOOD LUCK!!!!!!
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    ultraposh...that last message was for you! LOL. Not sure why it didn't address you when I hit reply to your message?!
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    Morning everyone. I too am coming up on graduation and have the desire to work in the ICU. I still have 2 weeks till O start precepting but other than the ACLS are there anyother certifications I should get? Wasnt sure if I could obtain the NIH stroke scale before being hired


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