New Grad working in a level one Trauma Center...Few questions
- 2Apr 7, '13 by francomlI just got accepted into an internship in Trauma/Surgical ICU!!! It is at a level one trauma center in Texas. I am excited but nervous to start because this is a regional trauma center, 200+ new graduates applied for this position and I was one of the lucky 20 who where hired. I know there are a million and a half things I need to learn but from an experienced ICU nurse, what are 3 or 4 things I should know going into this position? What are your opinions of new grads working trauma??
Oh and as a side note, to all the students out there... Don't let anyone tell you that your cannot do something! Everyone told me there is no way you will get to work T/SICU as a new grad! Dream big and fallow your heart!!!
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- 2Apr 7, '13 by Sun0408Know that you can be let go during orientation.. Sad but true Go in with your ears and eyes open, ready to learn. Know that trauma's are not an "expected" event and the pt and family are devastated by it. Know pain is a major issue; advocate for pain meds and pre medicate before procedures like massive or deep dressing changes, baths etc..know your neuro assessments, know spinal precautions, know emergency meds used to increase BP,HR etc. I still keep a small card as a cheat sheet for my "go to" meds. Brush up on your BLS. Get a head start in ACLS. You can purchase a TNCC book to give you a better understanding of what trauma is and how it is "worked up". You can get a used one and certify later if you like it.. Shock is a huge part of trauma's, fluids and pressors are used a lot...
Trauma is a very team oriented unit, when a new trauma comes in chances are there will be lots of hands on deck to help. When you pt is heading south, lots of hands will be there to help.. I love trauma and I love my team You are never alone.
Plan on doing a lot of reading and researching outside of work. I still do it after 2 years in trauma but don't let it take over. Take time to enjoy your time off as well.. Never be scared to ask a question; RT, your charge nurse,other nurses, the trauma doc,surgeon other MD's etc are a great resource.
Congrats to you and happy learning !!!
- 0Apr 7, '13 by francomlThank you for the advice!!! I will definitely be getting that TNCC book. I have a 13 week internship that will be a mix of 1:1 patient care with a preceptor and critical care classes 1-2 x's a week. I know 13 weeks is not enough to learn everything but I hope it is enough to give me a base to work from. Also I LOVE the team atmosphere of trauma and I plan to ask about 10,000 questions. One more question, How long did it take you to feel comfortable on your own??
- 0Apr 8, '13 by Sun0408I can't really answer that question because each surgical case, trauma or critical care pt is different You will see and care for all types. Exposure is key..Timing will depend on how fast you pick up on the CC stuff ie: drips and vents, as well as the new grad learning of time management, prioritization etc.. I was not a new nurse when I went into trauma so that did help but I still had the other stuff to learn and still learning... I am comfortable now with most cases but I still have back up when needed..
- 3Apr 8, '13 by HouTx GuideI went right into trauma ICU as a new grad. It felt as though I was 'home', and I actually never left; have worked in a lot of different ICU settings, but trauma is my fave - especially neuro.
Most important - drop your defenses & receive all critical feedback as it is intended - to help you develop your own skills and expertise. Be open to criticism & modify your behavior accordingly. Take up the slack by moving in to assist others when you're caught up. Be respectful. NEVER say anything negative about any of your co-workers. Sure, Suzy may be putting Joe down, but if you join in she's may be the first one to relay your comments to Joe.
Sure, you're concerned about the technical skills, but adapting and fitting in to the department culture is much more challenging - and far more important to your ultimate happiness & career success.